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radiotherapy

Safe use of controlled doses of radiation to treat disease, especially cancer.  Usually given by pointing an X-ray machine at the part of the body to be treated, but can also be given by drinking liquid, having an injection or having a radioactive implant put into your body (brachytherapy).

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Northern Centre for Cancer Care

Radiotherapy for Skin Cancer (Basal Cell Carcinoma and Squamous Cell Carcinoma)


IntroductionShow [+]Hide [-]

Your oncologist has advised a course of radiotherapy to treat your skin cancer.

Types of skin cancer

This information explains about the two most common types of skin cancer. These are also known as non-melanoma skin cancer. Over 90% of people with these skin cancers are completely cured.

• Basal Cell Carcinoma (BCC or Rodent Ulcers)

Basal Cell Carcinoma is the most common form of skin cancer. It is most often caused by long-term exposure to sunlight. More rarely it can be caused by exposure to certain chemicals at work.

Fortunately these types of cancers are very slow growing and rarely spread to other parts of the body. However if left untreated they can be disfiguring.

• Squamous Cell Carcinoma (SCC)

Squamous Cell Carcinoma is the second most common type of skin cancer. If left untreated it can spread to other parts of the body. However most people treated for SCC are cured.

Types of treatment

Treatment can be given by surgery, radiotherapy, chemotherapy creams, cryotherapy or photo-dynamic therapy.
 

Before your treatment Show [+]Hide [-]

How will my treatment be planned?

Before you start treatment your oncologist or a radiographer specialist will draw some marks on your skin to outline the treatment area. If the area for treatment is an unusual shape or in a difficult place to get to, you may also need to have a device made to protect the surrounding skin that we do not wish to treat.

A separate appointment will be given for this to be done.

Your oncologist will have explained about the benefits, risks and possible side effects of your treatment to you.

You are required to sign a consent form to say that you agree to go ahead with the treatment. A photograph will be taken of the treatment area for your health records. You will be asked to sign another consent form for this.

Please ask questions if there is anything you are unsure about.

During your treatmentShow [+]Hide [-]

How is radiotherapy given?

Radiotherapy is delivered by a superficial x-ray treatment machine (SXT)
An applicator is attached to the machine in order to direct the x-rays onto the skin.

superficial x-ray treatment machine

When do I attend for treatment?

Depending on the size of the area to be treated

  • some patients have just a single treatment.
  • some patients attend once a week.
  • some patients attend over a period of one to two weeks and you will need to come along every weekday during that time.

Treatment is not usually given on Saturdays, Sundays or on Bank Holidays. The radiographers will tell you about arrangements for missed treatments over Bank Holidays. 
 
Having your treatment

The radiographers will explain exactly what is going to happen and then position you on the couch.

They will use the marks put on your skin to correctly position you for treatment. A thin piece of protective metal will be placed on your skin outlining the area for treatment. The machine will then be positioned on top of this. It may press quite firmly but will not hurt.

If a device to protect the surrounding skin has been made, this will be fitted before treatment.

For any areas treated on the face and neck you will need to wear covers that will protect your eyes.

An individual protective shield may be required if treatment is directed near the nose or the mouth.

It is important that you keep still during treatment but you can breathe normally. If you feel uncomfortable and think you may not be able to stay in position, please tell us.

When you are in the correct position for treatment the radiographers leave the room and switch on the machine.

You are on your own in the room during treatment but the radiographers are just outside. It usually takes a couple of minutes to complete the treatment. The radiographers will watch you on a TV screen. They can hear you and can talk to you on an intercom. If you feel distress at any time during your treatment please alert them by raising a hand and they will stop your treatment immediately.  You won’t feel anything unusual whilst having your treatment (it is similar to having a normal x-ray). 

SXT
 

After your treatment Show [+]Hide [-]

When your treatment is over the radiographers will come back into the room and:

  • move the machine away
  • remove any protective shielding
  • you will then be escorted back to the waiting area and can go home
  • you will not be radioactive and you can’t harm your family and friends
     

Possible short term (early) side effects to the skin Show [+]Hide [-]

Early side effects are temporary and affect most patients. The side effects generally develop towards the end of the course of treatment. Sometimes side effects can last for several weeks. However they usually settle within three to four months.

Towards the end of treatment some patients may experience changes in the skin over the area that has been treated. The skin may:

  • feel tight and uncomfortable
  • itch
  • become pink or red
  • become more dry and flaky
  • the area may develop a crust which can occasionally bleed or weep.

Your skin will be monitored by your radiographers during radiotherapy and you will be given advice on skincare. You may also be seen weekly during treatment by your oncologist or specialist radiographer who will examine your skin and advise on any creams if necessary.

Skin care – what can I do to help?

Please do not remove the treatment marks until after your last treatment has finished. You may find that the marks naturally fade. The radiographers will re-mark the area as necessary.

We recommend that you take care of your skin during and for six weeks after your radiotherapy as the skin reaction will continue after treatment has finished.
You may find the treated area will form a crust or scab which will drop off and may possibly reform several times before healing completely.

  • Do not expose the treated area to the sun.

Whilst in the sun the treated area should be covered completely or a high protective factor suncream (25 or above) should be applied. Do not use a sunbed as this could make the reaction worse. 

  • Do not shave the treated area
  • Use a mild baby shampoo if the scalp is treated.
  • Do not use talcum powder, bubble baths, bath salts, shower gels or body lotions on the treated area as they tend to be highly perfumed and can dry or irritate the skin.

Your oncologist may prescribe a cream if needed or the radiographers may give you a moisturising cream to soothe the skin.

Possible long-term or permanent effects of treatment Show [+]Hide [-]

Discoloration of the skin

The skin in the treated area may look paler than the surrounding skin and feel quite thin and papery. Sometimes the skin may develop superficial thread veins in the treated area.

Any hair within the treated area may not grow back following treatment.

The treated area will always be more sensitive to sunlight therefore it should either be covered or a sunblock or high factor suncream (factor 25+) should be used.

Sex

Having radiotherapy for skin cancer will have no effect on your sex life.

Pregnancy

It is very important that women are not and do not become pregnant whilst undergoing radiotherapy. Please inform a member of staff immediately if you think you may be pregnant.

After your radiotherapy has finished

The side effects of radiotherapy can continue for several weeks after treatment has finished.

  •  continue with your skincare routine until any changes return to normal. You can then return to using your usual skin care products.
  • you will be sent a follow up appointment to see your specialist team at your referring hospital approximately eight to twelve weeks after finishing treatment
  • you will get a letter giving you a date and time for your appointment

If you are worried about side effects after your treatment has finished, please contact your GP for further advice. Your GP will have received information about the treatment you have had.

Useful contact telephone numbers:

NCCT Information Centre
Telephone: 0191 256 3596 or 0191 256 3597
Monday to Friday from 10.00am to 4.00pm

Macmillan Cancer Relief
020 7840 7840
Macmillan Cancer Relief

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