The process of informed consent involves patients receiving written information to help them to make a decision about treatment.
This page is a written version of the information the oncology doctor has told you about radiotherapy for skin cancer. It includes sections on the most commonly asked questions, about the treatment procedure and the side effects, which may occur with this sort of treatment. We hope it will help you in making your decision about radiotherapy treatment.
The page is only a short summary. Throughout the process the doctors, radiographers and nurses will be there to explain what will happen in more detail and to answer any questions you may have.
If you need further advice please do not hesitate to ask. The bottom of this page has further suggestions of where you may wish to go for help.
What is Radiotherapy?
- Radiotherapy is the use of high energy x-rays to treat cancer. The x-rays are produced by a machine called a linear accelerator and are able to damage and destroy cancer cells within the treatment area.
- Radiotherapy also affects normal cells in the area being treated, but they are generally more able to recover than cancer cells.
- Treatment is usually given regularly over a period of time to have the greatest effect on the cancer cells whilst limiting the damage to normal cells.
When is it used?
Radiotherapy is mainly used to treat skin cancer
- After surgery, to make sure that no cells have been left behind.
- Instead of surgery where the cancer is difficult to remove.
How is it given?
Radiotherapy is normally given in daily sessions - Monday to Friday as an outpatient and weekends off. The length of your treatment schedule will be discussed with you by your oncology doctor.
Radiotherapy should be given as a continuous daily treatment and therefore appointments ideally should not be missed. If you are too unwell or have an emergency and unable to attend your appointment, you should inform the radiographers as soon as possible.
If any scheduled ‘breaks’ are required during your treatment, such as Bank Holidays etc. you will be informed prior to starting your treatment.
Is there any preparation for the procedure?
When you attend for your planning session, no specific preparation is required of you, i.e. you can eat and drink as usual.
Planning your treatment
The aim of treatment is to treat the tumour, or tumour bed (where the tumour was before surgery), and the immediate area surrounding it. At the same time healthy tissue needs to be spared as much as possible.
Once the doctor has decided on the area and shape for treatment, it is marked with a special pen. These marks enable an accurate and consistent treatment each day, and it is important that you retain them. Photographs may also be taken as they are useful for future reference.
What does the treatment involve?
It takes approximately 10 minutes to position and treat you. The radiation beam is switched on for about 3 - 5 minutes in total.
The treatment is given using either a superficial x-ray machine or a bigger machine called a linear accelerator, which uses electrons although this is still a very superficial treatment.
You will lie on a treatment couch and the radiographers will carefully position you using marks that have been put on your skin. When you are in the correct position you will be asked to stay very still and breathe normally.
Although you will need to be in the room on your own whilst the radiation beam is on, the treatment team will be monitoring you on closed circuit television.
Will I be radioactive?
No. As soon as the radiation beam is completed all the radiation disappears. Once the treatment is finished you will be free to go home. It will be perfectly safe to be with other people including children.
Will the procedure be painful?
The treatment itself is totally painless. There is nothing to see or feel - you will hear the machine buzzing.
The treatment couch is quite firm to ensure accuracy but you will be made as comfortable as possible in the treatment position.
What side effects can I expect?
The effect of radiotherapy is dependent on the dose that is prescribed, the length and area of your treatment as well as whether you are having any chemotherapy. If you are, then this may have additional effects.
For most patients, side effects usually settle after a few weeks or months but it is possible that some side effects may be permanent and require further medical intervention.
The review radiographer team will be able to advise you on how to ensure side effects are kept to a minimum and any self-help measures. If necessary there are various medications that can be prescribed to help, so it is important to let staff know if you develop any problems.
For the majority of patients, some level of tiredness can be experienced. It is important to keep hydrated and ensure that you rest as and when necessary.
Short term side effects
The skin in the treatment area may become red, sore, or blistered; it may weep or even bleed. The area may later form a scab. The scab will eventually lift and fall off after some weeks, leaving a healed area underneath. The radiographers will monitor your skin reactions and advise you on skin care during your treatment. It is important to let them know if you develop any problems.
Long term side effects
The skin that has been treated usually becomes thinner and ‘papery’, and may show small visible blood vessels. The treated skin is often more fragile and therefore can be more easily damaged.
If you have further questions
If you are at all concerned about the treatment, what it involves and what it means for you, do not hesitate to ask at any time. You will find a number of contact names and numbers at the bottom of this page.
Further advice about your treatment
For advice or further information you can visit the Macmillan Information Centre located in the Centre for Oncology (Ground Floor). Opening times: Mon-Fri 9.00am to 4.00pm - No appointment Necessary or telephone 01604 544211
British Skin Foundation
Provides support, guidance and treatment advice http://www.melanomauk.org.uk or telephone 0808 171 2455.
Northampton General Hospital operates a smoke-free policy. This means that smoking is not allowed anywhere on the Trust site, this includes all buildings, grounds and car parks.
Leaflets, information, advice and support on giving up smoking and on nicotine replacement therapy are available from the local Stop Smoking helpline on 0845 6013116, the free national helpline on 0300 123 1044, email: email@example.com and pharmacies.
Car parking at Northampton General Hospital is extremely limited and it is essential to arrive early, allowing ample time for parking. You may find it more convenient to be dropped off and collected.
This information can be provided in other languages and formats upon request including Braille, audio cassette and CD. Please contact (01604) 544516 or the Patient Advice & Liaison Service (PALS) on (01604) 545784, email: firstname.lastname@example.org.
This information was taken from Northampton General Hospital leaflet PC141 (Feb 2018).