Expert-Led Training on Skin Cancer Radiotherapy Options
Are you a healthcare professional looking to expand your knowledge of basal cell skin cancer treatment and squamous cell skin cancer treatment options? This comprehensive educational resource features Dr. James Wilson, a leading oncology skin cancer specialist, sharing his expertise on non-surgical approaches to skin cancer management.
Why Consider Radiotherapy for Skin Cancer Treatment?
Radiotherapy offers an effective alternative to surgery for many patients with non-melanoma skin cancers. This educational video provides detailed insights into:
- Characterising risk in basal cell carcinoma and squamous cell carcinoma
- When to recommend skin cancer radiotherapy over surgical options
- Different types of radiotherapy techniques and their applications
- Treatment scheduling and patient care protocols
- Managing side effects and follow-up care
Find the Right Skin Cancer Treatment for Your Patients
For GPs, dermatologists, dermatological surgeons, plastic surgeons, and other healthcare professionals who encounter patients with skin cancer, understanding all available treatment modalities is essential for providing optimal care.
Key Topics Covered in This Educational Resource
Basal Cell Skin Cancer Treatment Options
Learn how to spot risk factors for basal cell carcinoma and when radiotherapy for basal cell skin cancer works best. In this part, Dr. Wilson clearly explains:
- How to group different BCC types by risk
- How to set margins for nodular vs infiltrative BCCs
- Radiotherapy methods that work well for facial BCCs
- Real patient cases showing good cosmetic results
Squamous Cell Skin Cancer Treatment Approaches
Next, learn about the newest ways to use radiotherapy for squamous cell skin cancer treatment, including:
- High-risk features that need special care
- When to use radiotherapy as first treatment vs after surgery
- How to treat patients with weak immune systems
- How to follow up with patients based on their risk level
Advanced Radiotherapy Planning and Techniques
Also, learn in-depth about:
- X-ray radiotherapy
- When and how to use electron beam therapy
- How to use 3D-printed custom bolus for tricky body areas
- New methods like Rhenium-SCT topical brachytherapy
Real Patient Cases and Treatment Results
This resource includes detailed patient cases showing:
- Before and after pictures of treatments
- How to manage side effects
- Long-term cosmetic results
- What patients say about their treatment
Who Should Watch This Educational Resource?
This training is very useful for:
- GPs who treat skin cancer patients
- Skin doctors looking for non-surgical options
- Surgeons thinking about using multiple treatment types to improve treatment results
- Cancer specialists who focus on skin cancer
- Health workers who treat older or medically complex patients
Making Treatment Decisions Based on Evidence
Also, learn how to weigh these three key factors when choosing skin cancer treatment:
- Chance of cure: Understanding success rates for different treatments
- How it will look: Comparing radiotherapy vs surgical results for different body areas
- Patient comfort: Thinking about treatment length, visits needed, and healing time
Access This Essential Educational Resource Now
Watch our video to boost your knowledge of basal cell skin cancer treatment and squamous cell skin cancer treatment options. You’ll feel more confident discussing all options with your patients and making smart suggestions based on each person’s needs.
Keep Learning About Skin Cancer Management
Stay up-to-date on skin cancer care by knowing when skin cancer radiotherapy works better than surgery, especially for:
- Patients with weak immune systems who need extra treatment
- Older patients with other health issues
- Patients taking blood thinners
- Face lesions that would need complex rebuilding
- Hard-to-treat spots (eyelids, nose, ears)
This educational resource is provided for healthcare professionals to enhance clinical knowledge and improve patient care outcomes.
Jon’s Journey with Melanoma Treatment
Finding the right treatment for melanoma skin cancer can be challenging. Jon’s personal story shows how modern treatments like immunotherapy have changed lives. After his melanoma returned in a lymph node, Jon received nivolumab (Opdivo) for one year. His experience highlights the real impact of current melanoma treatment options.
Jon faced the typical anxieties that come with cancer diagnosis—worry during biopsy waiting times, stress around staging scans, and having to cancel his marathon plans. Following surgery to remove the melanoma in his groin lymph node, Jon began immunotherapy treatment.
What makes Jon’s story so compelling is how he managed to protect his children from disruption while undergoing treatment for melanoma skin cancer. He experienced no side effects from nivolumab and believes he could have worked throughout his treatment period.
Living Through Melanoma: A Patient’s Perspective
Jon shares powerful strategies for coping with cancer-related anxiety, including what many patients call “scanxiety”—the overwhelming worry that builds around scan result appointments. Throughout his treatment for melanoma skin cancer, Jon kept setting personal goals, giving himself milestones to work towards.
