Nonmelanoma Skin Cancer: Radiation Therapy

You may have heard about radiation therapy for cancer treatment. But you may not be sure what it is or what it does. And if you need radiation for nonmelanoma skin cancer, you may feel worried or have questions. Learning more about it will help you understand how it may be a good treatment for you.

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.

Radiation therapy is a local treatment. This means it's only applied to the part of your body where the cancer is. The type of radiation usually used is called external beam radiation therapy (EBRT). It may focus on single cancer growths, a small area of the body, the large area of the skin, or specific lymph nodes.

Superficial radiation therapy or electron beam radiation may be used for some nonmelanoma skin cancers. Each treatment is a lot like getting an X-ray, but it takes longer and uses stronger radiation. The radiation is aimed from a machine at the cancer. This is a short process that only affects the skin's surface. Because it doesn't go beneath the surface, this method won't affect deep tissue. This helps limit side effects to healthy tissue.

Your health care team may suggest radiation therapy if:

• Surgery poses risks to your health, such as if you tend to bleed a lot.
• The cancer is in an area that would need a more extensive surgery, such as your eyelid, nose, or ear.
• The cancer tumor is large, and surgery might not be able to remove it.
• You had surgery to treat the cancer in the past and it's possible the cancer might return. 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 or other organs.

You and your team of cancer specialists, including a radiation oncologist, will create a treatment plan. The plan will cover:

• The kind of radiation therapy
• The dose
• The length of treatment

You will most likely get radiation treatment as an outpatient. This means you go home on the same day of treatment. You will likely have treatment 5 days a week for 3 to 6 weeks. Each treatment only takes a few minutes. But plan on the session lasting 1 hour from start to finish.

It's normal if you feel overwhelmed about your treatment plan. Remember that your health care team is there to help you through the process and answer your questions.

Before radiation treatments start, you will have a planning session. This is called simulation. Your radiation team will take careful measurements. They will decide where to aim the radiation, and make sure you can be positioned exactly the same way for each treatment. And they decide the dose and length of treatment. At the start of the treatment, a radiation therapist helps you get into position. They may use blocks or special shields to protect parts of your body from the radiation. The therapist will line up the machine so the radiation is directed at the right spot. When you are ready, the therapist leaves the room. Then they will turn on the machine. You may hear whirring or clicking noises as the machine moves. This may sound like a vacuum cleaner. The machine will not touch you.

During the session, you will be able to talk with the therapist over an intercom. You can't feel radiation, so the treatment is painless. You also won't be radioactive afterward.

Radiation therapy affects cancer cells. It also impacts some surrounding healthy cells. The side effects of the therapy depend on the dose, length of treatment, and the part of your body being treated.

Your doctors will talk with you about the possible side effects. They will tell you which ones you should let them know about as soon as possible. They will also give you ideas on how to ease side effects or even how to prevent some. Most side effects go away over time after you finish treatment.

Common side effects in the treatment area include:

• Red, dry, burning, blistered, or irritated skin
• Infected skin
• A rash or itching
• Change in skin color, which may fade over time
• Hair loss, which may be permanent

The side effects can get worse during the course of radiation treatment. They can take several weeks before they go away. It helps to keep a log of any side effects. That way, you can share the log with your doctors during follow-up appointments. Having these details may help your team adjust your treatment plan so that you can feel better.

Some long-term side effects can show up many years after you finish treatment. Your doctors will talk about possible future side effects and will guide you through a plan to address them if they happen.

Make sure you understand what side effects are more serious and when to report them to your doctor right away. Before your treatment starts, make sure to have your doctors' contact information handy (such as in your cellphone or on your fridge). Ask how you should contact them if needed after office hours, on weekends, or on holidays.