What is Radition Therapy?

If you have been diagnosed with skin cancer, your doctor may recommend that you undergo radiation therapy. Radiation therapy (XRT), or radiotherapy, is a treatment that uses high energy rays to destroy cancer cells. In most cases, radiation therapy is given during 15 to 30 separate sessions to fully eliminate the cancer. Radiation therapy can be used alone to treat skin cancer or it may be used in addition to another treatment, such as surgery.

Radiotherapy may also be required to treat skin cancer that has spread to the lymph nodes or other organs.

Surgery and radiation therapy are are both highly effective treatments for non-melanoma skin cancers. While surgery has a slightly higher cure rate, there are certain cases in which radiation may be the preferred treatment option. This is especially for cancers that have recurred after surgery or for those patients that aren’t good surgical candidates, such as patients with medical comorbidities or those on numerous immune suppressive medications. 

How does radiation therapy work?

Radiation is a very targeted form of therapy and thus only affects the part of the body that is being treated. The goal of radiation therapy is to damage and kill cancer cells, while preserving the function of nearby healthy cells and tissue. 

Nearly all cells in the body grow and divide to make new cells. The same is true for skin cancer cells, but they grow and divide at a much faster rate than surrounding normal cells.

Radiation therapy works by delivering large amounts of radiation energy, which causes small breaks to form in the cells’ DNA in the targeted area. The breaks in the DNA prevent the cancer cells from growing and dividing and typically cause them to die. Radiation therapy also affects normal cells in the targeted area, but unlike cancer cells, the normal cells recover from radiation and eventually resume their normal function.

Skin Cancers Treated with Radiation Therapy

Radiation therapy is most often used to treat basal cell or squamous cell skin cancers. It may also be used to slow the growth of more advanced or malignant cancers. While surgical removal of skin cancer is the most common and effective treatment for skin cancer, there are several reasons why a doctor may recommend radiation therapy instead.

Radiation therapy may be used:

  • To treat skin cancers that are very large or deep
  • On skin cancers that occur on a highly visible part of the body where surgery may leave an unsightly scar
  • In patients who are not fit enough to undergo surgery requiring a general
  • To treat skin cancers that have come back after initial surgical treatment
  • For skin cancers that will be difficult to treat with surgery due to their location
  • To slow the growth of a malignant skin cancer and relieve symptoms (palliative treatment)

If any of these factors apply, your doctor may recommend radiation therapy. Your doctor may also recommend that you undergo radiation therapy after surgical removal if he or she is concerned that cancer cells may still be present in the surgical site or if the cancer has spread to the lymph nodes or other organs.

Radiation Therapy Treatment Process

Your radiation therapy team will conduct a planning session before you undergo treatment. During this meeting, the doctor and his/her team will determine how much radiation will be required, where you will need it, how many treatment sessions will be required, and the intervals at which they should be spaced.

After the planning session, the radiotherapy team will use advanced computers to make a very precise plan for your treatment. This is done to ensure you are getting the precise dose required to destroy the cancer without being exposed to any unnecessary amount of radiation.

How to Prepare for Your Treatment and Recovery

During the course of your radiation treatment, it is very important that you get plenty of rest. You may feel unwell and tired – ask for help and try to take it easy so that your body can recover from the treatment and eliminate the cancer as efficiently as possible. Eat a healthy and well balanced diet. If you notice any change in the way food tastes, report this to your doctor. Radiation can change your sense of taste and the dose may be adjusted if necessary.

You will need to care for the skin that is exposed to radiation carefully. The skin in the targeted area will most likely be red and feel sore, similar to that of a sunburn, throughout the course of your treatment. The skin may get crusty and form a scab, but once the scab falls off healthy, normal skin will regrow. The treated area will be extremely sensitive to sunlight during treatment and will always be more sensitive than before after treatment is complete. You will need to avoid direct exposure to sunlight during treatment and cover up or use sunscreen on the area afterward to prevent changes in skin color or texture.

Risks and Benefits

Radiation therapy is a very effective treatment that causes few lasting side effects, making it a popular choice among doctors who treat skin cancer. As with all cancer treatment, however, certain risks and side effects should be expected. These include:

  • Sore, sensitive skin in the targeted area during treatment
  • Hair loss in the treatment area – hair usually grows back, but may not have the same texture or thickness
  • Fatigue and nausea during the treatment period
  • Recurrence or formation of another cancerous lesion in the area

In some cases, new skin cancers can develop many years later in the area that was treated by radiation therapy. For this reason, radiation therapy is rarely recommended to treat skin cancers in young people. It is also not recommended for individuals who suffer from certain diseases, such as lupus, as radiation can worsen these conditions.

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