What is radiotherapy?
Radiotherapy is the use of X-rays to destroy cancerous cells. In the context of the skin, it is predominantly used to treat basal cell carcinomas and squamous cell carcinomas although other conditions may also benefit from the therapy.
When is radiotherapy used?
- When the cancer is too large or in a difficult site for surgery.
- When the patient does not want surgery or is not fit enough for surgery.
- When radiotherapy will usually give a better cosmetic result than surgery (for instance, when the nose is involved).
- When there has been a big operation to remove the cancer and it is considered that radiotherapy might reduce the risk of recurrence.
Where will you receive the treatment?
Radiotherapy for skin cancer is generally given as an outpatient procedure in a Clinical Oncology Unit. Generally, you will not need to be admitted to hospital. Several outpatient visits are usually required.
What is the duration of the treatment?
For small cancers the treatment is often over a period of approximately 2 weeks, whilst for relatively larger cancers, particularly squamous cancers, it is about 4 weeks.
Planning your treatment
When you come for radiotherapy, the area of the skin to be treated will be marked using ink by a consultant oncologist. These ink marks will be used to line up the machine each time you are treated. Usually a photo is taken with the ink marks around the cancer but you may be asked to keep these marks until the treatment has been completed. Sometimes it is necessary to make a plastic mask that rests on your face to define where the treatment is to be given. A special metal cut-out may be used to treat the cancer and protect the rest of the skin.
Having your treatment
At the beginning of your treatment you may be given a written information leaflet on how to care for yourself during radiotherapy. The actual treatment only takes a few minutes. The radiographer will position you on a couch and make sure that you are comfortable, because you have to lie very still during the treatment. If your skin cancer is near your eye or teeth, a small lead shield will be applied during treatment to protect these areas from the radiation. You will be left alone while you have your treatment, but the radiographer will be able to hear and see you.
You will not be able to see or feel the radiotherapy as it is not painful.
Radiotherapy does not make you radioactive. It is perfectly safe to be with other people, including children, throughout your course of treatment.
Are there any side effects?
Radiotherapy for skin cancer only affects the area treated. You will not feel sick or tired from the treatment, or lose your hair, unless your skin cancer is in an area covered by hair. You should be able to continue your usual activities or work throughout your treatment, and any side effects you experience will be monitored regularly by a doctor/radiotherapist. The side effects normally occur in the latter part of the treatment and may continue for some weeks after completion. After the treatment, the affected skin will become red and sore - similar to sunburn. This reaction can take several weeks to settle. The area may become crusty and scab over, sometimes more than once. When the scab finally falls off, there will be good skin underneath. Sometimes a crust can form a second time before healing is complete. Scarring from radiotherapy is usually mild, but over years the scar tends to become paler (any such scarring may benefit from skin camouflage assistance; further information can be found on the BAD website under ‘Patient Support Groups’).
Where can I get more information about radiotherapy?
Web links to detailed leaflets:
Macmillan Cancer Support
89 Albert Embankment
London SE1 7UQ
Helpline (for emotional support): 0808 808 2020
Helpline (for information): 080