Find out what radiotherapy you have for skin cancer and the side effects.
What it is
Radiotherapy uses high energy x-rays to kill cancer cells in the area being treated. There are 2 main types of radiotherapy, external and internal radiotherapy (brachytherapy).
You usually have external radiotherapy for non melanoma skin cancer. But in some cases, your doctor might use brachytherapy instead but this is less common.
When you have it
Radiotherapy is a treatment for non melanoma skin cancers such as basal cell cancer (BCC) and squamous cell cancer (SCC). It's a treatment 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 don't want surgery
- in people who aren't fit enough for a general anaesthetic
You might have radiotherapy after surgery to try to lower the risk of the cancer coming back (adjuvant treatment).
Or you might have radiotherapy if your cancer has spread to your lymph nodes or another part of your body, such as the lungs.
How you have it
You have radiotherapy treatment in the hospital radiotherapy department. The number of treatments you have depends on the type of skin cancer you have, where it is and how big it is.
You usually have radiotherapy once a day, from Monday to Friday, over a number of weeks. You have a rest at the weekend. The length of treatment varies from one to about 6 weeks.
Older and frail people may have their radiotherapy treatment less often. So they don't need to attend the radiotherapy department daily. Some treatment plans might be once a week or 2 to 3 times a week.
Some people might have a single treatment of radiotherapy.
Your doctor will tell you what treatment plan is best for you.
The radiotherapy room
Radiotherapy machines are very big. They rotate around you to give you your treatment. The machine doesn't touch you at any point.
Before you start your course of treatment your radiographers explain what you will see and hear. In some departments the treatment rooms have docks for you to plug in your music player. So you can listen to your own music.
During the treatment
You need to lie very still on your back. Your radiographers might take images (x-rays or scans) before your treatment to make sure that you're in the right position. The machine makes whirring and beeping sounds. You won’t feel anything when you have the treatment.
Your radiographers can see and hear you on a CCTV screen in the next room. They can talk to you over an intercom and might ask you to hold your breath or take shallow breaths at times. You can also talk to them through the intercom or raise your hand if you need to stop or if you're uncomfortable.
Dan (radiographer): Before your treatment starts your doctor will need to work out exactly where the treatment needs to go and also which parts need to be avoided by the treatment. To have radiotherapy you lie in the same position as you did for your planning scans. We then line up the machine based on your tattoo marks. It is really important that you stay very, very still when you are having treatment it is also important to let the radiographers know right at the beginning if you are not comfortable so they can adjust your position
Radiographer: Ok all done, we’ll be back in a couple of minutes
Dan (radiographer): We leave the room and control the room from a separate room This is so we aren’t exposed to radiation. Treatment takes a few minutes and you will be able to talk to us using an intercom. We can see and hear you while you are having your treatment and will check that you are ok. When your treatment starts you won’t feel anything; you may hear the machine as it moves around you giving the treatment from different angles. Because we are aiming to give the same treatment to the same part of the body everyday then the treatment process is exactly the same everyday so you shouldn’t notice any difference. You’ll see someone from the team caring for you once a week while you are having treatment they’ll ask how you are and about any side effects.
Patient: They get you from one sitting area to another and then take you into the room where you undress to the waist and then lie down and line you up by either moving you or asking you to shuffle a little and they check the dimensions and they talk to one another and they say I am fine this side how are you ...yes fine...ok, stay where you are Jeff and that was it. There were a few little clicks and lights go on and off and you can see a green laser beam which line sup with certain things on your body uh so no, no real noise and no discomfort.
You won't be radioactive
This type of radiotherapy won't make you radioactive. It's safe to be around other people, including pregnant women and children.
Radiotherapy to the skin can cause the skin to become slightly red and sore during the treatment. This will begin to disappear once the treatment is finished. The skin may become crusty and scab over at first. When the scab falls off, there'll be healthy skin underneath. This area will be more sensitive to the sun in the future.
You might have some hair loss if you have radiotherapy to a part of the body that has hair. Your hair will start to grow back some time after treatment. This may take up to a year, depending on the amount of treatment. The regrowth may be patchy.