Radiotherapy for skin cancer

Radiotherapy is an excellent treatment method for large skin cancers, invasive skin cancers, or for patients who choose to avoid surgery. Skin cancer doctors at My Skin Clinics work in with radiation-oncologists to assist in the treatment of certain types of skin cancers. Radiotherapy entails several visits to a Radiation –Oncology Specialist Centre, usually over several weeks to months.

Important facts on Radiotherapy for skin cancer

Radiotherapy is a Specialist field
Treatments are performed in an out patient basis by a Radiation Oncologist
Large skin cancers, aggressive skin cancers, or multiple areas of skin cancers are ideally treated with radiation
In some situations, we combine both surgery AND radiotherapy to increase the cure rate and remission rate for skin cancers
Examples of skin cancers suited to radiotherapy include- invasive basal cell cancers that involve nerves and aggressive SCCs

In what situation will a skin cancer specialist refer you to a radiation oncologist?

The most common situation for radiotherapy of skin cancer arises when the skin cancer is either very large or if there is spread to surround areas, including nerves. Skin cancer doctors may refer you to a radiation oncologist in the following situations-

If your skin cancer such as a BCC or SCC is very large
If your skin cancer is aggressive, this includes infiltrative or morpheic BCCs
If your skin cancer has spread to involve other areas, or if nerves are involved- eg. BCC with Perineural invasion
If your skin cancer is in cosmetically sensitive areas such as the eyelid, ear, nose
If you exhibit lots of skin cancers in a defined areas- such as multiple skin cancers on the scalp on a background of severe sun damage

Remember, the doctors at My Skin Cancer Clinic work as a TEAM and will work in with Dermatologists, Plastic Surgeons, and Radiation Oncologists to provide you with the best possible solution for your type of skin cancer.

How do we administer radiotherapy for skin cancer treatment?

In Australia, radiation therapy is administered and supervised by Specialists Radiation oncologist. Radiotherapy is administered in clinical centers on an outpatient basis. This requires several visits to the Specialist, over a period of weeks or months.

The initial visit involves planning how many sessions and the type of therapy needed. Subsequent visits are very quick and involve radiation of the treated area and surrounding skin. Each session takes approximately 15 minutes to complete.

What types of skin cancer can be treated with radiotherapy?

Radiation therapy can be an excellent method to treat certain types of skin cancers because cancerous cells are sensitive to radiation -induced damage. The most frequently treated skin cancers in Australia are Basal Cell Cancers, and SCC or Squamous Cell Cancers.

Ideal skin cancers are-

Aggressive BCCs
BCCs with perineural spread or cancer within the nerves
Aggressive SCC or SCCs with nerve involvement
BCCs and SCCs (multiple) on the lower legs in elderly or frail patients
Multiple Skin Cancers on the scalp with extensive background sun-damage
In-operable skin cancers
Skin cancers in cosmetically sensitive areas such as the eyelid, inner ear, or nose in elderly patients.

Your skin cancer specialist will guide you as to the suitability of RADIATION therapy.

What are the side effects of radiation therapy for skin directed treatments?

Side effects from radiotherapy can be early, also known as acute, or late, or chronic.

Acute side effects can occur during early treatment of your skin cancer. The side effects developed in the treatment area will depend on the location of your skin cancer, the type of skin cancer treated (ulcerated cancer versus nerve involvement of cancer such as a Basal Cell Tumour), the dose of radiotherapy, your medical condition and how the dose is delivered. Acute side effects include hair loss in the treated area, or decreased salivary flow. This may occur if a skin cancer is treated around the mouth or lip area.

Chronic side effects following radiotherapy for skin cancer may or may not occur. Most common chronic side effects from skin cancer radiotherapy include discolouration of the skin, blood vessels, and changes in the texture of the skin. Rarely a second cancer may occur many years after radiotherapy of the area.

How effective is radiation therapy for the treatment of skin cancer?

Your radiation oncologist will discuss the prognosis of this therapy for YOUR SKIN CANCER. Success will depend on many factors including the location of your skin cancer, and the type of skin cancer.

Most commonly Skin Cancer doctors refer patients who have extensive basal cell cancers or BCCs with perineural or nerve spread. In this group, the use of adjunctive radiotherapy can be extremely successful.

Following radiotherapy, a regular skin check by your skin cancer doctor is recommended.

What is the cost of radiation therapy for skin cancers?

Medicare covers radiotherapy treatment for skin cancers, in some situations an out of pocket cost may apply.

Costing will depend on the number of treatments, and the number of skin cancers treated. Your oncologist will discuss this with you during your initial consultation.

Is radiation therapy performed at the skin cancer clinic?

No, radiotherapy is a very specialized field, and special equipment and safety requirements are needed. All radiotherapy procedures for skin cancers are performed in centres at the Wesley, Greenslopes or Mater Hospitals in an outpatient setting.

In cases where by sun-damage is thin (superficial) we may elect to use PDT, rather than radiation therapy.

Read more about PDT for Skin Cancers