KEY POINTS:
- Focused radiation may help selected skin cancer cases without surgery.
- A proper medical evaluation is needed before any treatment decision.
- The treatment is mainly discussed for basal cell and squamous cell skin cancers.
- The lesion’s type, size, depth, location, and risk level guide the plan.
- The process may include record review, examination, planning, safety checks, treatment, and aftercare.
- The radiation source does not stay in or on the body after treatment.
- Other options, such as surgery or external radiation, may be better for some cases.
- Follow-up care is important to monitor healing, side effects, and future skin changes.
HDR Brachytherapy Skin Cancer Treatment is a focused radiation option. It may help treat some basal cell and squamous cell skin cancers. It does not cut out the skin spot. A doctor must review your case first. This treatment is not right for every skin cancer.
At El Portal Comprehensive Cancer Centers, patients in Merced, Madera, and the Central Valley get support from the first visit to follow-up care. If you have a sore that will not heal, a rough patch that keeps coming back, or a spot that bleeds or changes, you do not have to figure it out alone. EPCC reviews the concern. The team checks test results when needed. Then it explains whether HDR brachytherapy or another treatment may fit your case.
What HDR Brachytherapy Means in Plain Terms
HDR means high-dose-rate. Brachytherapy means radiation is placed very close to the area that needs care. For skin cancer, a special applicator is placed on or near the skin. The radiation is given for a short time. Then the source goes back into the machine.
This form of targeted radiation therapy for skin cancer treats one planned area. The goal is to treat the cancer while limiting radiation to nearby healthy skin. The radiation source does not stay in or on your body. You are not radioactive after the session.
HDR brachytherapy is planned by a doctor. It may treat some non-melanoma skin cancers without a cut. First, the care team reviews the skin spot, test results, location, and treatment goals.
Why BCC and SCC Are the Main Focus
HDR brachytherapy is mainly discussed for basal cell carcinoma and squamous cell carcinoma. These are common non-melanoma skin cancers. They often appear on skin that gets a lot of sun, such as the face, ears, scalp, neck, arms, and hands.
| Type | What the Care Team Reviews |
|---|---|
| Basal cell carcinoma | Often slow-growing, but it can damage nearby tissue if not treated. |
| Squamous cell carcinoma | Needs careful review. Size, depth, location, and risk level can affect the plan. |
| Melanoma | Serious and usually treated in a different way. It is not the main focus here. |
Brachytherapy for Basal Cell Carcinoma may be discussed when the skin spot, test results, location, and health needs support focused radiation support. Brachytherapy for Squamous Cell Carcinoma needs careful doctor review. Some SCC cases may have higher risks. These risks may depend on depth, immune health, recurrence, or other factors.
How El Portal Decides Whether It Fits
HDR brachytherapy is never an automatic choice. The physician reviews the full clinical picture before recommending any treatment. Your role is to come in with the concern or diagnosis. The care team reviews the details and guides the medical decision.
The physician may review:
- The confirmed cancer type and test findings.
- The skin spot’s size, depth, shape, and location.
- Whether the spot is new, ongoing, or has returned.
- Past surgery, radiation, or treatment in the same area.
- How close it is to sensitive areas, such as the nose, ear, eyelid, or scalp.
- Your healing ability and general health.
- Appearance, comfort, and follow-up needs
When the case is suitable, the team may create an advanced brachytherapy treatment for skin cancer plan. The plan is based on the skin spot and nearby tissue. When the case is not suitable, the team explains why another option may be safer.
What Happens During the Treatment Process?
The schedule depends on the diagnosis and the doctor-approved plan. Some patients may need several sessions over days or weeks. EPCC explains the schedule before treatment starts. This helps patients and caregivers know what to expect.
A typical pathway may include:
- Evaluation and record review: The team reviews the skin concern, biopsy results, outside records, or pathology when available.
- Clinical examination: The skin spot is checked and measured to see if more review is needed.
- Treatment planning: The care team maps the area, chooses the applicator, and calculates the dose.
- Applicator placement: A special applicator is placed over or near the treatment site.
- Safety checks: The team checks the treatment area, setup, and machine settings.
- Radiation delivery: The planned dose is given while staff monitors the process.
- Aftercare guidance: The applicator is removed, and skin-care instructions are reviewed.
The treatment does not involve cutting. Patients do not feel radiation. Some may feel light pressure from the applicator. After the session, the radiation source is no longer present.
How It Compares With Other Options
No single treatment is right for every basal cell or squamous cell skin cancer. Surgery is still an important option. Some patients may need Mohs surgery, standard excision, external beam radiation, medicine, or another treatment.
| Option | How it works | When it may be discussed |
|---|---|---|
| Surgical excision | Removes the cancer with a margin of nearby tissue. | Many localized skin cancers. |
| Mohs surgery | Removes tissue in stages while checking margins. | Certain facial, recurrent, or high-risk cancers. |
| HDR brachytherapy | Places temporary radiation close to the lesion. | Selected cases suitable for focused radiation. |
| External beam radiation | Sends radiation from outside the body. | Cases needing a different treatment depth or area. |
| Other therapies | May include topical treatment, cryotherapy, or medication. | Specific cases based on diagnosis and risk. |
The care team explains why one option may fit better than another. Some patients benefit from surgery because tissue can be removed and checked. Others may be considered for focused radiation. This may be due to health needs, healing concerns, skin spot location, past treatment, or appearance needs.
Why Physician-Led Care Matters
Skin cancer treatment is not only about what appears on the surface. The care team must understand the test results. They also review the tissue under the visible spot, nearby structures, past treatment, and your overall health.
Dr. Alireza Mahmoudieh has been part of El Portal Comprehensive Cancer Centers since 2008. He previously directed the Prostate Brachytherapy Program at Kaiser Permanente in Sacramento and Roseville. That experience supports the center’s careful approach to diagnosis review, treatment planning, and follow-up.
This matters because HDR brachytherapy needs careful planning. The applicator, dose, treatment area, and follow-up plan must fit your case.
What Skin Reactions May Involve
Skin reactions can happen during treatment or after the final session. The treated area may become pink, red, dry, tender, itchy, darker, crusted, or mildly swollen. Healing is different for each patient. The care team gives instructions based on your skin and treatment area.
General aftercare may include:
- Keep the area clean as directed.
- Avoid scratching, rubbing, or picking at crusted skin.
- Use only approved creams or dressings.
- Protect the area from direct sunlight.
- Avoid home remedies unless the care team approves them.
- Attend all follow-up visits.
Patients should contact EPCC if they notice more pain, heavy bleeding, drainage, fever, worse swelling, severe blistering, an open wound, or any reaction that feels concerning.
When to Contact El Portal
Reach out if you have a sore that will not heal. You should also reach out if you have a rough patch that keeps coming back. A spot that bleeds or crusts should also be checked. If you have biopsy results and want help understanding them, the center can help with evaluation, diagnosis review, and treatment guidance.
You do not need to know whether the spot is cancer. You also do not need to decide whether brachytherapy is right for you. EPCC evaluates the concern, explains the diagnosis, and guides the next step.
Start With a Clear Evaluation
HDR brachytherapy may be a focused, non-surgical option for some basal cell and squamous cell skin cancers. Still, the decision must come after a doctor’s review. Some patients may need surgery, Mohs surgery, external radiation, or another treatment plan instead.
For patients in Merced, Madera, and California’s Central Valley, El Portal Comprehensive Cancer Centers brings evaluation, diagnosis review, treatment planning, and follow-up into one guided process. The goal is simple: help patients understand what is happening, what options may fit, and what comes next.