Reddit-based thematic analysis of patient preferences in non-melanoma skin cancer treatments

Summary: Superficial radiation therapy (SRT) is utilized to treat low risk cutaneous non-melanoma skin cancers (NMSCs). Dermatologists are increasingly fielding questions as to the utilization of SRT rather than undergoing Mohs micrographic surgery (MMS). While both target NMSCs with different risk profiles, SRT’s growing use suggests patient appeal. This study examines attitudes, preferences, and satisfaction with SRT compared to MMS. Reddit was searched using “Superficial Radiation Therapy Mohs,” “SRT Mohs,” and “GentleCure.” The first 50 posts from each search were screened for relevance. Posts discussing MMS or SRT for NMSCs were included. Two medical students independently identified themes, created a codebook, and applied it to all posts, resolving discrepancies by consensus. Mixed-methods analysis incorporated qualitative themes and quantitative content. Fifteen Reddit threads and 196 subthreads from 94 unique users were analyzed, revealing 20 themes. Common topics included independent treatment research (n=24), cosmetic concerns (n=22), and satisfaction/dissatisfaction with results (n=20). Many users were dissatisfied with the information provided by their care teams, prompting inquiries about SRT’s efficacy (n=19) and cost (n=8). Fears of facial scarring from MMS (n=22) led some to prefer SRT for its perceived cosmetic benefits, though concerns about SRT-related dyspigmentation, atrophy, and scarring (n=5) were noted. This is the first study to assess patient perspectives on SRT versus MMS for NMSCs. Frustration with inadequate SRT information drives some patients to unreliable sources like Reddit, emphasizing the need for thorough education. The focus on cosmetic outcomes highlights its importance in treatment discussions. Devon L. Barrett¹, Julia Rogers¹, Alison Gern¹, Jordan Lim^{1, 2} 1. Dermatology, Emory University School of Medicine, Atlanta, GA, United States. 2. Dermatology, Atlanta Veterans Affairs, Decatur, GA, United States. UV Biology/Injury and Non-melanoma Cancers