Today, Jon has returned to a full life. He works full-time and has even completed marathons to raise money for Macmillan Cancer Support. His journey from diagnosis through treatment to recovery offers hope to others facing similar challenges.
Dr James Wilson, cancer specialist, provides expert commentary alongside Jon’s story. Dr Wilson explains how immunotherapy side effects differ completely from traditional chemotherapy and addresses common misconceptions about treatment. He emphasises that outcomes for people with metastatic melanoma are better than ever, with immunotherapy revolutionising treatment for melanoma skin cancer.
Understanding Melanoma Skin Cancer Treatment
Melanoma skin cancer responds well to treatment, especially when caught early. Your treatment plan will depend on:
- Where the cancer is located
- If it has spread to other parts of your body
- Your general health condition
Surgery remains the main treatment for melanoma skin cancer, with radiotherapy, targeted medicines and chemotherapy used in certain cases. Your specialist care team will create a personalised treatment plan and discuss all options with you.
Surgery for Melanoma
Surgery is the primary treatment for melanoma skin cancer, particularly in early stages. Surgical options include:
- Removing the melanoma and surrounding healthy skin to prevent recurrence
- Removing swollen lymph glands if cancer has spread to them
- Surgery for melanoma that has spread to other body areas
For visible areas like the face, a plastic surgeon may perform the procedure to achieve the best cosmetic result. Larger removals may require skin grafts from another part of your body.
Radiation treatment for melanoma skin cancer
Doctors sometimes use radiotherapy to control melanoma that has spread and reduce symptoms. Treatment may involve single or multiple sessions, depending on the affected area and whether you’re receiving other treatments for melanoma skin cancer.
Stereotactic Radiotherapy for Oligometastatic Melanoma
When melanoma spreads from its original site, it can form metastases in various parts of the body. Common sites include the lungs, liver, brain, bones, lymph nodes, skin, and adrenal glands. Oligometastatic disease refers to a limited number of metastases (typically fewer than five).
Stereotactic radiotherapy—also known as SABR (Stereotactic Ablative Radiotherapy) or SBRT (Stereotactic Body Radiation Therapy)—offers a precise treatment option for melanoma that has spread. This advanced form of treatment for melanoma skin cancer delivers high-dose radiation with pinpoint accuracy to metastatic sites.
The treatment works by targeting each metastasis with intense, focused radiation beams from multiple angles. This precision helps protect surrounding healthy tissue while delivering a powerful dose to eradicate the melanoma metastases.
SABR/SBRT for melanoma has shown impressive results, with the potential to completely eliminate individual metastases. This treatment can be particularly valuable for patients with limited metastatic disease or when surgery isn’t possible. It often requires fewer treatment sessions than conventional radiotherapy.
Immunotherapy: A Revolutionary Approach
Immunotherapy represents one of the most promising advances in treatment for melanoma skin cancer. These treatments help your immune system recognise and attack cancer cells more effectively.
Your immune system naturally works to protect your body from infections and abnormal cells, including cancer. However, in melanoma patients, the immune system often sees the cancer but doesn’t recognise it as dangerous. Immunotherapy helps correct this problem.
Types of Immunotherapy treatment for melanoma skin cancer
Different immunotherapy approaches work in different ways:
Checkpoint Inhibitors: These drugs, including nivolumab (Opdivo), pembrolizumab (Keytruda), and ipilimumab (Yervoy), activate white blood cells to attack cancer cells. They’re given as intravenous infusions at a day unit. Jon received nivolumab for one year following his surgery.
Virus Therapy: T-VEC (Imlygic) uses a specially designed virus injected directly into melanoma lesions in the skin or lymph nodes. The virus infects cancer cells and helps your immune system find and destroy them.
When Is Immunotherapy Used?
You may receive immunotherapy for melanoma skin cancer:
- Before surgery (neoadjuvant treatment) to improve the likelihood of treatment success
- After surgery to reduce the risk of cancer returning (adjuvant treatment)
- To slow growth and extend life when melanoma cannot be surgically removed or has spread
Side Effects of Immunotherapy
Common side effects of immunotherapy may include:
- Fatigue
- Skin changes or rashes
- Diarrhoea
- Shortness of breath
While other side effects can occur, most are manageable with proper medical support. These may affect the gut, liver, hormone glands, or other organs. The good news is that your healthcare team is experienced in managing these effects, and many patients tolerate treatment well. Remember that Jon experienced no side effects, and many patients have a similar positive experience.
Your doctor will carefully monitor you throughout treatment and provide clear guidance on what to watch for. Always report any new or unusual symptoms promptly. With proper care, the benefits of immunotherapy for melanoma skin cancer often far outweigh the risks.
