Radiotherapy for skin cancer

Radiotherapy uses high energy rays to kill cancer cells. Radiotherapy can be used to treat basal cell or squamous cell cancers. It can be used for skin cancers

• That cover a large area
• In areas of the body that are difficult to operate on 
• Where the appearance after surgery may be poor
• In people who do not want surgery
• In people who are not fit enough for a general anaesthetic

Radiotherapy can also be given as an adjuvant treatment. This means given after surgery to try to lower the risk of the cancer coming back.

Sometimes radiotherapy may be used to treat cancers that have spread to the lymph nodes. Or elsewhere in the body such as the lungs.

The radiotherapy treatment is given in the hospital radiotherapy department. It can be given as a single treatment. But usually you have treatment once a day from Monday to Friday with a rest over the weekend. Or as a course of 3 treatments each week for a number of weeks. How many treatments you have will depend on the type, position and size of your skin cancer.

Before you begin your radiotherapy treatment it has to be carefully planned. CT scans and X-rays may be used to pinpoint the exact position of the cancer. This area will be marked on your skin using ink. The ink marks will be used to line up the radiotherapy machine each time you are treated. These marks will be left on your skin until the treatment course has ended. The staff will tell you about how you should look after your radiotherapy skin markings.

If your skin cancer is very near a delicate area, such as the eye, nose or lip, your planning will include making lead shields made to protect your eye or teeth from the radiation. These lead shields will only be put in place when you are actually being treated.

The radiotherapy treatment only takes a few minutes. The radiographer will position you on the couch and make sure you are comfortable. You will be left alone while you have your treatment, but the radiographer will be able to hear you.

Each radiotherapy treatment session is called a fraction. This is because the total amount of radiotherapy you will have is worked out and then divided up into fractions. Radiotherapy does not hurt. You will not be able to feel it. But you will have to lie very still for a few minutes during the treatment.

External radiotherapy does not make you radioactive. The radiation comes from the machine and is focussed on your cancer. It does not stay in your body. It is safe to be with other people, including children, throughout your course of treatment.

Radiotherapy to the skin does not have very many side effects. The skin may become slightly red and sore during the treatment period. This will begin to disappear once the treatment is over. It may become crusty and scab over at first. But when the scab falls off there will be healthy skin underneath. This area will be more sensitive to the sun in the future. If radiotherapy is given to a part of the body that has hair, you will have some hair loss. The hair will start to grow back some time after treatment has finished. This may take up to a year depending on how much treatment you had. The regrowth may be patchy.

There is more information in the main radiotherapy section in CancerHelp UK. It tells you more about this type of treatment including

• What radiotherapy is
• How your radiotherapy is planned
• Radiotherapy skin markings
• Possible side effects