Radiation therapy for non-melanoma skin cancer

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is sometimes used to treat non-melanoma skin cancer. Your healthcare team will consider your personal needs to plan the amount of radiation and when and how it is given. You may also 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 of the cancer coming back, or recurring (called adjuvant therapy)
  • relieve pain or control the symptoms of advanced non-melanoma skin cancer (called palliative therapy)

External beam radiation therapy is the type of radiation used to treat non-melanoma skin cancer.

External beam radiation therapy

During external beam radiation therapy, a machine directs radiation to the cancer and some of the tissue around it.

External beam radiation therapy is most often used instead of surgery to treat high-risk cancers. It is used when surgery can’t be done or when the area of skin is hard to treat with surgery. Some areas that may be treated with external beam radiation therapy are the skin around the eye, eyelid, ear and tip of the nose.

Sometimes external beam radiation therapy is used along with other treatments. It may be used after surgery when the cancer has grown into or around many nerves (called perineural invasion), was not completely removed by surgery (called incomplete excision) or has spread to nearby lymph nodes. It may also be used as a palliative therapy to help relieve or control symptoms of non-melanoma skin cancer that has grown into nearby areas (locally advanced) or non-melanoma skin cancer that has spread (metastatic).

Radiation therapy is usually given daily for several weeks. The dose of radiation and length of treatment depend on several factors, such as size of the tumour, if how the skin looks is important and your overall health.

Side effects

Side effects can happen with any type of treatment for non-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. Side effects 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 total dose of radiation and how long the radiation therapy is given. Some common side effects of radiation therapy used for non-melanoma skin cancer are:

  • skin problems, such as red and irritated skin
  • swelling (edema)
  • long-term red, irritated and sore skin (chronic dermatitis) if a large area of skin is treated

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.

Questions to ask about radiation therapy

Find out more about radiation therapy and side effects of radiation therapy. To make the decisions that are right for you, ask your healthcare team questions about radiation therapy.

Expert review and references

  • American Society of Clinical Oncology. Skin Cancer (Non-Melanoma). 2015: http://www.cancer.net/cancer-types/skin-cancer-non-melanoma.
  • Christensen SR, Leffell DJ . Cancer of the skin. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 92:1314-1336.
  • National Cancer Institute. Skin Cancer Treatment for Health Professionals (PDQ®). 2015: http://www.cancer.gov/types/skin/hp/skin-treatment-pdq.
  • National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Basal Cell Skin Cancer (Version 1.2015). 2015.
  • National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Squamous Cell Skin Cancer (Version 1.2015). 2015.
  • Sapijaszko M, Zloty D, Bourcier M, Poulin Y, Janiszewski P, Ashkenas J . Non-melanoma skin cancer in Canada chapter 5: management of squamous cell carcinoma. Journal of Cutaneous Medicine and Surgery. 2015.
  • Zloty D, Guenther LC, Sapijaszko M et al . Non-melanoma skin cancer in Canada chapter 4: management of basal cell carcinoma. Journal of Cutaneous Medicine and Surgery. 2015.