Let’s Start With After Care
Care for your skin, its delicate! After radiation therapy, the effects of the radiation do not immediately disappear from your skin, and, in fact, the radiation continues to have effects on your body for weeks to months. The side effects you experience in the weeks after treatment are typically mild, including erythema , dryness, tenderness, or itchiness in the treated area.
Intensity Modulated Radiation Therapy
Intensity modulated radiation therapy is a highly targeted form of treatment that helps doctors avoid surrounding healthy tissue. Its used to treat cancerous lymph nodes in people who arent candidates for surgery or in areas where lymph nodes were removed after surgery.
The radiation is delivered from different directions and is broken into many small, computer-controlled beams of different adjustable strengths. Together, these minibeams are sculpted in three dimensions to conform to the size, shape, and location of the area of tissue being targeted.
Why Does Radiation Therapy Cause Skin Reactions
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If you notice changes to your skin during or after radiation therapy, you are not alone. Skin irritation, such as redness or sensitivity, in the treated area, is one of the common side effects of radiation therapy. Your skin may also become dry, itchy or moist. These and other changes may be uncomfortable and upsetting. But advances in radiation oncology have produced technologies designed to help reduce the side effects of radiation therapy. And knowing what to expect before your radiation therapy may help reduce some of the discomfort the treatment may cause.
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What Is The Best Treatment For Breast Cancer
One common and effective treatment for breast cancer is radiation therapy . However, it does have some side effects. A doctor may recommend radiation therapy in combination with other treatments, such as surgery and chemotherapy. There are two main types of radiation treatment: External beam radiation: This involves a doctor applying radiation
Caring For Yourself During Treatment
- Get plenty of rest during treatment.
- Follow your doctors 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 theyre safe to use during radiation therapy.
- Eat a balanced diet. If food tastes funny or youre having trouble eating, tell your doctor of dietician. They may be able to help you change the way you eat.
- 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. Dont be afraid to ask friends, family, support groups and your radiation oncology team for help.
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Why People With Cancer Receive Radiation Therapy
Radiation therapy is used to treat cancer and ease cancer symptoms.
When used to treat cancer, radiation therapy can cure cancer, prevent it from returning, or stop or slow its growth.
When treatments are used to ease symptoms, they are known as palliative treatments. External beam radiation may shrink tumors to treat pain and other problems caused by the tumor, such as trouble breathing or loss of bowel and bladder control. Pain from cancer that has spread to the bone can be treated with systemic radiation therapy drugs called radiopharmaceuticals.
Does Radiation Cause Pain In The Shoulder Area
Pain: Some people experience mild discomfort or pain around the breast, or stiffness in the shoulder area. Over time, treatments should become less uncomfortable. Skin changes: Skin damage is a common side effect of radiation therapy, and having a good skin care routine is essential during treatment.
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What Else Do I Need To Know About Radiation Therapy Treatment Appointments
During your treatment period, your radiation oncologist will check how well radiation therapy is working. Typically, this will happen at least once a week. If needed, they may adjust your treatment plan.
While being treated, many people experience fatigue and sensitive skin at the site of radiation therapy. You may also experience emotional distress during radiation therapy. It is important to rest and take care of yourself during radiation therapy. Consider these ways to take care of yourself:
External Beam Radiation Therapy
External beam radiation therapy may be used to treat skin cancer itself or to relieve pain from cancer that has spread.
- Radiation oncologists deliver external beam radiation therapy to the cancer from a machine outside your body.
- Skin cancer is often treated with superficial forms of radiation. That means the radiation only penetrates only a short distance below the surface.
- Doctors target the radiation beams at your tumor, giving more radiation to the skin cancer while keeping it away from underlying organs.
- Treatments are usually scheduled every day, Monday through Friday, for several weeks to accurately deliver radiation to the cancer.
- Treatments are painless and take less than half an hour each, start to finish.
- Your treatment schedule will depend on your cancer, but it usually requires daily treatments for one or more weeks.
- Radiation therapy is often given in addition to surgery, chemotherapy or biologic therapy.
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What Tests Can Be Done To Detect Cancer
If symptoms, exams, or tests suggest a possible recurrence of your cancer, imaging tests such as an x-ray, CT scan, PET scan, MRI scan, bone scan, and/or a biopsy may be done. If the cancer recurrence is confirmed, your doctor may also look for circulating tumor cells in the blood, or measure levels of blood tumor markers such as CA-15-3, CA 27-29, or CEA. The blood levels of tumor markers go up in some women if their cancer recurs or has spread to other parts of the body. If a tumor marker level is high, your doctor might use it to monitor the results of treatment. But tumor marker levels dont go up in all women, so these tests arent always helpful, and they arent used to watch for cancer recurrence in women without any symptoms.
