New Clinical Trial at Winship Emory Cancer Institute Atlanta University is testing a new type of radiation therapy in patients suffering from recurring cases of a particular type of skin cancer, squamous cell carcinoma, which is the second most common type of skin cancer.
The trial does not include other types of skin cancer, such as melanoma, the deadliest form of skin cancer, but Dr. Zachary Buchwald, a radiation oncologist and cancer immunology researcher at Winship, said the treatment could potentially be used to treat other skin cancers as well.
Credit: Custom
Credit: Custom
This investigational treatment represents a new type of radiation used to treat cancer and a new way of delivering radiation therapy.
Typical radiation therapy requires regular visits to the hospital, where a bulky machine targets specific areas of the body with high-energy X-ray beams. The Emory trial is investigating a new way to deliver radiation by inserting tiny “seeds” the size of a grain of rice under the skin at the exact location of the cancerous tumor. The seeds are like “grains of rice on a string,” Buchwald said, and are injected with a simple needle procedure.
“You basically place the seeds in a lattice network to cover the entire tumor,” he said.
Targeted therapy is also Minimize damage to surrounding healthy tissue.
The treatment is done as an outpatient procedure and is left in place for two weeks, at which point patients return and the device is removed. Buchwald noted that this is convenient for patients, especially those who have to drive long distances to Emory University’s Winship Cancer Institute on Clifton Road in Atlanta, so they don’t have to travel every day for radiation treatments.
The seeds emit a type of high-energy radiation called alpha rays, which kills cancer cells. You may be familiar with prostate cancer treatments that use similar technology, in which radioactive seeds are implanted in the prostate. But the treatment in question uses a different type of radioactive material, Buchwald noted.
This trial We are accepting new patients suffering from recurrence of this type of cancer. There is no cost to participate in the study, and participants do not have to be patients of Emory Healthcare.
While the trials are still in their early stages, Buchwald said he is encouraged and hopeful by the early “impressive results.”
“I had a patient with multiple recurrent squamous cell carcinomas around his nose. Unfortunately, he had to have a total rhinectomy and his nose was basically removed. He had previously had radiation and multiple surgeries and was at a loss in controlling the cancer. We treated him in December as part of a clinical trial and at this time there are no signs of recurrence.”
There are no statistics on how many people develop or die from squamous cell carcinoma. Basal cell carcinoma and squamous cell carcinoma are the most common skin cancers and are not tracked in cancer registries.
Melanoma is the least common but most serious type of skin cancer tracked by health authorities: In 2021, the most recent year for which data is available, the CDC’s National Cancer Statistics reported 90,365 new cases of melanoma in the United States. That means 23 new cases are being reported per 100,000 people.
In Georgia, the rate is slightly higher, with 2,986 new melanoma cases in 2021, which equates to 25 cases per 100,000 people.
Most squamous cell carcinomas are caused by excessive exposure to ultraviolet radiation from sunlight or tanning beds. The UV index is a way to predict how strong UV rays will be outdoors. The higher the UV index, the less time it takes for the sun to damage your skin.
It’s estimated that one in five Americans will develop skin cancer in their lifetime, and according to the Centers for Disease Control and Prevention, Georgia has a higher rate of skin cancer than the national average.
“We have a higher average incidence of skin cancer here than in other parts of the U.S. because we have more days with strong UV rays,” Buchwald said of Georgia, “and people may not be practicing good sun hygiene practices, like wearing sunscreen.”
Limited access to dermatologists, especially in rural areas, may also be a factor, he said, as it could lead people to delay getting screened for skin cancer or not get screened at all.
The signs of skin cancer may not always be obvious.
“You want to be on the lookout for any new bumps that appear on your shoulders, face, back, especially in areas that are exposed to the sun, that last for a while,” Buchwald recommends. “Anything that looks even the slightest bit abnormal, anything that looks like a scab, any little red bump, anything that appears on the skin and lasts for a long time, I would say should be diagnosed by a dermatologist and have a biopsy.”
AJC Database Reporter Stephanie Lamm contributed to this story.
Skin Cancer Detection
Skin cancer can show up on the body in different ways. It may look like:
- A mole changes or looks different from other moles
- Domed growth
- Scaly spots
- Wounds that do not heal, or that heal and then recur
- Brown or black lines appearing under the nails
It can also appear in other forms.
You don’t need to memorize a long list to spot skin cancer on your body. Dermatologists summarize it as follows: If you notice any of the following spots on your skin, you should see a dermatologist:
- Unique
- change point
- itch
- bleeding
To make it easier to check your skin, the AAD has created the Body Mole Map, which provides illustrated instructions on how to examine your skin and what to look for: Body Mole Map.
Source: American Academy of Dermatology.
