Skin cancer: Understanding side effects of radiotherapy
Radiotherapy for skin cancer can cause side effects, which may happen during treatment, shortly after, or much later. Early side effects (also called acute) usually occur during or soon after treatment. Since everyone is different, it’s hard to predict exactly when side effects will start, how long they will last, or how severe they might be. If you’re worried about anything, it’s best to talk to your treatment team.
You may experience side effects or symptoms not listed here, as every person and treatment is different. These symptoms may also be caused by other parts of your cancer treatment. Research and support for managing radiotherapy side effects is improving.
Joining a support group can be a helpful way to share your experiences, feel less isolated, and cope with the physical and emotional effects of treatment. If you need extra support or experience any side effects, talk to your treatment or clinical team.
The side effects you experience can vary depending on which part of your body is being treated, the type of radiotherapy you are having, and what tissues or organs are affected by the treatment.
- For example, if you are having treatment for skin cancer on your upper back, there could be some impact on your lungs depending on the proximity of the treatment area. Rest assured, your treatment team will carefully plan your radiotherapy to lower the risk of side effects.
This page looks at early side effects.
How likely am I to get early side effects?
Before treatment you will discuss and sign a consent form with your clinical oncologist or therapeutic radiographer. They will tell you what to expect, and you can ask questions and discuss any concerns or worries you have about side effects.
You can read different radiotherapy consent forms (HERE) based on the specific area being treated. These consent forms are packed with useful information about early and late side effects.(1)
By signing the consent form, you are saying you understand that you might get early and late side effects. Your team will use words like Expected, Common, Less Common and Rare.
This table shows what these words mean.
| Wording on the consent form | % chance of side or late effect | How many patients will get this? |
|---|---|---|
| Expected | 50 to 100% | Between half and all patients |
| Common | 10 to 50% | Up to half of all patients |
| Less common | Less than 10% | Fewer than one in ten patients |
| Rare | Less than 1% | Fewer than one in 100 patients |
Early side effects (during or soon after treatment)
- Feeling very tired or fatigued: You might feel very tired during and after your treatment. It’s important to get plenty of rest but sometimes you will still feel really tired, even with lots of sleep. Some tiredness can be caused by having cancer and having cancer treatment, and some can be caused by travelling to and from hospital every day for treatment.
- Skin reactions: You might notice changes in your skin at the treatment site, such as colour discolouration, swelling, itching, flaking, peeling, dryness, or changes in texture. For lighter skin tones, this might appear as pink, red, or darker patches. For those with brown or black skin tones, the changes could include maroon, purple, yellow, or grey pigmentation, or a darker area compared to the surrounding skin. While these changes typically improve after treatment, it can take 4 to 6 weeks for your skin to recover fully. You may experience scabbing, skin breakdown, and weeping, which can cause soreness. Pain relief can help manage this discomfort.
- Infection: This is a less common side effect that may require antibiotics.
- Hair loss: You might lose hair in the area where you’re receiving treatment. In most cases, this hair loss is temporary, and the hair will grow back over time.
What can help with these early side effects?
- Resting: Try to get plenty of sleep and take breaks whenever you feel tired.
- Keeping active: Gentle movement can help you feel better, both during and after treatment. Your treatment team can guide you on safe activities.
- Drinking fluids: Drinking plenty of fluids such as water, juice and squash can help with fatigue and tiredness caused by your treatment. It can also help flush out toxins in your body caused by treatment. You can try diluted juice if you don’t like water.
- Skin reactions: Your treatment team can recommend creams to soothe your skin. If your skin breaks down, you may need extra care. Wear loose clothing and keep treatment area out of the sun. Talk to your team about how to wash and care for your skin during treatment. You might have to change your normal routine during treatment and for a short time after, especially if you have a radiation induced skin reaction.
- Medication: Pain relief medication can help if you are feeling discomfort or pain.
- Protecting your treatment area: it is important to keep the area where you have treatment protected from the sun and wind. During and straight after treatment, do not put sunscreen on the treatment area. Instead, cover up with large hats and loose, protective clothing. It’s best to minimise time spent in direct sun until you can use a protective sun cream. If you’re planning a holiday or spending extended time outdoors, ask your treatment team for specific advice.
- Sexual changes: Talk to your team if you are experiencing issues with sex and cancer and they can offer advice.
- Alcohol use: Please follow the NHS guidelines on safe drinking levels and any instructions you get from your team on what is right for you, your diagnosis and your treatment. If in doubt, please ask your team.
- Stop smoking: If you are looking to stop or reduce smoking, there are services available to help you.
Click here to learn more about late effects.
Further information
Learn more about radiotherapy consent forms here:
https://www.rcr.ac.uk/our-services/management-service-delivery/national-radiotherapy-consent-forms/
