Radiation therapy for nonmelanoma skin cancer

Radiation therapy involves the use of X-rays to destroy cancer cells. This procedure requires 15 to 30 visits to a facility for treatment with special X-ray equipment. The skin cancer is destroyed gradually. Radiation therapy may be used in combination with other types of therapy to treat aggressive or recurrent skin cancer.

Recovery time may vary depending on the site treated and the amount of radiation used.

Radiation therapy is not commonly used to treat skin cancer. It may be used:

• If you cannot undergo other procedures because of your age or other health problems.
• For skin cancers that are too large or deep to be treated with surgery or with surgery alone.
• For skin cancers in places that are difficult to treat with surgery, such as the eyelid, ear, or nose.
• For skin cancers that have returned after surgery (recurrent).
• To relieve symptoms but not to cure the skin cancer (palliative treatment).

Treatment with radiation therapy for skin cancer is usually reserved for people who cannot—or choose not to—have other treatments, such as excision or curettage and electrosurgery. Small studies found that recurrence rates decrease (from over 50% to between 20% and 25%) when radiation therapy is used after excision surgery to treat incompletely removed squamous cell carcinoma.¹

Risks of radiation therapy to treat skin cancer include the following:

• New skin cancers may develop in the surrounding area.
• Skin cancers may recur after radiation therapy and be harder to treat successfully.
• Skin may become dry and hairless, lose color, and become easily infected (chronic radiation dermatitis).
• Skin may shrink and waste away (skin atrophy).
• Healthy skin may be destroyed by radiation (cutaneous necrosis).

Side effects are common but generally go away when treatment is finished. They include:

• Fatigue.
• Redness and itching of the skin in the radiation field.
• Hair loss in the area inside the radiation field.
• Nausea, vomiting, or diarrhea if the abdomen or pelvis are radiated.

Radiation therapy is not commonly used to treat skin cancer.

Radiation therapy may be considered when:

• The skin cancer is very large.
• You cannot have surgery.

Radiation therapy is most often reserved for use in older adults. It may lead to the development of other skin cancers in younger people as they age.

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Citations

1. Green A, Marks R (2005). Squamous cell carcinoma of the skin (nonmetastatic). Clinical Evidence (14): 2086–2091.