Radiation therapy for melanoma skin cancer
Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is sometimes used to treat melanoma skin cancer. Your healthcare team will consider your personal needs to plan the type and amount of radiation, and when and how it is given. You will probably receive other treatments.
Radiation therapy is given for different reasons. You may have radiation therapy to:
- destroy the cancer cells
- destroy cancer cells left behind after surgery to reduce the risk that the cancer will come back (recur) (called adjuvant therapy)
- relieve pain or control symptoms of metastatic melanoma skin cancer (called palliative therapy)
External beam radiation therapy is the type of radiation used to treat melanoma skin cancer.
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During external beam radiation therapy, a machine directs radiation to the cancer and some of the tissue around it.
External beam radiation therapy may be used after surgery to lower the risk of the cancer coming back in the same area where it was removed (locally recurrent). It is mainly used for certain cases of early stage or locoregional melanoma skin cancer if:
- cancer cells are still in the surgical margin around the tumour but more surgery is not possible
- it is desmoplastic melanoma
- the tumour is more than 4 mm thick, especially when there is ulceration
- the melanoma skin cancer is on the head or neck, especially when it is mucosal melanoma
External beam radiation therapy may also be used for melanoma skin cancer that has spread to other parts of the body (metastatic melanoma skin cancer). It is mainly used as palliative therapy to control symptoms from widespread metastases. External beam radiation therapy can be given to the bone, brain, lung, liver or pelvis.
A special type of external beam radiation therapy called stereotactic radiation therapy may be used when there are only a few brain metastases. It delivers a high dose of radiation to very specific areas of the brain with only a few radiation treatments.
External beam radiation therapy is usually given once a day for several weeks. How long treatment is used depends on many factors such as the size and location of the cancer, the dose of radiation and your overall health.
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Side effects can happen with any type of treatment for melanoma skin cancer, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.
During radiation therapy, the healthcare team protects healthy cells in the treatment area as much as possible. But damage to healthy cells can happen and may cause side effects. If you develop side effects, they can happen any time during, immediately after or a few days or weeks after radiation therapy. Sometimes late side effects develop months or years after radiation therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.
Side effects of radiation therapy will depend mainly on the size of the area being treated, the specific area or organs being treated, the total dose of radiation and the treatment schedule. Some common side effects of radiation therapy for melanoma skin cancer are:
- skin problems, such as redness and irritation
- hair loss in the area being treated
- sore mouth and throat, if radiation is aimed at the head or neck
- lymphedema, if radiation is aimed under the arm or at the groin
Tell your healthcare team if you have these side effects or others you think might be from radiation therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.
American Cancer Society. Melanoma Skin Cancer. 2015: http://www.cancer.org/cancer/skincancer-melanoma/.
American Society of Clinical Oncology. Melanoma. 2015: http://www.cancer.net/cancer-types/melanoma/view-all.
Cancer Care Nova Scotia. Guidelines for the Management of Malignant Melanoma. 2013: http://www.cancercare.ns.ca/site-cc/media/cancercare/2014Management%20of%20Malignant%20Melanoma.pdf.
Cancer Care Ontario. Evidence-Based Series Guideline 8-9 (Summary): The Use of Adjuvant Radiation Therapy for Curatively Resected Cutaneous Melanoma. 2016: https://www.cancercare.on.ca/common/pages/UserFile.aspx?fileId=351575.
National Cancer Institute. Melanoma Treatment for Health Professionals (PDQ®). 2016: http://www.cancer.gov/types/skin/hp/melanoma-treatment-pdq.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Melanoma (Version 2.2016). 2016.
Princess Margaret Cancer Centre. Princess Margaret Cancer Centre Clinical Practice Guidelines: Melanoma. 2015: http://www.uhn.ca/PrincessMargaret/Health_Professionals/Programs_Departments/Melanoma_Skin_Oncology/Pages/clinical_practice_guidelines.aspx.
Ribas A, Slingluff Cl Jr, Rosenberg SA . Cutaneous melanoma. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 94:1346-1394.