We are changing the face of skin cancer treatment
At GenesisCare we deliver a personalised care experience close to home. We can treat some skin cancers using non-invasive modern radiation therapy techniques. Discover more about worldwide integrated cancer care provider, GenesisCare.
Find out more about the treatment journey for skin cancer at GenesisCare.
Frequently asked questions
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
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
This is a common treatment and involves cutting out the cancerous area. Sometimes some surrounding tissue is also removed.
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.
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
A procedure that destroys the cancer cells through extremely cold temperatures.13
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
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.
- Marcu LG. The first Rs of radiotherapy: or standing on the shoulders of giants. Australas Phys Eng Sci Med 2015 Dec;38(4):531-41
- Rong Y, Zuo L, Shang L, Bazan JG. Radiotherapy treatment for nonmelanoma skin cancer. Expert Rev Anticancer Ther 2015;15(7):765-76
- Ashby MA, Smith J, Ainslie J, McEwan L. Treatment of nonmelanoma skin cancer at a large Australian center. Cancer 1989 May 1;63(9):1863-71
- Leibovitch I, Huilgol SC, Selva D, Hill D, Richards S, Paver R. Cutaneous squamous cell carcinoma treated with Mohs micrographic surgery in Australia I. Experience over 10 years. J Am Acad Dermatol 2005 Aug;53(2):253-60
- Lansbury L, Bath-Hextall F, Perkins W, Stanton W, Leonardi-Bee J. Interventions for non-metastatic squamous cell carcinoma of the skin: systematic review and pooled analysis of observational studies. BMJ 2013 Nov 4;347:f6153
- Pugliano-Mauro M, Goldman G. Mohs surgery is effective for high-risk cutaneous squamous cell carcinoma. Dermatol Surg 2010 Oct;36(10):1544-53
- Chren MM, Linos E, Torres JS, Stuart SE, Parvataneni R, Boscardin WJ. Tumor recurrence 5 years after treatment of cutaneous basal cell carcinoma and squamous cell carcinoma. J Invest Dermatol 2013 May;133(5):1188-96
- Stuart SE, Schoen P, Jin C, Parvataneni R, Arron S, Linos E, et al. Tumor recurrence of keratinocyte carcinomas judged appropriate for Mohs micrographic surgery using Appropriate Use Criteria. J Am Acad Dermatol 2017 Jun;76(6):1131-1138.e1
- Ferry AM, Sarrami SM, Hollier PC, Gerich CF, Thornton JF. Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery. Plast Reconstr Surg Glob Open. 2020 Dec 22;8(12):e3300.
- Ahmed I, Berth-Jones J, Charles-Holmes S, O'Callaghan CJ, Ilchyshyn A. Comparison of cryotherapy with curettage in the treatment of Bowen's disease: a prospective study. Br J Dermatol 2000 Oct;143(4):759-66
- Kuijpers DI, Thissen MR, Berretty PJ, Ideler FH, Nelemans PJ, Neumann MH. Surgical excision versus curettage plus cryosurgery in the treatment of basal cell carcinoma. Dermatol Surg 2007 May;33(5):579-87
- Lindemalm-Lundstam B, Dalenbäck J. Prospective follow-up after curettage-cryosurgery for scalp and face skin cancers. Br J Dermatol 2009 Sep;161(3):568-76
- Zacarian SA. Cryosurgery of cutaneous carcinomas. An 18-year study of 3,022 patients with 4,228 carcinomas. J Am Acad Dermatol 1983 Dec;9(6):947-56
- Jansen MHE, Mosterd K, Arits AHMM, Roozeboom MH, Sommer A, Essers BAB, et al. Five-Year Results of a Randomized Controlled Trial Comparing Effectiveness of Photodynamic Therapy, Topical Imiquimod, and Topical 5-Fluorouracil in Patients with Superficial Basal Cell Carcinoma. J Invest Dermatol 2018 Mar;138(3):527-533
- Jansen MHE, Kessels JPHM, Nelemans PJ, Kouloubis N, Arits AHMM, van Pelt HPA, et al. Randomized Trial of Four Treatment Approaches for Actinic Keratosis. N Engl J Med 2019 Mar 7;380(10):935-946
- Morton C, Campbell S, Gupta G, Keohane S, Lear J, Zaki I, et al. Intraindividual, right-left comparison of topical methyl aminolaevulinate-photodynamic therapy and cryotherapy in subjects with actinic keratoses: a multicentre, randomized controlled study. Br J Dermatol 2006 Nov;155(5):1029-36
- Sekulic A, Migden MR, Oro AE, Dirix L, Lewis KD, Hainsworth JD, et al. Efficacy and safety of vismodegib in advanced basal-cell carcinoma. N Engl J Med 2012 Jun 7;366(23):2171-9
- Migden MR, Rischin D, Schmults CD, Guminski A, Hauschild A, Lewis KD, et al. PD-1 Blockade with Cemiplimab in Advanced Cutaneous Squamous-Cell Carcinoma. N Engl J Med 2018 Jul 26;379(4):341-351
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.1,2 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.
- Jonathan D, Tward JD, Christopher J, Anker CJ, et al. Radiation Therapy and Skin Cancer. In Natanasabapathi G. Modern Practices in Radiation Therapy. InTeched. 2012:207–246
- Santos DE, Green JA, Bhandari N, Hong A et al. Tangential Volumetric Modulated Radiotherapy - A New Technique for Large Scalp Lesions with a Case Study in Lentigo Maligna. Int J Bioautomation 2015 Jan 1;Volume 19, Number 2, 2015, pp. 223-236(14)
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.
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.
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.
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.
How to protect your skin
For the best protection, it is recommended to use a combination of sun protection measures:
1. Slip on some sun-protective clothing that covers as much skin as possible.
2. Slop on broad spectrum, water resistant SPF30 (or higher) sunscreen. Put it on 20 minutes before you go outdoors and every two hours afterwards. Sunscreen should never be used to extend the time you spend in the sun.
3. Slap on a hat – broad brim or legionnaire style to protect your face, head, neck and ears.
4. Seek shade.
5. Slide on some sunglasses – make sure they meet Australian Standards.
Find a centre near you
This webpage and any patient brochure is provided for informational purposes only. It is not a substitute for your own healthcare professional's advice. It should not be used to diagnose, treat, cure or prevent any disease. Any medical procedure or treatment involving the use of radiation carries risks, including skin irritation and associated pain. Individual treatment outcomes and experiences will vary.