Skin cancer occurs when skin cells become damaged, often from long-term sun exposure, allowing them to grow at an uncontrolled rate. Skin cancer can cause local damage, or spread to other areas of the body, causing severe disease or death.

Non-melanoma skin cancers start in the top layer of the skin, called the epidermis and are often related to sun exposure. There are two main types of non-melanoma skin cancer, basal cell carcinoma and squamous cell carcinoma, depending on the type of skin cells affected. About 7 out of 10 cases of non-melanoma skin cancers are basal cell carcinomas.

Non-melanoma skin cancers are the most common cancers in Australia. They are less likely to be life-threatening than other cancers, however, patients tend to develop multiple lesions, which increases the burden of disease.

Actinic keratoses (also known as ‘solar keratoses’) are pre-cancerous lesions on the skin, usually caused by sun damage and may occur across large areas. Even though actinic keratoses are not cancerous, they can turn into skin cancers and may require treatment.

Non-melanoma skin cancer can be treated in several ways. The treatment decision is determined by skin specialist clinicians such as a dermatologist, plastic surgeon, or radiation oncologist. A clinician will take into account patient factors, such as age and medical history, as well as certain risk factors of the individual cancer.^1,2

Radiation therapy

Uses measured doses of radiation directed to specific parts of the skin to stop the growth of cancer cells or destroy them completely. For early stage disease, results are comparable to surgery.³

Surgery

This is a common treatment and involves cutting out the cancerous area. Sometimes some surrounding tissue is also removed.

Mohs Surgery

Is one of the most effective options (in terms of clearance) for treating BCCs and SCCs.^4-8 It involves the sequential removal and microscopic examination of small layers of skin to ensure that all cancer cells are removed. This procedure is generally used only for skin cancers that are perceived to be of a higher risk. It can be laborious and expensive, but may minimise the risk of disease recurrence/spread that requires future interventions.

Simple excision

Is a common surgical method of skin cancer removal.9 It often involves removing a larger area of skin than Mohs Surgery. The process is quicker but can leave a larger scar. The specimen is then sent off for microscopic examination by a histopathologist, which means that a patient may require subsequent treatment at a later date if the pathologist finds residual cancer cells. 

Curettage and electrodessication

A procedure of scraping away the cancerous cells and killing the remaining cancer cells with an electric needle.^10-12

Cryotherapy

A procedure that destroys the cancer cells through extremely cold temperatures.¹³

Topical treatments

Creams and gels containing chemotherapy or immunotherapy can be applied to the skin to directly kill the cancer cells, or to stimulate an immune response that destroys the cells.^14-16

Systemic therapies

For patients with advanced disease that has spread beyond the skin, systemic therapies may be administered to the patient with the goal of killing the cancer cells throughout the body, or preventing further spread.^17,18

Our goal is to get the best possible outcomes for you. Your doctor and healthcare team will work with you to determine which treatment is most suitable for you. This will depend on a number of factors including the part of your body that is affected, the size of the cancer, potential side effects and what you wish to achieve from treatment.

Radiation therapy is a treatment that uses measured and precisely targeted doses of radiation to destroy and stop the growth of cancer cells.

Radiation therapy may control the growth of cancer cells and destroy cancer cells that already exist. It can be used alone or as part of your treatment plan after surgery to try to prevent cancerous cells from reappearing or new cancerous cells from forming.

Radiation therapy has been used as a cancer treatment for over 100 years.^19,20 In recent years, there have been many advances in radiation therapy technology. At GenesisCare, we use the latest techniques to aim to deliver the best possible outcomes and to minimise side effects. Radiation therapy may be used to treat small lesions in cosmetically challenging areas right through to very large areas of the body affected by skin cancer where tissue conservation is important.

Your doctor may determine that radiation therapy is a suitable choice for you, including if:

• you have tried other treatments in the past that have not been successful
• you are unable to or prefer not to undergo surgery
• the skin cancer is in an area of the body where surgery might not be appropriate, for example where the cosmetic outcome may be poor
• you have a large area of skin to be treated.

