Radiation therapy is a preferred treatment modality in tumours whose excision would produce significant cosmetic deformity especially on the ear, eyelid margin or nasal alar rim. Radiation may also be preferable in older patients or others in whom surgery might be contra-indicated for reasons of general health, debility, etc.
If a skin cancer has recurred after radiation therapy, further radiation therapy is usually not possible. Excision of such a recurrence would be the treatment of choice, and consideration should be given to Mohs micrographic surgery.
Because of long-term damage to the skin, radiation therapy usually is not given to persons under the age of forty and is uncommonly given to patients under fifty. Surgery, including Mohs micrographic surgery, is usually performed in the younger patient.
Under normal circumstances patients receive a one-week course of irradiation for small lesions (<4.0 cm) and a two-week course or longer for larger lesions.
One week after the treatment brisk erythema will develop in the irradiated area. If the original lesion is ulcerated, there will be a period of exudation after which a large and unsightly crust will form. This process takes about six weeks to resolve. The development of secondary infection, of course, would require the appropriate treatment, although such infection does not normally occur.