Targeted Medicines
Targeted medicines aim to stop cancer growth by targeting specific genetic changes in melanoma cells. Doctors usually test a sample of your melanoma to determine if targeted therapy might work for you.
Chemotherapy
While less commonly used than other options, chemotherapy still plays a role in treating advanced melanoma skin cancer. It’s typically considered when targeted medicines and immunotherapy aren’t suitable.
Living with Advanced Melanoma
If you’ve been diagnosed with advanced melanoma that cannot be cured, treatment focuses on limiting the cancer, controlling symptoms, and helping you live longer. Your doctor will work with you to manage symptoms and set the priorities for your treatment that most matter to you.
Finding Support
Throughout your treatment for melanoma skin cancer, regular check-ups and tests will monitor your progress. Never hesitate to contact your healthcare team about any symptoms or concerns between appointments.
As Jon’s story demonstrates, many people continue to lead full lives during and after treatment for melanoma skin cancer. Setting goals, finding support, and working closely with your healthcare team can help you navigate this challenging journey.
Introduction to Basal Cell Carcinoma
Radiotherapy is a highly effective treatment for basal cell carcinoma (BCC), the most common type of skin cancer worldwide. It develops in the basal cells, which are found in the outer layer of your skin, the epidermis. The main cause is long-term exposure to sunlight. You may be more likely to develop this cancer if you have fair skin, have had bad sunburns, have been exposed to certain chemicals, or have a weakened immune system. It’s important to protect yourself by avoiding too much sun exposure and using proper sun protection.
These skin cancers often look like a small, shiny bump or a patch on your skin. They can be flesh-coloured, pink, or slightly darker than your surrounding skin. Unlike other skin cancers, BCC usually grows slowly and very rarely spreads to other parts of your body. However, if left untreated, it can damage nearby tissues and cause scarring.
Early diagnosis and treatment are very important. Your skin specialist (dermatologist) will usually examine your skin carefully and may take a small sample (biopsy) to confirm if it’s BCC. Finding and treating it early means simpler treatment is often possible. There are two main treatment options: radiotherapy and surgery. Understanding what BCC is and your treatment choices will help you make informed decisions about your care.
Overview of Treatment Options for BCC
If you’ve been diagnosed with basal cell carcinoma (BCC), you have several treatment options. The main ones are surgery, radiotherapy, skin creams, and light therapy. Each has its own benefits and drawbacks, and what’s right for you depends on your particular situation.
Surgery remains the most common treatment for BCC, especially when the cancer is in one spot and easy to reach. The most precise type of surgery is called Mohs surgery, which carefully removes the cancer while saving as much healthy skin as possible. This is particularly useful for cancers on the face. However, surgery might not be suitable for everyone, especially if you have certain health conditions or take particular medications.
Radiotherapy is an effective alternative, particularly if surgery isn’t suitable. It uses high-energy x-rays to target and destroy cancer cells. While it doesn’t involve cutting, it can cause some temporary skin irritation.
Skin creams containing special medicines can help with surface (superficial) BCCs, especially if you prefer a treatment without surgery. These creams are applied directly to your skin.
Light therapy uses special light-sensitive medicine and light to destroy cancer cells. This is usually only used for superficial BCCs and offers a non-surgical option with quick recovery time. Your healthcare team will consider your cancer’s size and location, as well as your overall health, to recommend the best treatment option for you.
Understanding Radiotherapy: How It Works
Radiotherapy is an important treatment option for people with basal cell carcinoma (BCC). It works by using targeted radiation to damage cancer cells, which stops them from growing and causes them to die. The treatment aims to destroy the cancer cells while causing as little harm as possible to surrounding healthy skin.
There are two main types of radiotherapy: external beam radiotherapy and radiotherapy that comes from radioactive material placed close to the skin (also called brachytherapy). External beam radiotherapy directs x-rays from outside your body towards the cancer.
Rhenium-SCT (Rhenium-188 topical therapy) offers several unique advantages for selected BCC patients. This single-visit treatment applies a radioactive paste directly to the skin cancer, with clinical studies showing:
- 97.5% response rates at 12 months
- 95% complete responses
- Superior cosmetic outcomes in 41% of cases
Your treatment will begin with a consultation where your doctor will assess your condition and overall health. You might need some scans to help plan your treatment. Once the plan is ready, you’ll have several treatment sessions, usually over a 1-2 weeks. Each session typically lasts only a few minutes, during which you’ll need to lie still while the radiotherapy machine is precisely positioned. Rhenium-SCT only requires one visit of usually around an hour or two.
