Radiation Therapy

Radiation therapy may be used to treat all types of skin cancers--basal and squamous cell, and melanoma.

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Radiation therapy uses high-energy photons (X-rays) to destroy tissue. It targets the tumor site as well as a surrounding margin of skin. Shields are custom made for each patient to protect as much of the nontargeted tissue as possible. The therapy is spread over several visits per week for many weeks.

Radiation therapy can be adjusted to be superficial or deeply penetrating, which means it can treat a variety of tumors. Properly performed, radiation therapy can achieve high cure rates with little or no scarring. Patients who have multiple lesions in one region of skin may have radiation therapy instead of surgery. It is an excellent alternative when surgery would be too deforming or risky for the patient. Radiation therapy may also be used after surgery for patients who have residual cancer in the tissue. Radiation therapy may be combined with chemotherapy, in chemoradiation, for advanced tumors.

For very high-risk skin cancers, which are those that have spread to lymph nodes or nerves, radiation therapy may be used after surgery to increase the chance for cure. While the skin is healing, weeping wounds, blisters, pain, and burnlike reactions may occur and require intense wound care. In the longer term, radiated skin is thinner, smoother, fibrotic (scarlike), and lighter in color than normal skin. It is also hairless and has difficulty healing if injured. Irradiated skin is also particularly susceptible to infection. Many patients feel tired during radiation treatment but are still able to work and enjoy their normal activities.

Rare complications may include necrosis of bone. The risk of secondary cancers induced by radiation is very low, and these cancers usually do not occur until 20 years or more after radiation. Because of that possibility, radiation is not the first choice to treat skin cancers in younger patients.