A Kinder, Gentler Way to Treat Skin Cancer

November 17, 2022

The Xoft system offers innovative cancer therapy more quickly, with better results and--most importantly--less disruption to your busy life.

Diana Margileth is an avid golfer and spends a lot of time in the sun, covered with sunscreen and a big hat. But there was a tiny spot on her nose that kept peeling off and coming back. “The dermatologist did a biopsy,” Margileth says, “and it was superficial basal cell carcinoma.” She knew she needed to have it removed, but she also knew that traditional surgery might lead to reconstruction. Margileth’s dermatologist sent her to Tanuja Bhandari, MD, a board-certified radiation oncologist at Providence St. Joseph Hospital. Along with her colleagues Robert Ash, MD, and Venita Williams, MD, Dr. Bhandari has been using a new innovative skin brachytherapy called Xoft that Providence St. Joseph recently purchased thanks to generous philanthropic donors.


Xoft, an X-ray that uses targeted, low-dose radiation, has been used with great success for non-melanoma skin cancers. “The Xoft allows you to treat cancers in a very small area with eight to 10 treatments,” says Dr. Bhandari. Margileth’s tumor was less than two millimeters in diameter, so she was a good candidate. “I had the 10-minute treatment twice a week for four weeks,” Margileth says. “You don’t feel anything, and there’s a little pink spot that just lasts for a little while.”

“The Xoft brachytherapy is the preferred treatment modality for a better cosmetic outcome,” says Dr. Bhandari. “We treat eyes, ears, nose, lips, many areas on the face, to avoid scarring or asymmetry. Traditional radiation can mean daily sessions (called fractions) for five to six weeks.” During the weeks of her treatments, Margileth was able to play golf and travel, according to Dr. Bhandari.

The key to Margileth’s success—as with most positive cancer outcomes—was early detection. “I’ve spent a great deal of time outdoors,” she says. “I was a water-skier when I was younger, I played tennis and now I golf. I have the kind of skin that freckles easily. So I know to keep an eye on my skin.”

Margileth recommends that anyone in her position check out Providence St. Joseph’s Center for Cancer Treatment and Prevention and the Xoft; she also had some familiarity with the department because her husband, David Margileth, MD, is retired from medical oncology at Providence St. Joseph. “Dr. Bhandari and her staff are really amazing. They helped me fit all the treatments into my schedule and bent over backwards to keep us informed about everything,” she says.

Dr. Bhandari emphasizes, “Each skin cancer has individual features and cure rates.” It is important for doctors to discuss the risks, benefits and alternatives to various treatment methods together with their patients and bring the patient’s point of view into the shared decision-making.

For more information on the Center for Cancer Prevention and Treatment, call (714) 734-6200 or visit providence.org/sjocancer. 

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