How Does Radiation Affect Skin Recovery
Doctors use high-energy radiation to shrink or kill cancer cells. Radiation is often part of the treatment plan for many types of cancer, including lung, breast, prostate, and lymphoma. It is usually administered from a machine outside the body via radiation beams or x-rays.
When radiation passes through the skin, the healthy cells in the treated area may be damaged. Though the skin is good at repairing itself, multiple radiation treatments given over weeks or months may challenge that repair cycle. The skin may not have the time it needs to recover, resulting in a variety of symptoms.
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The Sero Approach To Treating Skin Cancer With Radiation
As radiation oncologists, we coordinate with the physicist and treatment planning team to personalize the therapy to cover the exact depth and perimeter of the skin cancer with a very small border of normal skin. This will effectively eradicate the cancer while disturbing as little normal tissue as possible. Generally, photos are taken before, during and after the treatment for documentation and to aid in follow-up.
SERO has a long history of treating skin cancers given the high rate of skin cancer in the Carolinas and our greater than 30-year history of serving this region. Challenging and difficult cases are frequently presented in tumor board forums with many cancer specialists present to aid in acquiring the most current information available. Second opinions and multidisciplinary panels are so vitally important yet easy to obtain for all challenging skin cancer cases.
Cancer Types And Ionizing Radiation
Ionizing radiation can cause cancer in whichever part of the body is exposed to it, but some cancer types seem more common than others. They include leukemia and cancers of the bone marrow, as well as thyroid cancer. Other cancers associated with exposure include lung cancer, skin cancer, breast cancer and stomach cancer. For instance, some studies have shown that women with Hodgkins lymphoma who are treated with chest radiation are at higher risk of developing breast cancer when they are older.
You can read more about secondary cancers caused by cancer treatment at the American Cancer Society.
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Cataracts And Other Eye Damage
Cataracts are a form of eye damage in which a loss of transparency in the lens of the eye clouds vision. If left untreated, cataracts can lead to blindness. Research has shown that UV radiation increases the likelihood of certain cataracts. Although curable with modern eye surgery, cataracts diminish the eyesight of millions of Americans and cost billions of dollars in medical care each year.
Other kinds of eye damage include pterygium , skin cancer around the eyes, and degeneration of the macula . All of these problems can be lessened with proper eye protection. Look for sunglasses, glasses or contact lenses if you wear them, that offer 99 to 100 percent UV protection.
When Is Radiation Therapy Used As Adjuvant Treatment
Adjuvant therapy is an additional cancer treatment that is given after the primary treatment. Adjuvant therapy lowers the risk that the cancer comes back. Primary treatment for skin cancer is often surgery, with radiation therapy as an adjuvant therapy. Radiation kills cancer cells left after the skin cancer was removed.2 This is recommended for:
- BCC, SCC, or melanoma that grew into a nerve.6,8,9
- Non-melanoma skin cancer when cancer cells are found on the edges of the sample despite Mohs surgery.
- Deep desmoplastic melanoma, a type of melanoma that is likely to recur.6
- Melanoma that recurs.6
Adjuvant radiation therapy is also recommend after lymph node removal.4,6 Without radiation therapy, about 40% of high-risk individuals have recurrent melanoma in the remaining lymph nodes.10 With adjuvant radiation therapy, about 10% of people have lymph node cancer recurrence.10
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Who Is Not A Candidate For Radiation Therapy
Some genetic conditions increase the risk of skin cancer. Examples include basal cell nevus syndrome or xeroderma pigmentosum. Radiation therapy is not used to treat people with these conditions.
Radiation therapy can cause long-term side effects. One of the long-term risks is future skin cancer in the treatment area. For this reason, doctors may be reluctant to treat people younger than 60 with radiation.8
Living As A Basal Or Squamous Cell Skin Cancer Survivor
For most people with basal or squamous cell skin cancers, treatment will remove or destroy the cancer. Completing treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer growing or coming back. This is very common if youve had cancer.
For a small number of people with more advanced skin cancers, the cancer may never go away completely. These people may get regular treatment with radiation therapy, chemotherapy, or other treatments to help keep the cancer in check for as long as possible. Learning to live with cancer that does not go away can be difficult and very stressful.
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How You Have It
You have radiotherapy treatment in the hospital radiotherapy department. The number of treatments you have depends on the type of skin cancer you have, where it is and how big it is.
You usually have radiotherapy once a day, from Monday to Friday, over a number of weeks. You have a rest at the weekend. The length of treatment varies from one to about 6 weeks.
Older and frail people may have their radiotherapy treatment less often. So they dont need to attend the radiotherapy department daily. Some treatment plans might be once a week or 2 to 3 times a week.
