What are the aims of this leaflet?
This leaflet has been written for patients who are going to receive radiotherapy for skin cancer. It aims to help you understand more about your radiotherapy treatment.
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 cancers and squamous cell cancers although other conditions may also benefit from this treatment.
When is radiotherapy used?
- When the cancer is too large or in a difficult site 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 might reduce the risk of the cancer returning
Where will you receive the treatment?
Radiotherapy for skin cancer is given as an outpatient procedure, mainly in the Orthovoltage Department at Clatterbridge Cancer Centre - Wirral or at Clatterbridge Cancer Centre - Liverpool. Generally, you will not need to be admitted to hospital.
What is the duration of the treatment?
The number of treatments you have will depend on the type, position and size of your skin cancer. It can sometimes be given as a single treatment, but usually you have treatment once a day over a period of one to two weeks or more. This will be confirmed by your oncologist (doctor specialising in the treatment of cancer).
Treatment is not usually given on Saturdays, Sundays and only occasionally on bank holidays. The therapeutic radiographers will tell you about the arrangements for any missed treatments over bank holidays.
When you come for radiotherapy, the area of the skin to be treated will be marked using a marker pen by an oncologist. These ink marks will be used to line-up the machine each time you are treated. Usually, a photograph is taken with the ink marks around the cancer, but you may be asked to keep these marks until the treatment has been completed.
If the area to be treated is on your head and is large or complex, it may be necessary to make a plastic mask that rests on your face to help you and the staff to get you in the same position for each treatment. The staff who are looking after you will explain about this in more detail, if it is needed. A special lead cut-out may be used to treat an irregular shaped area of skin.
The actual treatment only takes a few minutes. The therapeutic radiographer will position you on a couch and make sure that you are comfortable, because you have to lie very still during the treatment breathing normally throughout.
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 therapeutic radiographer will be able to hear and see you. You will not be able to see or feel the radiotherapy.
Radiotherapy does not make you radioactive. It is perfectly safe to be with other people, including children, throughout your course of treatment.
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 or therapeutic radiographer.
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 skin of the treated area tends to become paler.
Radiotherapy skin reactions are variable in appearance and timing. Some patients having large areas of skin treated may need contact with district nurses for dressings for a short time.
These pictures give a general idea of what you might expect from your treatment.
Week 1
During the first week after treatment, your skin will get red and sore. During this time you can apply creams as recommended by your Radiotherapy team.
Weeks 2 to 4
A scab has formed. The area may bleed or weep. Use dry dressings only.
Weeks 4 to 6
The scab will be dry and eventually come away.
Month 2 onwards
Final result - use moisturisers and a high-factor sunblock (SPF50) regularly to treated areas of skin which are exposed to the sun.
How should you take care of your skin?
While on treatment, you should aim to keep the treatment area as dry as possible, however, when carrying out normal washing routine you can wash the area, gently, using warm, tepid water. 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 being treated, but allow it 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.
Pregnancy
It is very important that individuals are not and do not become pregnant whilst having radiotherapy. Please inform a member of staff immediately if you think you may be pregnant.
What happens after you have completed your radiotherapy treatment?
Your oncologist will arrange for you to be seen in clinic around 6 weeks after you have finished your treatment.
Clatterbridge Cancer Centre - Liverpool
65 Pembroke Place, Liverpool, L7 8YA
Tel: 0151 556 5000
www.
Clatterbridge Cancer Centre - Wirral
Clatterbridge Road, Bebington, Wirral, CH63 4JY
Tel: 0151 556 5000
www.
Macmillan Cancer Support
Tel: 0808 808 0000 or www.
Cancer Information and Support Centre
Clatterbridge Cancer Centre - Liverpool. Tel: 0151 318 8805
If you have any general enquiries prior to starting your treatment, please contact the Skin Specialist Therapy Radiographer on 0151 556 5079 or 0151 318 8414, Monday to Friday during office hours, 9:00am - 5:00pm (09:00-17:00).
Maggie's
Maggie's is a charity providing free cancer support and information to anybody who been affected by cancer. Our cancer nurse specialists, psychologists and benefits advisors are here to support you during treatment or after your treatment has finished.
The Maggie's Centres allow you to share experiences with others in a similar situation around our kitchen table. We provide courses on survivorship, bereavement, stress management, mindfulness, tai chi, yoga, relaxation or cancer support groups. You do not need an appointment or a referral to access any support from Maggie's - you can just drop in. Our telephone number is 0151 334 4301.