Melanoma: Radiation Therapy

Radiation therapy uses strong X-rays to kill cancer cells. It is not a common treatment for melanoma, but it can be helpful in some cases. It may be used on its own, or along with other types of treatment.

When radiation therapy is used

Your doctor may advise radiation therapy for any of these reasons:

  • The melanoma could not be removed completely by surgery.

  • Surgery is not a good option for you. For example, if you are elderly or you have melanoma in a hard-to-treat area, such as your eyelid, nose, or ear.

  • You have had lymph nodes removed but are at high risk of the cancer coming back.

  • The melanoma has grown again after surgery, either on your skin or in your lymph nodes.

  • You have pain or other symptoms that radiation therapy could help reduce.

  • The melanoma has spread to your brain, spinal cord, or other organs. 

Before treatment

A doctor called a radiation oncologist creates your treatment plan. The plan shows what kind of radiation you’ll have and how long the treatment will last. This doctor can also prepare you for how you may feel during and after the treatment.

You may have imaging tests, such as CT scans. Imaging tests take pictures of the inside of your body. They help find out where you need treatment. You may have the same tests after treatment to see how well the treatment worked.

Once your radiation oncologist has mapped out your treatment plan, a radiation therapist gives you the radiation. You may have this treatment as an outpatient. This means you go home the same day of treatment. Or you may have it as an inpatient.  This means you stay overnight in the hospital. If you’re having treatment directed at just a small part of your body, it will most likely be outpatient.

During treatment

External radiation for melanoma is done with a machine that directs strong X-rays at the tumor. Depending on why you are getting the radiation, it may be given in one (or a few) treatment sessions. Or treatment might be spread out over a few weeks. Your doctor will discuss your treatment schedule with you. Each treatment session only takes a few minutes and is painless.

Side effects of radiation therapy

Radiation therapy affects normal cells as well as cancer cells. The side effects of radiation depend on the amount and the type of radiation you get, as well as the area of the body being treated.

Side effects can include:                                                                                                                                                             

  • Red, dry, burning, or irritated skin in the area being treated

  • Fatigue (extreme tiredness)

  • Appetite loss

  • Nausea

  • Diarrhea, if your abdomen is being treated

  • Hair loss, if your head is being treated

  • Mouth and throat sores, if that area is being treated

  • Infection risk

Most of these side effects will get better or go away over time after you finish treatment. Your doctor will discuss other possible long-term side effects.

Radiation to your chest or neck can damage your salivary glands. It can cause dry mouth. Radiation in this area can also cause inflammation of the esophagus (esophagitis). It leads to difficult and painful swallowing. Radiation to the stomach can cause upset stomach and diarrhea.

Radiation may worsen the side effects of chemotherapy. Long-term side effects of radiation therapy may not show up for many years after you complete treatments. How severe the side effects are depends on the dose you get, how often you get treatments, and where the treatments are directed. In rare cases, cancer can develop in other parts of your body.

When to call your healthcare provider

Call your doctor if you have signs of infection, such as fever or pain. Also call if you have side effects that are causing a lot of discomfort.