GenesisCare operates both public and private facilities around Australia and we aim to help make treatment affordable for everyone.

For patients who are eligible for Medicare, approximately 80 to 90% of radiation therapy treatment costs are often covered by Medicare rebates. Private health insurance is not required for radiation therapy. Those with a Department of Veterans’ Affairs (DVA) Gold Health Card may receive treatment without any out-of-pocket costs.

Any out-of-pocket costs will depend on the complexity of treatment and the area being treated. As such, we will be able to provide you with a guide of what you are likely to pay out-of-pocket at your first appointment. GenesisCare have a number of payment plans available that may suit your individual financial situation.

Consultation

After you have received a referral to GenesisCare from your GP or specialist, the process of radiation therapy starts with a consultation with a specialist cancer doctor known as a radiation oncologist.

Your radiation oncologist will review your medical history and complete a physical examination to assess if radiation therapy is appropriate for you. If so, they will organise a treatment plan tailored for you.

Treatment planning and CT simulation

If treatment is recommended, an appointment will be made for you to have a simulation scan of the treatment area. This process will take about one hour.

The radiation oncologist and radiation therapist will then develop a customised treatment plan for your specific condition and treatment will usually commence within 7-10 days.

Before treatment commences

Before your treatment commences you will have a radiation therapy education session with a nurse who will discuss any concerns you may have regarding what to expect during treatment.

Treatment sessions

During your first treatment session, a radiation therapist will explain the treatment process and answer any questions you may have to ensure you are comfortable with the care provided.

Your first appointment will take around 20–30 minutes. The remaining appointments should only take around 10–15 minutes. The treatment session itself only lasts for 6–10 minutes.

The number of treatment sessions needed can vary depending on your personal plan.

Your radiation therapy is delivered by machines similar to those that administer x-rays. A nurse will be available for advice and support throughout the course of your treatment.

Follow-up care

At your final session, a nurse will discuss your post-treatment care with you and provide contact details in case you have any questions after treatment is completed.

Your radiation oncologist may arrange for a follow-up appointment shortly after you finish your treatment.

To receive treatment at GenesisCare, you will need a referral from your doctor (GP) or specialist. Other than this, there is nothing you need to do to prepare for your first appointment. But if you’re unsure about anything, please feel free to call us at any time before or during your treatment, we’re here to help.

As a general guide, treatment is given each day on Monday to Friday for around 5 weeks. The number of treatment sessions will vary and will depend on your individual treatment plan. Each treatment session is generally very quick and usually only lasts 6-10 minutes.

There’s no need for you to stay in the centre other than to receive your treatment. We’ll also work with you to arrange your appointment times to suit your daily life requirements.

Receiving radiation therapy itself isn’t painful - it is similar to having an X-ray. However, as your skin starts to heal, you may experience some reactions such as redness, dryness, itching and inflammation. Your skin may become sore or painful. These reactions may develop slowly and gradually. If this occurs, please let our nurses know. Our nurses are available throughout your treatment to support you in managing any pain or discomfort you might be experiencing.

The most common side effects associated with radiation therapy for non-melanoma skin cancer are redness, itching and irritation of the skin, similar to a severe sunburn. These side effects usually develop gradually two weeks into your treatment and are experienced until around two weeks after you complete your course of treatment (though it can vary).

There are other less common side effects. Our nurses will provide you with more information about possible side effects and how to manage them.

Prior to starting treatment, your radiation oncologist and nurses will provide you with the necessary skin care treatment information. You will be monitored closely during the course of treatment for any skin reactions.

Healing time may vary, depending on your skin and the area of skin that was treated. You may notice that the appearance of your skin will get worse before it gets better and this is a normal response to radiation therapy. The worst skin reaction is usually experienced towards the end of treatment and for a further two weeks after completion of radiation therapy. It generally takes somewhere between four to eight weeks for your skin to heal completely after treatment is completed.

After your treatment is completed, we will arrange a follow-up appointment with you to check on your progress and answer any questions you have post-treatment. We are here to support you for as long as you need.