RADIOTHERAPY FOR SKIN CANCER
What are the aims of this leaflet?
This leaflet has been written to help you understand more about radiotherapy treatment for skin cancer.
What is radiotherapy?
Radiotherapy is the use of X-rays to destroy cancerous cells. In the skin, it is mainly 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 place in the body for surgery.
When the patient does not want surgery or is not fit enough for surgery.
When radiotherapy may give a better cosmetic result than surgery (for instance, some cancers on the nose).
When there has been an operation to remove the cancer and it is considered that radiotherapy may reduce the risk of the cancer returning.
Where will you receive the treatment?
Radiotherapy for skin cancer is given as an outpatient procedure in a Radiotherapy Department. 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 larger cancers, particularly squamous cell carcinomas, it may be over about 4 weeks.
Planning your treatment
CT scans may be used to show the exact area to be treated. These areas are then marked by an oncologist (doctor specialising in treatment of cancer) using a marker pen. The ink marks will be used to line up the x-ray machine each time you are treated to ensure you will be in exactly the same position. If the area to be treated is on your head and is large or complex, it may be necessary to make a plastic mesh mask to help keep your head from moving. The staff who are looking after you will explain about this in more detail as needed. A special lead cut-out may be used to shape the radiotherapy beam and protect the surrounding skin.
Having your treatment
At the beginning of your treatment you should 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; it is important that you 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 and 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, like sunburn. This reaction can take several weeks to settle. The area may become crusty and scab over, sometimes more than once. When the scab falls off, there will be good skin underneath. 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 below).
How should you look after your skin?
While on treatment you should wash the area with mild fragrance free soap and warm or cool water. Gently pat dry the skin with a towel. You should not apply any cream or lotions to the treated area until any reaction from the treatment has settled down; this includes cosmetics and sunblock if your face is being treated. If you are having treatment near the hair line, be careful when washing your hair and do not use a hair dryer near the area; allow your hair to dry naturally. It is better to keep the treated area out of strong winds and sunlight as these can irritate the skin and make the reaction worse. Try to avoid clothes rubbing the treated area.
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): 0808 800 1234
Link to patient support groups:
British Association of Skin Camouflage (NHS and private practice)
Tel: 01254 703 107
The Squire Centre
33-37 University Street
London, WC1E 6JN
Tel: 0300 012 0275 (for support and advice)
Tel: 0300 012 0276 (for the Skin Camouflage Service)
For details of source materials used please contact the Clinical Standards Unit (firstname.lastname@example.org).
This leaflet aims to provide accurate information about the subject and is a consensus of the views held by representatives of the British Association of Dermatologists: individual patient circumstances may differ, which might alter both the advice and course of therapy given to you by your doctor.
This leaflet has been assessed for readability by the British Association of Dermatologists’ Patient Information Lay Review Panel
BRITISH ASSOCIATION OF DERMATOLOGISTS
PATIENT INFORMATION LEAFLET
PRODUCED JUNE 2010
UPDATED OCTOBER 2013, DECEMBER 2016
REVIEW DATE DECEMBER 2019