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Farmington Hills, MI 48336-5919
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Fall 2013

Botsford HealthSource Magazine


Craig J. Gordon, D.O. and Leo Dabelstein
Lending a hand: Craig J. Gordon, D.O. and
the state-of-the-art technology available at
Botsford Cancer Center are defeating Leo
cancer and saving his hand.
The healing is amazing--and Dabelstein is

A new age of skin cancer care

Skin cancer accounts for nearly half of the cancer diagnosed in the United States.  But caught early, it has a high cure rate. That’s in part because of the progress that’s been made in care–improving the odds of a positive outcome and evening out side effects for patients.

Case in point: Leo Dabelstein
Earlier this year, losing his hand to skin cancer was a real possibility for Leo Dabelstein, of Westland.  But thanks to treatments available at Botsford Cancer Center and the skill and compassion of those who cared for him, he’s kept his hand –and made a dramatic recovery.

The situation started with a growth on the palm of Dabelstein’s left hand. He admits he should have acted sooner.  But he was afraid. By the time he finally sought medical help, the growth was covering most of his hand. He was diagnosed with squamous cell skin cancer—a cancer that rarely poses a threat if treated early.

Doctors considered amputation, but Dabelstein was understandably reluctant. Instead, he opted to try chemotherapy and radiation. Part of his treatment included high-dose-rate (HDR) radiation, a type of outpatient therapy that’s both fast and effective.

A different radiation
HDR, the radiation Dabelstein received, is delivered directly to a tumor site with a needle or catheter—or, in the case of skin cancers like Dabelstein’s, noninvasively with special applicators placed directly over the problem area. That’s different from the traditionally known external beam radiation therapy (EBRT), which is delivered by a machine from outside the body.

James Fontanesi, M.D.
James Fontanesi, M.D.

“HDR radiation is well-suited for cases where it’s difficult to do surgery,” says James Fontanesi, M.D., a radiation oncologist at Botsford Hospital, who treated Dabelstein. “That might be because someone is unable to tolerate an operation or because surgical removal could be disfiguring. Sometimes there’s a risk that surgery will interfere with the body’s ability to function too.”

As its name suggests, HDR radiation is delivered in higher doses than traditional external beam radiation therapy. It’s also extremely precise and limits contact with healthy surrounding tissue. The higher doses mean fewer treatments—perhaps only a handful, as opposed to 30 or more, a real benefit for people who travel long distances. It also means managing treatment schedules is easier and less disruptive to your life.

According to Dr. Fontanesi, advances in technology and treatment planning have enabled doctors to minimize side effects associated with the radiation. “There may be some reddening and drying of the skin, and may be even some scabbing,” he says. “But you don’t see the same kinds of serious problems that you used to see with radiation.”

The incredible shrinking tumor
Dabelstein’s treatment included simultaneous chemotherapy and radiation. The applicator used—a Frieberg flap—is a mesh like structure that wraps around the hand, making it easier to deliver radiation on its sloped surface. It connects to a machine that houses a radiation source about the size of a sprinkle you’d find topping a cupcake. When treatment starts, the sprinkle, which is attached to a cord, moves through a tube from the machine to the mesh, where it delivers the radiation.

Dabelstein had HDR radiation three times a week for three weeks. Chemotherapy continued for months. The radiation was painless. And although he did lose some weight and have two brief bouts of nausea with his chemo, the experience was nowhere near as bad as he’d imagined. That was thanks, in part, to the efforts of Craig J. Gordon, D.O., his medical oncologist, who has been recognized as an Hour Detroit magazine Top Doc.

What’s most significant is that Dabelstein appears to have beaten the odds. With virtually every treatment, his cancer shrunk—and he’s regained much of the function of this hand. “They’re amazed when they look at what was on my hand before,” he says.

What also impresses Dabelstein—aside from the improvement—is the care he received at Botsford Cancer Center. “I’m so thrilled with the doctors and nurses—they’ve gone out of their way to take care of me,” he says.

Leo Daelstein beat the odds. Diagnosed with squamous cell skin cancer, he received high-dose-rate radiation at Botsford Cancer Center. With virtually every treatment, his tumor shrank--and he's regained much of the function of his hand.

Continued with "Cancer care: It's come along way" »



Botsford Cancer Center