Can SkinCure Oncology’s image-guided superficial radiotherapy lead to fewer painful surgeries?

Image-guided superficial radiotherapy (IG-SRT) is an alternative to Mohs surgery and SRT without image guidance. SkinCure Oncology says its IG-SRT hardware uses low levels of X-ray energy to kill nonmelanoma skin-cancer cells for nonmelanoma skin cancer treatment.

With IG-SRT, physicians and trained therapists use ultrasound imaging to view the tumor in the SRT procedure.

Practitioners use the images to navigate the procedure and show patients the state of the tumor before and after treatment.

“Without image guidance, the physician and radiation therapist must rely on intuition and experience. They look at the visible tumor on the outside of the skin, and they think about their experience treating similar-looking tumors,” says Steven Scott, chief operations and radiation safety officer at SkinCure Oncology.

Apart from the image guidance technology, says Scott, the practitioners guess at what’s going on under the skin. “Then they give themselves a little extra margin and apply the radiation dose. They’ll likely treat some excess healthy tissue to have a better chance at getting all the cancer cells, but they won’t know for certain because they can’t see what’s going on under the skin,” Scott explains.

Image-guided SRT in a skin-cancer medical practice

Jon R. Ward, M.D., is a board-certified Mohs surgeon and dermatologist practicing at Dermatology Specialists in Panama City, Florida. According to Ward, the practice provides cosmetic and medical services for patients with chronic sun damage and skin cancers. Ward uses the SkinCure Oncology IG-SRT in his practice.

“Before adopting image-guided SRT, we really didn’t have any good alternatives to Mohs surgery,” says Ward. When Ward found IG-SRT, he was searching for a treatment that didn’t expose patients to Mohs fatigue, which happens when patients become exhausted due to the repeated cutting throughout the surgeries, he says.

With IG-SRT, patients escape Mohs fatigue, Ward says. Many first-time skin cancer patients choose it for cosmetic or functional reasons, due to poor health conditions that complicate surgery, or to avoid undergoing surgery, he says.

Before IG-SRT, the practice scheduled many skin cancer patients three or more weeks out, Ward says. With many of those patients now electing the non-surgical IG- SRT procedure, the wait times for Mohs surgery have dropped to about a week, he says. “For image-guided SRT, we can typically schedule treatment to start within a day or two,” Ward says.

When there is a skin-cancer diagnosis, Ward and his colleagues sit with the patient to discuss treatment options. Patients choosing IG-SRT meet with the radiation therapist, who performs a simulation of the procedure to tailor the treatment plan to the patient’s specific situation, Ward says. Patients come in a few times a week for IG-SRT treatment for several weeks, with a follow-up appointment a month or two after treatment completion, he says. “The actual treatment literally takes only a minute or so, and each office visit runs about 10 to 15 minutes,” Ward says.

Ward’s patients benefit from short wait times and avoid the cutting, bleeding, pain, stitches and surgical scars that come with Mohs surgery, and the reconstructive surgery that may follow it, Ward says. “Image guidance allows us to see the tumor and adapt the treatment based on tumor response. That’s how we achieve a cure rate comparable to Mohs surgery,” Ward says.

Image guidance also lets patients see their progress from treatment to treatment, Ward says. “Our patients have confidence that the procedure is working because they have visual proof, which brings a sense of relief,” Ward says.

Ward finds IG-SRT relieving, too. “Every Mohs surgeon has moments when they wish they didn’t have to cut,” Ward says. Sometimes, eradicating cancer creates cosmetic defects that are difficult, if not impossible, to correct, he says. “When we’re worried about the potential cosmetic impact on a given patient, it’s a blessing to have image-guided SRT as an option. I sleep better at night knowing my patients and I have options,” Ward says.

Ward’s favorite feature with the IG-SRT is that its image guidance is built directly into the SRT machine, Ward says. “There’s nothing better than turning the screen to face the patient to show them the before and after ultrasound images, and say to them, see, no more visible signs of cancer,” Ward says. •