Nonmelanoma Skin Cancer: Radiation Therapy

Radiation therapy uses beams of X-rays or other particles to kill cancer cells. It may be used on its own or along with other types of treatment.

How is radiation therapy given?

For nonmelanoma skin cancer, the type of radiation most commonly used is called superficial radiation therapy or electron beam radiation. These types of radiation don't go deeper than the skin. This helps limit side effects. Sometimes radiation that travels deeper is used if the cancer is very large.

Each treatment is a lot like getting an X-ray, but it takes longer and uses stronger radiation as well. The radiation is aimed at the cancer. It damages the cancer cells and stops them from growing and dividing.

Radiation therapy is a local therapy. This means that it affects the cancer cells only in the treated area. It does not go throughout the body.

When is radiation therapy used for nonmelanoma skin cancer?

Your healthcare provider may advise radiation therapy for any of these reasons:

• You’re unable to have surgery due to a health condition, like bleeding problems.

• The cancer is in an area that makes it hard to remove with surgery, such as your eyelid, nose, or ear.

• The tumor is large, which makes it hard to remove.

• You’ve had surgery, but you have an increased risk of the cancer coming back. In this case, radiation might be given after surgery to kill any cancer cells that may be left in the area. This is called adjuvant radiation therapy.

• The cancer has spread to lymph nodes of other organs.

Before treatment

To plan your treatment, you'll meet with a team of cancer specialists. A healthcare provider called a radiation oncologist will create your treatment plan. The plan shows what kind of radiation you’ll get, the dose, and how long treatment will last. This provider can also prepare you for how you may feel during and after treatment.

Once your radiation oncologist has mapped out your treatment plan, a radiation therapist gives you the radiation. You'll most likely get radiation treatments as an outpatient. This means you go home the same day of treatment. Treatment is usually given 3 to 5 days a week for anywhere from 3 to 6 weeks.

On the days you get treatment

Each treatment takes only a few minutes to deliver. But you should plan on being there for about an hour.

At the start of the treatment session, a radiation therapist helps you get into position. They may use blocks or special shields to protect parts of your body from exposure to radiation. The therapist then lines up the machine so the radiation is directed to the right spot. When you’re ready, the therapist leaves the room and turns on the machine. You may hear whirring or clicking noises as the machine moves during radiation. This may sound like a vacuum cleaner. The machine won't touch you. During the session, you’ll be able to talk to and hear the therapist over an intercom. You can’t feel radiation, so the process will be painless. You won't be radioactive afterward.

Possible side effects

Radiation therapy affects nearby normal cells as well as cancer cells. The side effects of radiation depend on the amount and the type of radiation you get, as well as the part of your body being treated. Many side effects can be treated or even prevented. Most go away over time after you finish treatment.

Common side effects can include:

• Red, dry, burning, blistered, peeling, or irritated skin in the area being treated

• Increased risk of skin infection

• A rash or itching in the area being treated

• Change in the color of the skin (This may get better over time.)

• Hair loss in the area being treated (This may be permanent.)

It may be helpful to keep a diary of your side effects. A written list will make it easier to remember your questions when you go to appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage side effects.

Some long-term side effects of radiation may not show up for many years after you finish treatment. These depend on the dose of the radiation and the area that's treated. They also depend on how many times you have treatment. Ask your healthcare provider what you may expect.

When to call your healthcare provider

Talk to your treatment team about what side effects you can expect. Also talk about what can be done to prevent or ease them. Ask what symptoms you should watch for. Know when you should call your healthcare team. Also be sure you know how to get help after office hours and on weekends and holidays.