Making the Case to Preserve SRT
Why a less effective treatment may still have a role to play in the treatment of NMSC
If a better treatment exists, should we still offer the older one?
That’s the question we’ve been building toward.
In the first article in this series, we made the case that image-guided superficial radiation therapy (IGSRT) represents a clear advancement over traditional SRT.
In the second article, we clarified that outcomes are not driven by the device alone, but by the model delivering the care.
So now we arrive at the logical conclusion:
If IGSRT is superior… should SRT still exist at all?
Let’s Start with the Honest Answer
For many practices, the answer is straightforward:
No.
If you can offer IGSRT delivered through a structured, high-quality model, continuing to rely on traditional SRT becomes increasingly difficult to justify.
Because at this point, the tradeoff is clear:
Less precision
Less visibility
Less consistency
In exchange for what, exactly?
The Case for Moving Forward
Dermatology has always evolved alongside technology.
We moved from:
Blind excisions to Mohs with margin control
Visual assessment to dermoscopy
Generalized treatment to precision approaches
IGSRT fits squarely into that progression.
For practices currently offering SRT, the question is no longer:
“Does this work?”
It’s:
“Is this still the best we can offer?”
The Reality Many Practices Are Facing
Practices offering SRT today are increasingly facing a fork in the road:
Continue with a legacy approach that delivers acceptable, but not optimal, outcomes
Upgrade to a modern, image-guided model aligned with where the field is going
And while change requires investment, training, and operational shifts, so did every meaningful advancement in medicine.
The Risk of Standing Still
There’s another factor that’s easy to overlook:
Patient expectations are changing.
As awareness of non-surgical options grows, patients are becoming more informed and more selective.
They are asking:
What are my options?
Which treatment has the best outcomes?
Where can I get it?
And increasingly, they are finding answers on their own.
Practices that don’t evolve risk being defined by what they don’t offer.
But Here’s Where the Conversation Needs Nuance
Despite all of this, eliminating SRT entirely would be an oversimplification.
Because medicine doesn’t operate in a vacuum.
It operates in the real world.
And in the real world, access matters.
Where SRT Still Has a Role
1. Rural and Underserved Markets
In areas with:
Low population density
Limited access to specialists
No Mohs surgeon nearby
The economics of implementing IGSRT may not be practical.
In those settings:
The choice isn’t IGSRT vs. SRT.
It’s SRT vs. no radiation-based option at all.
And in that context:
SRT is not outdated; it’s necessary.
Because providing a viable non-surgical treatment option—even if not optimal—is better than leaving patients without access entirely.
2. Non-Oncologic Use Cases (e.g., Keloids)
In cosmetic or procedure-focused practices treating conditions like keloids:
The objective is different
The target is visible
Subsurface imaging may not change management
In these scenarios:
The added precision of IGSRT may not be required to achieve the desired outcome.
And SRT can remain a practical, effective solution.
The Incentive Problem No One Wants to Talk About
There’s another force shaping this conversation—one that has nothing to do with clinical outcomes.
Reimbursement.
Recent changes in billing and coding have created a new dynamic:
Certain treatments are being positioned as more financially attractive
Messaging is shifting toward revenue potential—not clinical performance
And that introduces a risk the field should take seriously:
When financial incentives start to influence treatment selection, patient outcomes can quietly become secondary.
The Line That Matters
The best treatment should not be the one that reimburses the most.
It should be the one that delivers the best outcome.
Bringing It Back to the Decision at Hand
If IGSRT is:
More precise
More consistent
And increasingly supported by superior outcomes
Then choosing a less advanced modality, primarily because it is more profitable, raises an uncomfortable but necessary question:
Are we optimizing for patient care or for practice economics?
Where Standards Are Actually Defined
Every specialty faces this tension.
But standards of care are not defined by reimbursement schedules.
They are defined by outcomes.
And over time, the field aligns around what delivers those outcomes most consistently.
The New Standard Is Taking Shape
For most dermatology practices treating NMSC, particularly in well-served markets, the direction is becoming clear:
IGSRT, delivered through a structured model like GentleCure, represents where the standard is heading.
Not because SRT stopped working.
But because we now have the ability to do better.
The Strategic Decision Ahead
Every practice offering SRT today faces the same question:
Do we maintain what we have, or evolve toward what’s next?
This isn’t just a clinical decision; it’s a strategic one.
It impacts:
Patient trust
Referral patterns
Competitive positioning
And long-term relevance
The Takeaway
SRT still has a role, but it is no longer the leading role.
For practices capable of evolving, the question is no longer whether to adopt IGSRT; it’s how quickly they choose to.
For the 275,000 Americans diagnosed with nonmelanoma skin cancer each month, let’s hope it’s sooner rather than later.
I’m Adam Lefton, and I’m the Chief Brand Officer for GentleCure by SkinCure Oncology. Together, with our 400-plus practice partners, we’re changing the face of skin cancer treatment in America
Stay Ahead of the Shift
This series has explored where non-surgical skin cancer treatment is today—and where it’s going next.
Subscribe to Skin Cancer Treatment Journal for continued insights on:
Emerging treatment models
Practice growth strategies
And the future of dermatologic oncology