Most people cope well with radiotherapy for BCC, though you might experience some side effects like skin irritation or tiredness in the weeks after treatment. It’s important to keep talking with your doctor, as they can help you manage any side effects. Radiotherapy can be particularly helpful for people who can’t have surgery, have recurring BCC, or have high-risk BCC.
(A before and after image of a BCC on the nose that was successfully treated with radiotherapy)
Surgical Treatments for BCC: An Overview
There are different types of surgery available for treating basal cell carcinoma (BCC). One of the most advanced techniques is Mohs surgery, which is a specialised procedure that removes the cancer layer by layer. During this surgery, each layer is checked under a microscope to ensure all cancer cells are removed while saving as much healthy skin as possible. This type of surgery is often recommended for BCCs on the face, neck, and ears, where appearance is particularly important.
Another common option is standard surgery, where the surgeon removes the cancer along with a small margin of healthy skin around it. This method effectively removes BCC and can be done in most areas of the body. While it might not be as precise as Mohs surgery, it’s usually quicker and simpler, and can often be done as an daycase procedure.
After surgery, you might experience some swelling, bruising, or discomfort in the treated area, but this usually improves over time. Sometimes, you might need additional surgery with a plastic or dermatological surgeon to improve the appearance of the treated area. This depends on the size and location of the original surgery.
Your doctor will help you choose the most appropriate type of surgery based on several factors, including where your BCC is located, its size, your general health, and what you prefer. It’s important to discuss these options with your healthcare team to understand which approach might work best for you.
Pros and Cons of Radiotherapy for BCC
Radiotherapy is a common treatment option for basal cell carcinoma (BCC), particularly for people who might not be suitable for surgery. One of the main advantages is that it doesn’t involve any cutting. Unlike surgery, radiotherapy can be given as an outpatient treatment, which means you remain at home with minimal disruption to your daily routine.
Another benefit of radiotherapy is that it works well for certain groups of people, especially those with larger skin cancers or those who can’t have surgery due to age or other health conditions. In these cases, radiotherapy can effectively target the cancer while protecting the surrounding healthy tissue. Many people also find they have fewer immediate side effects compared to surgery.
However, radiotherapy does have some drawbacks. While your radiotherapy is designed to minimise damage to healthy areas, you might experience side effects such as skin irritation and tiredness. In very rare cases, there’s a small risk of developing another cancer in the treated area many years later. The risk of this is small and occurs many years after treatment (risk of second cancer 3:1000 at 10 years and 5:1000 at 15 years after radiotherapy).
Also, radiotherapy treatment usually requires more hospital visits than surgery, as you’ll need several sessions over a period of 1-2 weeks. This longer treatment time can be inconvenient for some people.
Pros and Cons of Surgery for BCC
When considering treatment for basal cell carcinoma (BCC), surgery is one of the most traditional approaches. The main advantage of surgery is that it completely removes the cancer cells. Surgical procedures, such as standard excision or Mohs surgery, focus on making sure all the cancer is removed, which means there’s less chance of it coming back.
Surgery often provides immediate results, which can be reassuring for many people. You can usually see straight away that the cancer has been removed, which can reduce worry about ongoing treatment. The success rate of surgery is very good, and your doctor can check the removed tissue to confirm that all the cancer cells have been taken out.
However, surgery does have some disadvantages. One main concern is scarring. Depending on where the surgery was done and how much skin needed to be removed, you might have a visible scar. Sometimes, you might need further cosmetic procedures to improve how the scar looks. Also, like any surgery, there are risks such as infection or slow healing and swelling, particularly if you’re older or have other health conditions.
Recovery time is another thing to consider. Unlike some non-surgical treatments, you’ll need time to heal after surgery, during which you might need to limit your activities. While many people have successful outcomes with surgery, it’s important to carefully consider these pros and cons. Your healthcare team will help you decide if surgery is the right choice for you.
Factors Influencing Treatment Choice
The decision between radiotherapy and surgery for treating basal cell skin cancer (BCC) depends on many factors that are specific to you. First, the characteristics of your skin cancer play a big role. The size, depth, and location of the cancer can help determine whether surgery or radiotherapy would work better. For example, smaller cancers in easy-to-reach areas might be better suited for surgery, while larger or more complicated ones might respond better to radiotherapy. Radiotherapy is particularly good for BCCs around the eyes, nose and lips.
Age is another important factor to consider. Older people might have other health conditions that make surgery more risky, making radiotherapy a better option. Younger people might prefer surgery to avoid the longer treatment schedule of radiotherapy. Your overall health is also important; if you have a weakened immune system or other health problems, this might affect which treatment is safer for you. Your doctor will carefully consider your medical history and current health when recommending treatment.
