How Is Skin Cancer Treated? Advice from a Radiation Oncologist

When it comes to skin cancer, early detection is only half the battle. The next step is understanding your treatment options. In this article, Dr. Issra Rashed, Radiation Oncologist with the Riverside Cancer Institute, discusses how skin cancer is addressed and what patients can expect in terms of outcomes. But first, it’s important to understand some facts surrounding skin cancer and its development.

Skin Cancer Types and Risk Factors

Skin cancer comes in many forms, but the most common types are basal cell carcinoma and squamous cell carcinoma—both primarily caused by sun exposure. Other, less common types include melanoma and skin lymphomas, which may not be sun-related.

Several factors can increase the risk of developing skin cancer. Genetics play a role, with familial history being a known risk factor. Environmental exposures, particularly to the sun, are the most common cause, but occupational hazards, toxins, immunosuppressive conditions, and certain medications can also contribute. Even repeated trauma to the skin may elevate risk over time.

With skin cancer, early detection is critical. Smaller tumors offer more treatment options—including surgery, radiation, topical therapies, or other non-invasive methods. As cancers advance, treatment becomes more limited and complex.

Fortunately, high-risk individuals—such as those with a history of sun exposure, autoimmune disorders, or immune-modulating drugs—often see dermatologists regularly and may catch precancerous lesions before they become malignant. Like many cancers, skin cancer prognosis is tied to staging, with earlier stages (like stage one) offering the highest chance of a cure.

Skin Cancer Treatment Options

Skin cancer is extremely prevalent, with an estimated one in five Americans likely to develop it in their lifetime. Fortunately, most cases are highly treatable, especially when caught early.

Treatment options for skin cancer depend on the type, size, and location of the tumor and may include surgery, radiation, drug therapy, or even phototherapy. For early-stage cancers, dermatologists can often perform a quick, minimally invasive procedure—especially in less cosmetically sensitive areas like the back, arms, or scalp. Ultimately, treatment decisions aim to balance cancer control with side effects, patient convenience, and long-term outcomes.

“I get involved when patients can't have surgery for one reason or another. Perhaps the tumor is in a location where surgery is unacceptable because it might need more complicated tactics to ensure the incision closes properly. It might be disfiguring, and cosmetically, the outcome is just not acceptable. Or, patients just don't want surgery. They say, ‘I've had enough procedures done, and I'd like to look at non-surgical options.’ That's when radiation typically comes into play,” explains Dr. Rashed.

Brachytherapy: A Viable, Effective Treatment Option

Brachytherapy is an effective treatment for early-stage skin cancers that are confined to the outer layer of the skin (the epidermis). While it's often used for small tumors, it can also treat larger ones as long as they haven't penetrated deeper layers. This form of radiation therapy involves placing the radiation source directly on the tumor, allowing precise treatment without affecting surrounding healthy tissue. Essentially, it's a targeted, topical approach to radiation that delivers the necessary dose to the cancer while minimizing deeper exposure.

“It's extremely effective and just as good as any other type of radiation, often just as good as surgery. Toxicity wise, you'll get a sunburn. Not much else,” assures Dr. Rashed. “The nice aspect is it's not disfiguring because there's no cutting. In the long term, however, you might get a bit of discoloration of the skin.”

Multidisciplinary Approach to Treatment Ensures Optimal Outcomes

Skin cancer treatment often involves a collaborative, team-based approach. While radiation can be effective, it’s not always the most practical option—especially for early-stage cancers that could be removed with a simple outpatient procedure. In such cases, a radiation oncologist may refer the patient to a dermatologist for surgery instead of subjecting them to weeks of radiation.

Typically, patients are referred to radiation oncology by dermatologists, medical oncologists, or primary care providers. These specialists frequently consult one another, including with plastic surgeons and ENT doctors when needed, to determine the best, most personalized treatment plan based on the tumor, logistics, and patient preferences.

“Just know there are many doctors here, and each of them has a role to play. So, it’s not just dermatology. It's not just ‘cutting’ if that's not what you want to do. There are many different types of radiation, and there is even drug therapy now,” shares Dr. Rashed. “Together, we’ll find something that works for your lifestyle and still get you a good disease outcome.”

For more information on Riverside Cancer Institute, go to myrhc.net/cancer or call (815) 933-9660.