Skin Care Patients (and an alternative to surgery) eight fractions up to 12 fractions for the various protocols. The protocol that will deliver the best results for the specific lesion due to size, location, and histology, is prescribed by a Radiation Oncologist. “The treatments are typically painfree and well-tolerated with fast recovery times relative to protracted external beam radiotherapy (EBRT) during which schedules are frequently 20 to 30 daily fractions to 50 to 60Gy”.4 Licensed Radiation Physicists calculate and calibrate the precise prescription of radiation dose prescribed by the Radiation Oncologist. Licensed Radiation Therapists are the medical professionals that will interact, treat, and care for the patients in the dermatology clinic while they undergo the treatment protocol. A post-biopsy patient with a pathology report confirming the evidence of cancer can schedule a consultation and simulation to begin. From there, the medical team will develop a treatment plan to begin electronic brachytherapy radiation treatment. The patient can begin treatments within a week of consultation, in most cases, once insurance benefits have been processed. The treatments are delivered at least 36 hours apart for two treatments per week over a four-to-five-week period for most patients. In comparison to MOHS surgery, the most common toxicity between the two modalities is hypopigmentation.5 Radiation can cause mild side effects such as erythema, dry and moist desquamation (skin peeling), hypo and hyperpigmentation, and telangiectasia (dilated small blood vessels on the skin). The most common side effect is very comparable to phases of sunburn, ranging from mild to severe. Despite the skin The magazine for women affected by cancer
changes the patient undergoes during electronic brachytherapy, “physicians rated cosmesis of the treatment sites as “excellent” or “good” in 98% of EBT-treated lesions”. Radiation related side 3 effects are confined to the targeted area and do not extend to other anatomy of the body.
What is Consultation and Simulation?
The consultation consists of extensive information about this modality shared with the patient. Question and answer session between the patient and the therapist comprises most of the time during this appointment. The essential goal is to assist the patient in making an informed decision on the treatment option that best suits them personally. Every patient is unique, as is their cancer journey. If the patient decides to continue with electronic brachytherapy to treat their cancer lesion, the next step is simulation. The simulation consists of deciding which standard surface applicator is adequate, flexi-shield cutout size and placement, if applicable, and prescribed fractionation. This is a process of measuring the skin cancer lesion and including a 5mm (about 0.2 in) margin to encompass any residual disease that is not visible to the naked eye. Photographs are taken and uploaded to the patient’s medical chart to document the precise location and setup for treatment. The information gathered is accessible by the Radiation Oncologist and physics team to create a radiation treatment plan.
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