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Radiotherapy may be used for those unfit for surgery because of another medical condition or for those with a skin cancer in an awkward place for surgery (for example close to the eyes). Radiotherapy uses radiation to kill cancer cells. It is given using a machine called a linear accelerator that carefully targets high-energy rays at the cancer cells.
It can also be used after surgery, to try to make sure any remaining cancer cells are killed. Radiotherapy is also used to relieve symptoms when SCC has spread to other parts of the body. Radiotherapy is rarely used to treat BCCs.
Melanoma does not respond to radiotherapy in a predictable way. For this reason it is rarely used for treating primary melanoma, but is very occasionally used when surgery is not suitable.
It is used to treat the pre-cancerous condition lentigo maligna (also called in situ lentigo maligna melanoma). It is also used to treat secondary tumours, including brain tumours.
Your treatment will be carefully planned with you. You may need one or more visits to the Radiotherapy Department to complete the preparation work in readiness for treatment. Your treatment may require that a metal shield is made, which allows the X-rays to reach only the cancer cells, while protecting the surrounding normal skin.
Your treatment team will also decide how much radiation you need, and whether you should have it all in one go or in several doses – called fractions – over a longer period. For many patients, several short daily visits will be needed. How many depends on the type, size and position of the tumour.
You will have to lie on the couch underneath the X-ray machine. Each treatment dose will only take a few minutes, and it is painless. The radiographer will tell you when it is important to keep very still.
You will be alone in the room while the treatment is given, but the radiographer will monitor you the whole time using closed circuit television.
The treatment can leave the skin feeling sore and red for several weeks. Occasionally a scab develops over the treated area, and for a while the skin may look worse than before treatment. You will be given advice on how to care for the tender skin. As it heals, the treated area will look pink, but gradually over the next few months this will fade. Sometimes the treated area of skin may be left looking paler than the skin around it.
Hair is likely to be lost in the treated area, but it may grow back over a period of 6-12 months. Sweat glands in the treated area may be affected too.
You will be able to talk about the possible side-effects of your treatment with your doctor.
We have more information about radiotherapy here.