Yes, absolutely. Opting for IG-SRT now does not prevent you from having surgery in the future – either for a new skin cancer or even for the same area if something unexpected were to happen. There’s no rule like “if you do radiation, you can’t do surgery later.” For instance, if years down the line another skin cancer appears in the vicinity, you could still undergo Mohs or excision for that new lesion. Or if (in the rare event) the original lesion wasn’t fully controlled by IG-SRT, a surgical salvage could be performed to remove any remaining cancer. The skin that’s been treated with radiation might have some changes (perhaps a bit of scarring or reduced vascularity), but surgeons are accustomed to operating on previously radiated tissue when necessary. It can be slightly less straightforward because radiated skin doesn’t heal quite as robustly as never-radiated skin, but minor procedures and even Mohs can still be done. It might mean a bit slower healing or careful attention to wound care, but it’s definitely possible.
Also, importantly, choosing IG-SRT doesn’t “burn bridges” for other therapies – you can still have any other dermatologic treatments in that area later (like cosmetic treatments, if desired, once healed, or further skin cancer treatments). For example, some patients do IG-SRT and later if they get another unrelated issue, they can still have that addressed surgically.
So, if your concern is “If I don’t do Mohs now, am I forfeiting my chance to ever do Mohs on this spot?” – the answer is no, you’re not forfeiting it, it’s just that we usually won’t need to if IG-SRT works. But if needed, surgery remains on the table. Many patients find comfort in knowing that Mohs could be a backup if necessary. Fortunately, with IG-SRT’s success rate, needing that backup is unlikely. But it’s good to know you have all options open in the future. The medical team will always pick what’s best for your situation at any given time.
One thing to note: if IG-SRT is successful, you won’t require surgery on that lesion at all. But if new lesions pop up elsewhere or any recurrence happens, surgery can be done then. In short, choosing IG-SRT now does not disqualify you from surgery later – they are complementary tools. Our goal is to cure the cancer with the least morbidity now; if later on something else is needed, we still have surgery in our toolkit (as well as other modalities). So you’re not locking yourself out of future options by choosing radiation at this time.
