This Monday (25), after , is a complementary treatment indicated to reduce the risk of the tumor returning to the site.
According to a medical bulletin released by Hospital Sírio-Libanês in Brasília, this is superficial radiotherapy, with 15 sessions expected over the next three weeks, without the need for time off from activities.
The lesion removed at the end of April was a basal cell carcinoma, the most common and least aggressive type of skin carcinoma, with a low probability of spreading to other organs.
In most cases, surgery is sufficient to excise the tumor. There are situations, however, in which the .
Although the official bulletin does not detail the specific reason for recommending treatment, doctors consulted by the Sheet state that the conduct is not unusual.
One of the classic indications occurs when the pathological examination detects perineural invasion, a situation in which tumor cells are found around small nerves.
“Even with free margins, this finding increases the risk of local return and usually justifies additional radiotherapy”, says Rodrigo Guedes, director of the Brazilian Society of Clinical Oncology (SBOC) and specialist in skin cancer.
Another circumstance is when the surgical margin is very narrow — or positive, when there are still signs of tumor on the edge of the removed tissue. In these cases, radiotherapy works as a booster to eliminate possible remaining cancer cells.
Guedes also points out a third possibility: recurrence in the same location. “When the tumor reappears after previous surgery, it is common to combine radiotherapy to reduce the chance of a new recurrence.”
Radio-oncologist Denise Ferreira, director of the Brazilian Society of Radiotherapy, states that radiotherapy is one of the main treatments for skin tumors, although it is often less remembered because small lesions are usually resolved surgically.
“Radiotherapy treatment is an important curative option. It is often not the first choice because surgery resolves quickly, but there are situations in which radiotherapy is more appropriate, whether for anatomical, aesthetic reasons or the complexity of the resection”, he says.
According to her, in the case of tumors located on the scalp, the decision may occur when, during surgery, it is found that the lesion is more infiltrative than it initially appeared.
“To avoid very extensive surgery, requiring flaps and greater morbidity, one can opt for complementary radiotherapy, which also has an excellent control rate.”
Ferreira highlights that another possible scenario is the presence of pathological signs of greater risk, such as narrow margins, vascular or perineural infiltration.
Radio-oncologist Elton Leite, from the skin tumor team of the radiotherapy service at the Cancer Institute of the State of São Paulo Octavio Frias de Oliveira, states that postoperative radiotherapy is routine in specific cases of basal cell carcinoma.
“Even though it is a tumor with an excellent prognosis, depending on the location and factors found in the pathological examination, radiotherapy works as consolidation. It sterilizes the tumor bed and further reduces the chance of recurrence”, he states.
He cites other examples in which radiotherapy is indicated in this type of skin cancer, such as invasion of the scalp muscles or possible bone involvement. “The chance of cure is already very high, but with radiotherapy we were able to push it even further, closer to 100%.”
Despite the need for complementary treatment, doctors say the prognosis is very favorable. “The chance of a cure is usually very high, greater than 90%,” says Guedes.
The technique used in these cases is generally superficial radiotherapy, with electron beams that concentrate the dose on the skin and shallow tissues, sparing deep structures.
“Today we are able to perform very superficial radiotherapy, without reaching brain tissue or deep regions, which makes the procedure very safe”, explains Leite, from Icesp.
According to Ferreira, the radiotherapy regimen adopted in this case is hypofractionation — slightly larger doses in fewer sessions. “It is a modern, well-established format that reduces total treatment time and facilitates the patient’s routine without compromising effectiveness.”
Therefore, side effects tend to be localized and mild. Among the most common are redness in the irradiated area, skin irritation — known as radiodermatitis — and temporary hair loss in the treated area.
“It is a well-tolerated treatment. The effects are predominantly local and, in general, do not impede normal routine”, says Guedes.
Ferreira states that there may also be a need for extra care with irradiated skin to avoid irritation or local infection. Leite adds that fatigue can occur, but is usually discreet. “If it appears, it is mild, practically imperceptible, with no impact on daily activities.”
Maintaining the presidential agenda is in line with this therapeutic profile, according to doctors.
For Ferreira, the case also helps to broaden the debate about a sport that is still little known to the public. “Radiotherapy for skin tumors has low visibility, but often avoids multiple surgeries and better preserves aesthetics and function. It is important that the population knows that it is also a curative option.”
