No to Radiation Therapy

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Radiation Therapy for Keloids

Radiation therapy is a method of treating cancers. Radiation therapy uses high-energy particles or waves, such as x-rays, gamma rays, electron beams, or protons, to destroy or damage cancer cells. Same radiation is used for treatment of keloids often after the keloid is removed surgically.

Radiation therapy remains a rather controversial issue in treatment of keloid with the most important concern being the development of cancer and other serious medical complications following this method of treatment.

Using radiation therapy for treatment of benign skin conditions has long been abandoned due to excess rate of developing cancers in patients. Although effective, radiation therapy usage for treatment of facial acne and fungal infections of scalp was abandoned several decades ago, mostly due to excess number of cancers and leukemia seen in these patients.

Radiation therapy can cause cancer: Women will have a much higher risk of breast cancer if they receive radiation in their chest. Keep in mind that there is major opposition to performing routine mammograms in women, of the fear of mammogram causing breast cancer. The dose of radiation used in mammography is about 0.3 cGy. After 20 annual mammograms, a woman will receive only 6 cGy of radiation. The does used in treating keloids varies form 1,000-1,800 cGy. Despite the knowledge about the carcinogenic risk of radiation, some radiation therapy centers still provide this treatment to young keloid patients. We also know that exposure to radiation in Hiroshima and Chernobyl resulted in excess risk of various cancers and leukemia.

In my opinion, Radiation Therapy should not be used for treatment of keloids. Several decades ago, radiation therapy at even lower doses was used for treatment of acne and fungal infections of the scalp. Although very effective, these practices were banned because of documented increased risk of cancer among the treated patients. Perhaps economy plays a role in utilization of radiation therapy for keloid patients. Cost of delivery of radiation therapy to a keloid is in range of $10,000.

The patient shown in the image below had surgery followed by radiation therapy to her neck keloid. The treatment not only did not help her, but instead resulted in development of a much worse keloid. Radiation therapy also can cause permanent damage to tissues nearby, in this case to her thyroid gland and made her hypothyroid. She will have to take thyroid supplement medications for the rest of her life.

Neck Keloid

Hypothyroidsm after radiation therapy for treatment of keloids

Patient depicted below also had surgery followed by radiation therapy to the keloid in his neck area. The treatment not only did not help him, but resulted in recurrence of a worse keloid that has now limited his ability to move his neck. Radiation therapy also caused a permanent damage and fibrosis of his neck tissue and serious abscesses under the keloid tissue and cause constant infections and drain pus at all times. Such complications can be totally avoided if radiation is not used in treating keloids. This patient, at age of 23, is also at risk of other long term complications from the radiation.