Superficial Radiotherapy (SRT)

For Skin Cancer Treatment without surgery, scarring or down-time

Information and Instructions regarding your treatment

We want you to be completely informed and be comfortable throughout the treatment process. Please share this information with your family and caregivers so that they may participate in the healing process. If you would like more detailed information about your own treatment, please ask the staff.

What is Superficial radiotherapy and how does it work?

Superficial Radiotherapy (SRT) is the use of carefully measured doses of x-ray radiation to treat skin cancer. SRT is specifically engineered to deliver 100% of the energy at the skin surface. This energy dispersal makes SRT the most effective method of targeting and treating skin cancer and related diseases. A Radiation Technologist is responsible for operating the radiotherapy machine. They are specially trained health care professionals who are involved in radiotherapy planning, treatment and care.


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When the energy wave from the SRT beam hits a cell that is dividing, the cell will be damaged. Cancer cells are much less able than normal cells to repair themselves, causing the cancer cell to be destroyed and fall off. As the damaged cells die, healthy cells begin to replace them. Radiotherapy works by damaging cancer cells while causing as little damage as possible to normal cells.

What will happen if I do not have this treatment?

There is a risk that your cancer may continue to grow and your symptoms may get worse.

How do I prepare for my treatment?

Several days prior to treatment one of our doctors will perform a “simulation”. Using the information from the biopsy, the doctor will outline the treatment area with a marking pen and prescribe a dose. Generally this dose is divided up into 8-10 equal treatments called “fractions”. This method allows for the skin to make the best cosmetic recovery. A custom shield is cut from a piece of lead to minimize the area exposed by the SRT beam. If your treatment is near the eye you may need to wear a protective eye shield. This will be inserted after using local anesthetic eye drops. The eye will need to be covered for at least two hours afterwards. In these circumstances it is best not to drive yourself. Treatment on the nose, around the nostril is often shielded from the inside as well. Both methods are done with very little discomfort.


What happens when I have my treatment?

On the day of treatment, you will arrive at the reception area and check in. The radiation technologist (RT) will meet you and bring you into the treatment area. The RT will take your information and input the precise treatment prescribed by the doctor. The technician will adjust both the bed and the machine to the exact positions that are needed. The RT will ask you to remove any clothing that covers the area being treated. The shield cut-out created earlier will be placed over the treatment area. The machine will rest gently on the shield. You will also be asked to keep as still as possible. The treatment is absolutely painless. It is just like having an x-ray picture taken, but it takes slightly longer (around 30 seconds). When all the adjustments have been made, the radiographers will leave the room and will switch on the machine from outside. The entire process normally lasts less than 5 minutes. We request that you turn off your mobile phone during the treatment program as electronic devices can interfere with the treatment equipment.

The overall treatment session may take a total of 15 minutes, allowing time for discussion and for machine set up. Treatments are generally 10 consecutive sessions. Monday thru Friday; the same time of day. This routine will go on each day until your course of treatment is finished. It is very important that you do not miss treatment days as it may make your treatment less effective. If you feel you are unable to attend for any reason, please telephone the scheduling desk.

Will radiotherapy hurt?

No. You will feel no pain at all while you are actually having your treatment. As your treatment progresses you will develop some inflammation which may result in some soreness around the area being treated. Many patients equate the sensation to a minor sunburn.

Is Superficial Radiotherapy (SRT) safe?

Radiation used in medical treatment is given in controlled, carefully measured doses. In addition to your doctor, the treatment protocol is validated by a medical physicist that follows the process of your treatment. The aim is to include all tissues that could possibly contain cancer cells while minimizing the dose to the normal tissue.

Will I be radioactive?

No. Patients treated by x-rays do not become radioactive. The radiation does not stay in your body after treatment, so you cannot do anyone else any harm. It is safe for you to have contact with other people including children and pregnant.


What are the side effects?

The acute side effects are temporary and affect all patients. Only the area being treated, called the treatment field, will be affected.

  • The area will become red and sometimes a little sore over the next 5 to 10 days.
  • A scab may form.
  • There may be some bleeding (this is unusual but not a problem.)
  • The area may take 4 to 6 weeks or more to heal.

There are some possible late side effects. These can occur months or even years after treatment.

  • The treated area may be paler than the surrounding skin.
  • Small veins may appear in the treated area.
  • If the scalp or beard area is treated, permanent hair loss can occur in the treated area.
  • On rare occasions an ulcer may form.

What can I use on my skin during the course of treatment?

  • Try to leave the marker lines on your skin for as many days as possible. You can get your skin wet but avoid rubbing the area.
  • Avoid using cleansers, moisturizers, make-up and sunscreens on the area that contain oils, petrolatum or alcohol, starting the first morning of your treatment. Continue until the day of your last treatment.

Examples of products you can use are: mineral makeup (powder), Cetaphil, Purpose or Neutrogena gentle cleansers (available in stores), Fenix rehydrating moisturizing sunscreen (available in our office), Neova Silc Sheer tinted moisturizing sunscreen (available in our office). You can use what you wish on the rest of your face and body.


How should I take care of the area during the course of my treatment ?

  • If the area is bleeding or unsightly, cover with a band-aid or small piece of gauze. Do not put any adhesive surface directly on the treated area.
  • Avoid swimming or soaking the area. After gentle cleansing dry by patting gently with a soft towel.
  • If the beard is being treated, do not shave in the treated area during the course of your treatment. If the scalp is being treated; wash hair with mild shampoo. Allow hair to dry naturally. Do not use a hairdryer.
  • If the area is uncomfortable you can apply Biafine, available for purchase in our office.

What should I expect after the treatment is completed?

Your side effects may last for some weeks after the treatment finishes. Make sure you always where a sunscreen on the treated area when outside.

Scheduling and Cancellation

It is very important that you keep all your appointments for your simulation and treatment course. We are scheduling the radiotherapy unit and technician to come to our office specifically for you. If you need to reschedule or cancel your appointment time, please contact us as soon as possible. There may be a charge for no-shows and cancellations less than 1 week prior to your simulation appointment to cover the overhead cost of the SRT and RT. These late cancellation/no show charges are not covered by insurance or Medicare.

**Radiation can be harmful to an unborn child. It is important to let the technician know if you have missed a period or suspect that you might be pregnant before you are exposed to any radiation.