Superficial Radiotherapy

  • Reference Number: HEY-315/2015
  • Departments: Radiotherapy


This leaflet has been produced to provide general information about superficial radiotherapy treatment.  Many of your questions should be answered by this leaflet.  It is not intended to replace discussion between your doctor and you.  If after reading it, you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

What is Radiotherapy?

Radiotherapy is the use of X-rays to treat cancer. In this case, low energy X-rays ensures superficial (shallow) penetration of the skin. The X-rays focus on the precise area for treatment that has been decided by your consultant. They will also prescribe the most effective treatment for each individual. This could mean one visit or several visits.

Shows a typical superficial treatment
Fig 1. Shows a typical superficial treatment.

Before treatment

You will be given an appointment to have the area for treatment ‘marked up’. This means your consultant will mark up the precise treatment area and the details will be recorded. This could involve drawing on your skin with a temporary marker pen, making a template, taking measurements or even taking a photograph. Once this process is complete, the treatment dose can be calculated and any further equipment such as shielding, to protect areas we want to avoid treating, can be made. This shielding, if required, is very small and can be placed easily onto your skin.

For some patients whose treatment is near to the eye it may be necessary to use an internal eye shield to protect the eye. This would involve eye-drops to numb the eye prior to inserting the shield under your eyelid, just like a contact lens.

It is sometimes possible for your treatment to start on the same day as your ‘mark up’.

How is my treatment given?

Superficial radiotherapy is a quick, simple and painless process. You will be positioned on the treatment couch as comfortably as possible and the machine positioned over the area to be treated with light contact of the skin. Once set up, the radiographers will stand in the control room, next to the treatment room where you will be observed at all times through a window.

Treatment times and number of visits vary according to your prescription. Typically, treatment time is 1–2 minutes and the number of visits from 1–20 (Monday-Friday). You will normally visit as an outpatient and your course of treatment will depend on the type of cancer, its location and size.

Short term and long term side effects

During treatment, the area being treated could gradually become red. You may experience irritation and in some cases the area being treated may discharge a little, and form scabs. During your period of treatment, you will be regularly reviewed and advised about skin care. The effects of the treatment will continue for approximately 4 weeks after completion of your course.

Long term effects include skin colour alterations in the area treated, skin atrophy (thinning of the skin), increased sensitivity to the sun, telangiectasia, (enlarged thin walled blood vessels close to the surface of the skin). This can take several years to develop.

Skin care

Prior to treatment, you will be given advice about how to look after your skin while on treatment, in order to minimise side effects. During your course of treatment, the radiographers will monitor the area being treated and refer you to the skin care nurse if necessary. Please see the ‘Skin Care during Radiotherapy’ leaflet you will have been given prior to starting your course of treatments.

What happens when I finish treatment?

Once your treatment is finished, you will be given advice about continuing skin care and what you can expect in the next few weeks. A follow up appointment will be made and your progress can be discussed with your consultant during the follow up visit.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Radiotherapy Information and Support Team on telephone number: (01482) 461206, or Email:

Please find below the contact details of useful organisations that provide information about cancer including radiotherapy treatments:

Cancerbackup and MacMillan Cancer Support provides information from specialist nurses on all aspects of cancer and its treatment, and on the practical and emotional aspects of living with cancer.

Free phone help line: 0800 8001234 (Monday – Friday 9:00am – 8:00pm)
Write to: 3 Bath Place, Rivington Street, London, EC2A 3JR

PALS (Patient Advice and Liaison Service)
Provide confidential advice and support, helping you to sort out any concerns you may have about the care we provide, guiding you through the different services available from the NHS.

Telephone: (01482) 623065 (Monday – Friday 9:00am – 4:00pm)

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.