Skin Cancer Foundation Position: Surface Electronic Brachytherapy (eBx)

New York, NY (October 2, 2017) – This non-surgical procedure to treat non-melanoma skin cancers holds promise, but it’s too early to determine the procedure’s safety and efficacy. 

Surgery remains the primary treatment for non-melanoma skin cancers, but eBx may be considered when surgery is not feasible. For example, it may prove to be most useful for elderly patients in their 80s or 90s who are not candidates for surgery because of infirmity or being on blood thinners. This is also a viable solution for small tumors that have formed in critical locations, such as the tip of the nose or eyelid. 

There are two basic issues with eBx.  First, it requires multiple treatments – usually about 16 or more within a fairly short time span of a month or less.  That presents problems for older patients who may have transportation issues. With Mohs surgery, one visit to the dermatologist is usually enough.  Second, radiation itself can induce changes in the skin that potentially lead to the development of “new” skin cancers.  

Size, location and histopathology of the tumor should also be considered before choosing this method of treatment. If a tumor is likely to recur, like those that appear on the scalp or ear, surgery would be favored. And while eBx claims pleasing cosmetic results, patients must understand that there is still the possibility of developing hypopigmentation (loss of skin color) and thinning of the skin.

We are encouraged to see that more research on the procedure is being planned; large, multi-center studies with long-term follow up are needed to collect the data which will ultimately determine the safety and efficacy of Surface Electronic Brachytherapy. 

Deborah S. Sarnoff, MD
The Skin Cancer Foundation


About The Skin Cancer Foundation
The Skin Cancer Foundation is the only global organization solely devoted to the prevention, early detection and treatment of skin cancer. The mission of the Foundation is to decrease the incidence of skin cancer through public and professional education and research. Since its inception in 1979, the Foundation has recommended following a complete sun protection regimen that includes seeking shade and covering up with clothing, including a wide-brimmed hat and UV-blocking sunglasses, in addition to daily sunscreen use. For more information, visit