Some people might have a single treatment of radiotherapy.
Your doctor will tell you what treatment plan is best for you.
Radiation For Metastatic Melanoma
Radiation can also help people with melanoma that has spread to other areas of the body. For example, when melanoma spreads to the brain, one option may be stereotactic radiosurgery. This procedure allows doctors to deliver a single high dose of radiation directly to a tumor. It can eliminate the tumor with few side effects.
IMRT can be combined with image-guidance technology. This approach is called IG-IMRT. It allows for a precise delivery thats more effective than other forms of radiation therapy at controlling melanoma. Some metastatic tumors can be eliminated when high doses of radiation are used with stereotactic techniques, also known as SBRT.
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Having Radiotherapy For Skin Cancer
Radiotherapy uses x-rays to destroy the cancer cells, while doing as little harm as possible to normal cells.
It is sometimes used instead of surgery to treat basal cell carcinoma and squamous cell carcinoma of the skin. You usually have external beam radiotherapy for skin cancer. Occasionally, a type of internal radiotherapy called brachytherapy might be used.
Radiotherapy is particularly useful if surgery might be too difficult or affect your appearance. For example, it may be used for skin cancer that:
- affect parts of the face, such as the nose
- affect large areas
- are deep in the skin.
Radiotherapy is not recommended for young people with skin cancer. This is because it can cause skin changes that may become more noticeable over time.
Radiotherapy is occasionally used when a non-melanoma skin cancer has spread to other places. This can include lymph nodes or an organ such as, the lungs. Sometimes it may be given after surgery if there is a risk that not all the cancer cells have been removed.
You have radiotherapy in the hospital outpatient department. Depending on the type and size of skin cancer, you may only have 1 treatment session. But usually several sessions are needed. You may have radiotherapy each day, 5 days of the week, for 1 or more weeks. Your doctor will discuss your treatment plan with you.
If you are having brachytherapy your doctor will explain more about it.
If The Cancer Comes Back
If your cancer does come back at some point, your treatment options will depend on where the cancer is and what treatments youve had before. If the cancer comes back just on the skin, options might include surgery, radiation therapy, or other types of local treatments. If the cancer comes back in another part of the body, other treatments such as targeted therapy, immunotherapy, or chemotherapy might be needed. For more general information on dealing with a recurrence, see our Recurrence section.
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What Are The Risks Of Radiation Therapy
The electrons used for external-beam radiation therapy for skin cancer do not go deeper than the skin.1,2 This limits the side effects of radiation therapy.2 Nevertheless, there are many possible side effects of radiation. They include:2,4,6
- Skin irritation or sunburn-like reaction
- Changes in skin color
Brain radiation therapy can cause problems such as memory loss, headaches, trouble thinking, and reduced sexual desire.4
Personal Or Family History Of Skin Cancer
Individuals who have been diagnosed with melanoma are at increased risk for a second primary melanoma. That risk may be as high as 5% and is higher in older men and in those whose first melanoma was on the upper body and face.
People with family members who have or had melanoma have approximately twice the risk of developing melanoma as those without a family history, and should be examined on a regular basis.
Nonmelanoma Skin Cancers
The evidence for an increased risk of nonmelanoma skin cancers with a family history of such cancers is increasing, but it is still weaker than the evidence for a familial connection to the risk of melanoma. The nonmelanoma skin cancers at this time are more related to sun exposure than genetics.
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What Are The Common Side Effects Of Radiation Therapy
Radiation therapy is called a local treatment. This means that it only affects the specific area of the body that is targeted. For example, radiation therapy to the scalp may cause hair loss. But people who have radiation therapy to other parts of their body do not usually lose the hair on their head.
Common physical side effects of radiation therapy include:
Skin changes. Some people who receive radiation therapy experience dryness, itching, blistering, or peeling on the skin in the area being treated. Skin changes from radiation therapy usually go away a few weeks after treatment ends. If skin damage becomes a serious problem, your doctor may change your treatment plan. Lotion may help with skin changes, but be sure to check with your health care team about which cream they recommend and when to apply it. It is also best to protect affected skin from the sun. Learn more about skin-related treatment side effects.
Fatigue. Fatigue is a term used to describe feeling physical, emotional, and mental exhaustion even if you are getting enough rest and sleep. Many patients experience fatigue. Your level of fatigue may increase if you are receiving more than 1 type of treatment, such as radiation therapy combined with chemotherapy. Learn how to cope with fatigue.
How Do I Know That The Radiation Worked
A carefully prescribed dose, based on clinical trials and years of research was used to determine the amount of radiation you needed to eliminate the type of skin cancer you had. Your dermatologist will not re-biopsy the site because it isnt necessary. The skin will be monitored as you come back for future skin examinations.
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