Treating skin cancer with radiation therapy

May 16, 2024

LCRP Radiation Oncologist Dr. John Pablo explains what to expect if your skin cancer diagnosis calls for radiation therapy

Skin cancer by far is the No. 1 diagnosed cancer in the United States. The number of people developing skin cancer has been increasing for many years most likely from a combination of better skin cancer detection, people getting more sun exposure and people living longer.

There are basically two categories of skin cancer: melanomas and non-melanomas. The most commonly diagnosed non-melanomas are basal and squamous cell skin cancers. Merkel cell is another type of non-melanoma and is rarer, but diagnoses are becoming more common as the population ages and people have more lifetime sun exposure, says Radiation Oncologist Dr. John Pablo, medical director of the Nancy N. and J.C. Lewis Cancer & Research Pavilion’s Radiation Oncology Center in Savannah, Bluffton and Hilton Head.

Dr. John Pablo, radiation oncologist

Related Article: Understanding basal and squamous cell skin cancers

If you are one of the millions diagnosed with any type of skin cancer sometime during your lifetime, the good news is treating skin cancer is improving. There are many ways to treat skin cancer. It can be as simple as your dermatologist scrapping off a mole or a little more complex with surgery, chemotherapy, immunotherapy, target therapy or radiation therapy, or maybe a combination of any of those modalities.

Treating skin cancer with radiation therapy

Most skin cancers start with surgery, especially melanomas, which are a rare type of skin cancer but also the deadliest. Radiation therapy can be used in combination with surgery or separate to treat most any type of skin cancer.

“We treat them after surgery if they are high risk of recurrence or if the tumor is really large, deeply penetrated within the skin or if it’s attached to a nerve,” Dr. Pablo explains. “The other instance in non-melanoma skin cancers that we treat with radiation therapy is in patients that are not good candidates for surgery or if the cancer is in a place that would cause a fair amount of deficit with surgery, such as the eye, lip, nose or ear.”

To treat non-melanoma skin cancer with radiation therapy, radiation oncologists use an electron beam, which is a beam that penetrates just through the skin, not affecting other organs, Dr. Pablo explains. The electron beam is delivered via our linear accelerator TrueBeam® machine. The machine’s beams are pointed straight at a target that is drawn on the skin.

Treatment on TrueBeam® can be done at our Savannah, Bluffton and Hilton Head locations. Treatment typically is five days a week and takes anywhere from two weeks to sometimes up to six weeks.

When it comes to treating melanomas, most of the time, you are not treating the actual skin, but where the melanoma has spread to different organs or lymph glands, Dr. Pablo says. Your radiation oncologist can use either the TrueBeam® or CyberKnife® machine to help treat melanomas.

There are side effects that come with treating skin cancer with radiation therapy. One of the biggest ones is your time, since treatment takes an average of four weeks, five days a week. Other physical side effects may include redness of the skin, irritation of the skin and fatigue.

“As we have an aging population of pretty healthy people and people are living longer, we are seeing a lot more skin cancers,” Dr. Pablo says. “There’s been some recently FDA-approved  target therapies and immunotherapies for skin cancer. There are topical chemotherapy options. But I think there will always be a place for radiation therapy to treat skin cancer.”


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