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What is electron beam radiotherapy?

Electron beam radiotherapy is treatment using a radiation beam of particles called electrons. This radiation is strong enough to kill cancer cells but does not penetrate more than a few centimetres beyond the surface of the skin. It is given using equipment similar to a large x-ray machine. It is very effective at treating skin cancers and tumours near to the skin’s surface as well as avoiding any deeper sensitive structures.

Each treatment is called a ‘fraction’. Giving the treatment in fractions ensures that normal cells are damaged less than cancer cells. The treatment is given to you as an outpatient in the radiotherapy department. Your consultant will discuss your individual treatment plan with you.

External electron beam radiotherapy does not make you radioactive so it is safe for you to be with people, including children, after each treatment.

 

Positioning

During the treatment planning session you will be lying on a fairly hard couch, identical to the one that you will lie on during treatment. The radiographers will make you as comfortable as possible. The oncologist will decide the area to be treated and draw some ink marks on your skin. We need you to lie very still for a few minutes so that photographs and accurate measurements can be taken and your exact position recorded. The radiographers can then make sure that you are lying in the correct position for each fraction of your treatment.

The ink marks can be removed before you go home. Occasionally permanent skin marks, the size of a pinpoint, may be necessary but this will be discussed with you beforehand. You may meet a few members of staff at this appointment as some patients’ treatment may need to be discussed with other teams e.g. Physicists or Radiotherapy planning.

 

Having your treatment

Before your first treatment the radiographers will explain to you what you will see and hear. It’s quite normal to feel anxious about having your treatment, but as you get to know the staff and understand what is going on it should become easier. Don't be afraid to talk about any fears or worries to the staff; they are there to help you, and the more you understand about your treatment the more relaxed you will be. Radiotherapy is painless and the treatment itself lasts just a few minutes but the whole session takes approximately 20 minutes in total.

Your positioning is very important, so the radiographers may take a little while to get you ready (they may call this 'setting up') and to adjust the height and position of the table. The radiographers will move the treatment machine close to you but it will not touch you.

As soon as you are positioned correctly the staff will need to leave the room to prevent them from being exposed to any unnecessary radiation. During treatment you will be alone for a few minutes but there will be a radiographer watching you during this time on a monitor camera. To protect your privacy, nobody else will be able to see you. If you have any problems you can raise your hand to attract the radiographer’s attention and they will come in to help you.

 

Short term side effects

You will be monitored throughout your treatment by the radiotherapy team. Please let them know if you experience any of the following problems:

Skin changes:

You may notice some redness (like sunburn), increased pigmentation (darkening), tenderness or itching of the skin in the treatment area. Your skin may peel or flake as treatment continues and this may result in a sore and weepy skin reaction.

Your skin reaction can be affected by the dose and type of treatment that your consultant has prescribed. It can also be dependent on your type of skin, your shape, any existing conditions such as diabetes and especially if you smoke.

Advice can be provided to help you stop smoking.

Tips for helping your skin include:

• Wash the skin gently using soap and gently pat dry
• To reduce irritation to the treatment area you may use a moisturiser sparingly (your radiographer can advise on this)
• Continue to use normal deodorant unless this irritates the skin or the skin is broken
• Wear loose fitting natural fibre clothing next to the skin
• Avoid heating and cooling pads/ice
• Avoid hair removal products
• Avoid adhesive tape
• Ensure the skin is covered when out in the sun; your skin may be more sensitive to the sun especially in your first year after treatment so it is advisable to apply a high factor sun screen.

After finishing treatment you may be aware of your skin reaction becoming worse for up to another two weeks. Continue with the suggested skin care tips, returning gradually to your usual skin care regime when your skin has returned to normal.

For some people a scab may form over the treatment area. This may peel away and reform several times before leaving healed skin underneath and any redness in the treatment area will begin to fade. At first, this new skin will look pinker than the skin around it. This will gradually fade, and the treated area will come to look like the skin around it, though maybe slightly paler.