Recent research has found that some skin cancers can be cured in just a matter of two hours. Researchers have developed a radioactive 'paste' that can destroy tumours caused by skin cancers without surgery or conventional radiotherapy. The treatment, however, is not suitable for malignant melanoma, the deadliest form of skin cancer. Experts say there are minimal side effects and the treatment does not even leave a scar. The breakthrough therapy, which has been used on 700 patients in Italy with a success rate of up to 95 per cent, could be available abroad within two years. The new technique can treat basal cell carcinoma and squamous cell carcinoma. The vast majority of those who suffer the less dangerous forms have surgery to remove the affected tissue. Other treatments include radiotherapy and 'freezing' of the tumours if they are small and superficial.
But an estimated three per cent of patients have deep tumours that are difficult to remove surgically because they are on sensitive areas such as the eyes, nose or ears. Others cannot have surgery due to age or medical conditions. These patients are given radiotherapy that often results in serious side-effects. For the new technique, Italian researchers harnessed rhenium-188, a radioactive isotope that was previously rare and expensive. But now it is being supplied in quantities large enough to treat thousands of patients a week by nuclear physicists at the British-funded Institut Laue-Langevin in France. The treatment, which is said to be painless, involves putting a piece of surgical foil on the tumour area, painting on the radioactive paste and removing it one or two hours later. Researchers believe that the radiation causes healthy skin to re-grow, so there is no scarring. In the Italian trial, 85 per cent of patients were cured after one treatment and up to 95 per cent after three treatments. Oliver Buck, chief executive of the German technology firm ITM which developed the therapy, said, "This means that patients with large and difficult-to-treat tumours not only have hope but keep their quality of life under what would otherwise be dire conditions." Trials are now being held in Germany and Australia, and Buck believes the treatment could be licensed in Britain within two years.
Dr Prasad Raj Dandekar, Consultant Radiation Oncologist: Rhenium-188 is a good radioactive isotope for medical purpose due to its high energy beta particle emission and short half life. In the past it has been used to treat bone metastases from various cancers, skin cancers and even osteoarthritis. The current research in focus is the first time it has been used as a paste to treat skin cancers. This is a significant leap in the treatment of non melanoma skin cancers (NMSC). Fortunately, skin cancers are very rare in India (less than one per cent of all cancer patients). In skin cancer patients in our country, squamous cell cancer is more common than basal cell cancer. Since this is a very rare condition in India, this research will not be able to make a great impact in the cancer cure rates in India. Another problem with patients in India is that due to lack of awareness about skin cancer, patients present to doctors at a much later stage. In the western population, due to high awareness about skin cancer, the patients present to doctors at a very early stage, when the cancer is less than five mm in size. Since most of our patients present late, this Rhenium-188 therapy will not be applicable in them. Most of them will have to under go surgery and radiotherapy for the cure. I hope that such simple and effective treatments are developed for more serious cancers such as head and neck cancers which are a major health hazard in India.
Dr Abhijit Desai, Dermatologist: This is a new modality, but no scientific study has yet been done. The isotope Rh 188 holds a lot of promise in treating various forms of cancer, like bone metastases and liver cancers or skin cancers. But, as yet, reliable stage III studies have not yet been completed to evaluate efficacy and potential side effects both short and long term. The commonest skin cancer in India is melanoma where this drug is of no use.
Dr Ashish Vijay Bakshi, Consultant Medical Oncologist and Hemato-Oncologist: This is a new form of treatment for basal and squamous cell carcinomas of skin. These tumours are fairly common in our country and are traditionally treated with surgery and/or radiotherapy with good results. There is a subgroup of patients where because of medical or technical reasons these treatments are not possible. In such cases we use topical Chemotherapy Agents. The rhenium therapy is a new treatment option for patients with early stages of cancer. Although the early results of this therapy are encouraging with good long-term disease control as a standalone treatment modality, they will require evaluation in large scale trials before it can be recommended in routine use.
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