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What do you need to know?

Having radiotherapy for skin cancer

When you first attend the Spire Oncology Centre, a therapy radiographer will explain the treatment process and will discuss any possible side effects and their management during and after radiotherapy.

Your first appointment at the Spire Specialist Care Centre will be for a CT scan to aid the planning of your radiotherapy treatment. The therapy radiographers may give you some small permanent skin marks called tattoos that allow your position to be replicated for treatment daily.

Alternatively, if you are having a more superficial skin treatment using electrons your Oncologist may mark the area for treatment directly onto your skin using pen marks.

Following this, your next appointment will be for your first radiotherapy treatment. The subsequent number of treatments will have been defined by your Oncologist as indicated on your appointment list.

You may have been given a gown to wear for your treatment sessions, it is your choice to wear this , please inform the therapy radiographers if you do not wish to wear one.

The therapy radiographers will ask you to lie on the couch in the position you were at the CT planning appointment. They will use your skin marks to accurately align you for treatment. When you are in the correct position the radiographers will inform you that they are leaving the room, and you will be asked to remain as still as possible and breathe normally.

The therapy radiographers will be observing you from outside of the treatment room via a video link and can speak to you via an intercom system.

The radiotherapy machine will not touch you and there is nothing to feel or see whilst the radiotherapy treatment is taking place. The average treatment appointment time takes approximately 20-30 minutes. Most of this time is taken to get you set up in the correct position for your treatment and the actual treatment beam that is delivered is usually very quick.

Preparing for treatment

Planning appointment

Your first appointment at the centre will be for a CT scan to aid the planning of your radiotherapy treatment. 

When you arrive at the centre a therapy radiographer will explain to you the procedure required for the preparation needed for the CT scan. The therapy radiographer will be able to answer any questions and address any concerns you may have. There may be some preparation that is required prior to the CT scan to ensure that your treatment can be effectively planned and tattoos or skin marks will be applied to aid with setup as described above. The therapy radiographer will also indicate if you require a treatment shell or immobilisation cast to be made (this is dependent on area of the body where the skin is being treated).

Short-term side effects

Radiotherapy to the skin is often associated with minimal side effects when compared to treating other areas of the body. The side effects explained below are some of the common side effects experienced by patients. It is also important to remember that each patient is individual and so too are the side effects that a patient may or may not experience.

Radiotherapy may cause a change to your skin in the treatment area (e.g. reddening/soreness of the skin). This normally occurs 10-12 days after starting the radiotherapy treatment. Everyone is different in how they react to the radiotherapy treatment and varies from person to person.

Long-term side effects

Some people find that the side effects from the radiotherapy subside quite quickly after the treatment course has finished, for most this occurs from 3-6 weeks after radiotherapy. The skin within the treatment area may become a shade or two darker than your normal shade. This may in time lighten again.

Skin care during and after treatment

The effects of radiotherapy will still be ongoing after the radiotherapy has finished. These side effects may continue between 2-4 weeks post radiotherapy. 

It is recommended that you continue with the skin care during this time after radiotherapy. The radiotherapy team will still be available to give advice or medication/creams/lotions or dressings after you have finished the radiotherapy treatment.

Washing

You are advised to bath or shower as normal during your radiotherapy course. Avoid very hot or cold water in the treatment area and use a mild unperfumed soap such as a ‘baby’ soap to avoid irritating the skin. If you wouldprefer to use your own product the therapy radiographers would be happy to advise you.

When drying your skin pat it gently with a soft towel to avoid friction. We will supply you with a mild unperfumed moisturising which will help keep your skin elastic and hydrated.

This will not prevent the skin reaction occurring but it can make you more comfortable during your treatment. The skin reaction commonly caused by radiotherapy is called erythema; this can be noticed as a pink/reddening/discolouration of the skin. Sometimes it can feel dry and itchy and in some cases the skin may peel and break.

Your skin will be monitored daily by your team of radiographers; they will advise you regarding creams and dressings you may need over the course of treatment. This treatment reaction begins to resolve a week or two after the treatment is over. If you have radiotherapy to a part of the body which has hair, you will have some hair loss. The hair will start to grow back some time after treatment has finished but the regrowth may be patchy.

Clothing

It may be more comfortable to wear loose clothing made of natural fibres around the treatment area. Some people find that the ink marks put on the skin can rub off on to clothing. These should wash off but it may be advisable to wear older clothes for your treatment.

Sun exposure

Your skin in the treatment area will always be more sensitive to the sun even after the radiotherapy treatment has finished.

It is best to avoid direct sun exposure to the treatment area whilst you are undergoing radiotherapy. Please do not put any sun protection creams on your skin whilst having treatment and for a couple of weeks after the radiotherapy has finished, until your treatment reaction has settled down. 

In the future, it is recommended to cover the area of treatment that may be exposed to the sun or use a sun block SPF 50.

Other considerations during your radiotherapy treatment

Smoking

If you are a smoker your skin reaction can often be more severe and prolonged. We can help support you in trying to stop. 

Fatigue

Some people can experience tiredness during their course of radiotherapy. Some people manage to continue working whilst they are having radiotherapy whilst others find they are too tired. It is best to listen to your body and do as much as you feel capable, resting when necessary. 

Light exercise can help with energy levels. It is advisable to drink plenty of fluids as this can help combat tiredness, 2 litres of water (3-4 Pints) is recommended for your daily intake, try to consume caffeinated drinks in moderation as these can dehydrate you. Your radiotherapy team will be able to advise you of ways to help manage tiredness if this becomes an issue for you.

Eating well

It is recommended that you follow a balanced healthy diet during treatment. We will advise you if you need to change your diet during radiotherapy. Drinking plenty of fluids is also advised.

Emotional effects

A cancer diagnosis can bring with it many feelings of fear, anxiety, low mood and depression.

We understand that going through diagnosis and cancer treatment can be both difficult for you and your friends and family. At the Spire Specialist Care Centre we are here to provide a supportive environment. Please mention to the therapy radiographers if you feel you need some emotional support.