The skin is the body’s largest organ. Its job is to protect internal organs against damage, heat and infection. The skin is also the most exposed organ to sunlight and other forms of harmful ultraviolet rays.
According to the American Cancer Society, more than one million cases of basal and squamous cell skin cancers will be diagnosed in the United States this year. These cancers can usually be cured. In addition, 73,870 cases of melanoma will be diagnosed. Skin cancer is 10 times more common among Caucasians than African-Americans.
Basal cell carcinoma: The most common form of skin cancer, and is very curable. This cancer begins in the outer layer of skin (epidermis). Basal cell cancer rarely spreads to other parts of the body. Radiation therapy is very effective for treating basal cell cancers that have not spread elsewhere. Other common treatments include surgery, chemotherapy and cryosurgery.
Squamous cell carcinoma: The second most common type of skin cancer. This cancer also begins in the epidermis. Radiation therapy can be used to treat squamous cell cancers that start on the skin and sometimes nearby lymph nodes with or without surgery. Other common treatments include surgery, chemotherapy and cryotherapy.
Melanoma: The most serious skin cancer; it begins in skin cells called melanocytes that produce skin color (melanin). Radiation therapy is used mostly for melanomas that started in another part of the body (metastases). It is used to treat areas where doctors think the disease may spread, such as the lymph nodes. Melanoma is usually treated first with surgery and may be followed by chemotherapy, radiation therapy and biologic therapy.
Merkel cell carcinoma: A rare skin cancer that develops between the dermis and epidermis. This cancer often requires treatment with a combination of surgery, chemotherapy and radiation.
The treatment you receive depends on several factors, including your overall health, the stage of the disease and whether the cancer has spread to other parts of your body. Doctors may check to see if the cancer has spread to the lymph nodes in patients with some types of squamous cell cancer and melanoma. Treatments can be used on their own (radiation alone or surgery alone) or they can be combined.
- Radiation therapy: The radiation oncologist uses various forms of radiation to treat cancer and other diseases.
- Brachytherapy: A special form of radiation that places the radiation source very close to the tumor. This form of radiation tends to be shorter in duration than regular radiation therapy.
- Surgery: The cancer cells are cut out and removed.
- Moh’s surgery: A form of surgery where the tumor is removed one layer at a time. This technique may allow a dermatologist to preserve more healthy tissue.
- Cryosurgery: The cancer is frozen and removed.
- Laser surgery: Cancer cells are killed by laser beams.
- Electrodessication: The cancer is dried with an electric current and removed.
- Photodynamic therapy: The cancer is treated with a drug that is very sensitive to a special kind of light. When exposed to that special light, the drug produces a chemical reaction that kills nearby cells.
- Chemotherapy: The cancer cells are attacked by a drug that is either taken internally or applied on the skin.
- Biologic therapy: Medication given to help your immune system fight the cancer better.
Radiation therapy, also called radiotherapy, is the careful use of radiation to treat many different kinds of cancer including skin cancers. Radiation oncologists use radiation therapy to try to cure cancer, to control cancer growth or to relieve symptoms such as pain.
Radiation therapy works within cancer cells by damaging their ability to multiply. When these cells die, the body naturally eliminates them. Healthy cells that grow and divide quickly are also harmed by radiation, but they are able to repair themselves in a way that cancer cells cannot.
Most radiation is given with an external beam, but treatment can be given with a radioactive source close to the skin with a treatment called brachytherapy.
Brachytherapy is a form of radiation where the radiation source is placed very close to the skin cancer. This form of radiation can be applied to the tumor using metal applicators, a series of tubes, or a flap of beads that conforms to the skin (Freiburg flap). When high-dose-rate (HDR) treatments are given, treatments are usually scheduled two days per week instead of each day. Long-term studies following patients who have received brachytherapy show that this form of radiation is very effective in treating skin cancer and the vast majority continue to remain cancer free many years after treatment. In general, the cosmetic outcome with HDR brachytherapy is excellent and recovery time is minimal.
The side effects you might feel will depend on the part of your body being treated, the dose of radiation given and whether you also receive other treatments like chemotherapy. Before treatment begins, ask your doctor about possible side effects and how you can best manage them.
Talk to your doctor or nurse about any discomfort you feel. He or she may be able to provide medications or other treatments to help.
- Get plenty of rest during treatment.
- Follow your doctor’s orders. Ask if you are unsure about anything or if you have questions about your treatments and side effects.
- Tell your doctor about any medications or vitamins you are taking, to make sure if they’re safe to use during radiation therapy.
- Eat a balanced diet. If food tastes funny or you’re having trouble eating, tell your doctor or dietician. They will work with you to help you make changes in your diet.
- Keep very well hydrated by drinking eight, 8 oz, glasses of fluid daily. Gelatin, broth, sherbet, etc. are all considered to be part of your fluid intake.
- Treat the skin exposed to radiation with special care. Stay out of the sun, avoid hot or cold packs, and only use lotions and ointments after checking with your doctor or nurse. When cleaning the area, use only water and a mild soap.
- Battling cancer is tough. Don’t be afraid to ask friends, family, support groups and your radiation oncology team for help.
*Content provided by the American Society for Radiation Oncology, www.rtanswers.org, and the American Cancer Society.