Skip to main content

Radiation Therapy for Basal and Squamous Cell Skin Cancers

Radiation therapy uses high-energy rays (such as x-rays) or particles (such as photons, electrons, or protons) to kill cancer cells.

When is radiation therapy used?

If a tumor is very large or is on an area of the skin that makes it hard to remove with surgery, radiation therapy may be used as the main treatment. Radiation therapy can also be useful for some patients who, for other health reasons, can’t have surgery. Radiation therapy can often cure small basal or squamous cell skin cancers and can delay the growth of more advanced cancers.

Radiation is also useful when combined with other treatments. For example, radiation can be used after surgery as an adjuvant (additional) treatment to kill any small areas of remaining cancer cells that may not have been visible during surgery. This lowers the risk of cancer coming back after surgery. Radiation may also be used to help treat skin cancer that has spread to lymph nodes or other organs.

How is radiation therapy given?

When radiation therapy is used to treat skin cancers, the radiation is focused from outside the body onto the tumor. This is often done using a beam of low-energy x-rays (superficial radiation therapy) or electrons (electron beam radiation). These types of radiation don’t go any deeper than the skin. This helps limit the side effects to other organs and body tissues.

Getting radiation treatment is much like getting an x-ray, but the radiation is stronger and aimed more precisely at the cancer. The procedure itself is painless. Each treatment lasts only a few minutes, although the setup time – getting you into place for treatment – takes longer.

Possible side effects of radiation

Side effects of radiation are usually limited to the area getting radiation, and can include:

  • Skin irritation, ranging from redness to blistering and peeling
  • Changes in skin color
  • Hair loss in the area being treated
  • Damage to saliva-making glands and teeth when treating cancers near these structures

With longer treatment, these side effects may get worse.

After many years, new skin cancers sometimes develop in areas previously treated by radiation. For this reason, radiation usually is not used to treat skin cancer in young people. Radiation is also not recommended for people with certain inherited conditions (such as basal cell nevus syndrome or xeroderma pigmentosum), who may be at higher risk for new cancers, or for people with connective tissue diseases (such as lupus or scleroderma), which radiation might make worse.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Aasi SZ, Hong AM. Treatment and prognosis of low-risk cutaneous squamous cell carcinoma. UpToDate. 2019. Accessed at https://www.uptodate.com/contents/treatment-and-prognosis-of-low-risk-cutaneous-squamous-cell-carcinoma on June 4, 2019.

Christensen SR, Wilson LD, Leffell DJ. Chapter 90: Cancer of the Skin. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.

National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Basal Cell Skin Cancer. Version 1.2019. Accessed at www.nccn.org/professionals/physician_gls/PDF/nmsc.pdf on June 4, 2019.

National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Squamous Cell Skin Cancer. Version 2.2019. Accessed at www.nccn.org/professionals/physician_gls/pdf/squamous.pdf on June 4, 2019.

Xu YG, Aylward JL, Swanson AM, et al. Chapter 67: Nonmelanoma Skin Cancers. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.

Last Revised: July 26, 2019