Your personal preferences are also very important in making this decision. Some people might feel anxious about having surgery, while others might prefer the quicker results that surgery can provide. Your healthcare team will discuss all available options with you, explaining the potential benefits and drawbacks of each treatment method. By carefully considering these factors, you can make an informed choice that suits your needs, health condition, and lifestyle.
Success Rates of Surgery and Radiotherapy for BCC
When choosing between treatments for basal cell skin cancer (BCC), it’s helpful to understand how well each treatment works for different people. Medical studies give us valuable information about success rates, how often the cancer comes back, and how satisfied people are with their treatment.
Research looking at people treated with Mohs surgery, a precise type of surgical treatment for BCC, shows very good results. This method successfully removes the cancer in about 98 out of 100 cases, with the cancer coming back in fewer than 5 out of 100 cases within five years. Many people were happy with this treatment because they could see results straight away and it preserved as much healthy skin as possible.
Studies of people who had radiotherapy (often because they couldn’t have surgery) also show good results. Radiotherapy successfully controlled the cancer in about 90 out of 100 cases, with the cancer coming back in about 10 out of 100 cases over five years. People had different views about this treatment; many liked that it didn’t involve surgery, but some were concerned about the length of treatment and changes to their skin afterwards. If the cancer comes back after a long time, radiotherapy may be considered again to treat the recurrent BCC.
These findings show that both treatments can work well. Surgery might have slightly better immediate success rates, while radiotherapy remains a good option for people who can’t have, or don’t want to have, surgery. Your healthcare team will help you understand which treatment might work best for your situation.
Consultation and Making an Informed Decision
When you’re diagnosed with basal cell skin cancer, you’ll need to consider different treatment options, mainly radiotherapy and surgery. Having thorough discussions with your healthcare team is essential for making the right decision about your treatment. These discussions should start soon after diagnosis to give you enough time to consider all your options.
To get the most from these discussions, it helps to prepare. Make a list of any symptoms you’ve noticed, your medical history, and any previous treatments you’ve had. This information will help your healthcare team suggest the most suitable treatment for you. It’s useful to ask about specific aspects of your skin cancer, such as its type, size, and location, as these factors can influence whether radiotherapy or surgery would be better.
You should also ask about the benefits and risks of each treatment option. For example, surgery might remove the cancer more quickly, while radiotherapy might be easier if you have other health conditions. Important questions to ask include: How likely is the cancer to come back with each treatment? What side effects might I get? How will treatment affect my daily life? These questions will help you understand what to expect from each treatment option.
You might also want to get a second opinion to help you feel more confident about your decision. It’s important to weigh up the advantages and disadvantages of each approach, considering both your physical health and personal preferences. Having open and informative conversations with your healthcare team will help you make decisions that are right for you.
Frequently Asked Questions about treatment for BCC
Treatment Selection
Q: What determines the choice between surgery and radiotherapy for BCC?
A: Key factors include age, BCC location, size and type, general health, and personal preferences. The pros and cons of both approaches should be discussed with you before you make a final treatment decision
Q: How effective is radiotherapy for BCC?
A: Cure rates are comparable to surgery in appropriate cases, with excellent outcomes for both primary and recurrent BCCs. Ask your doctor if there are any differences in cure rates in your particular situation
Treatment Process
Q: How many treatments are needed when treating a BCC?
A: Conventional radiotherapy typically requires 5-10 daily treatments over 1-2 weeks, though there are other treatment schedules depending upon your unique situarion. Rhenium-SCT requires just one visit.
Q: What are the side effects of radiotherapy for BCC?
A: Early effects include skin irritation and mild fatigue. Late effects may include slight skin colour or texture changes. Effects are usually mild and well-tolerated. There are other less common side effects that will be discussed with you in detail. The side effects very much depend on which part of your body is being treated.
Aftercare
Q: How do I care for my skin during radiotherapy for basal cell carcinoma?
A: Key recommendations include:
- Gentle cleaning with warm water
- Avoiding soaps in the treatment area
- Using recommended moisturisers or other creams provided to you by your oncologist
- Sun protection
Q: What follow-up care is needed?
A: Regular monitoring appointments check treatment response and provide ongoing care advice.
Your medical team
Treatment is delivered by consultant clinical oncologists specialising in skin cancers, working closely with dermatologists and plastic surgeons to ensure optimal care pathways and so you can be sure that all treatment options have been considered with the aim of giving you the best results. All practices follow current evidence and guidelines from the British Association of Dermatologists and the Royal College of Radiologists.