What to expect from radiotherapy for Merkel cell carcinoma

Your radiation oncologist uses examination and scans to shape treatment around the original skin site and, when appropriate, nearby lymph-node areas. A planning session may include marks on the skin and a mould or other support to keep the body still. At each appointment, staff position you, leave the room while the machine delivers the dose, and return to check you afterwards. The treatment does not make you radioactive.

Skin changes are the main local concern: redness, dryness, darkening, peeling or soreness can appear gradually. Hair in the treated patch may thin temporarily or for longer. Fatigue may increase during the course. Effects vary with the site, field size and whether surgery or other treatment has also occurred.

Keep the treatment area clean with lukewarm water and a mild product approved by your team. Pat rather than rub, avoid shaving or adhesive products over the field unless cleared, and protect the skin from sun and friction. Wear soft, loose clothing where possible. Tell the team about creams, medicines, allergies and any wound or recent surgery before the first session. Keep hydrated, plan lighter activities on tiring days, and do not pick at peeling skin or dressings.

Call your treatment team promptly if the treated skin opens, blisters, drains, becomes increasingly hot or painful, or develops a rapidly spreading rash. Report fever, chills, worsening swelling, uncontrolled pain, new facial or limb weakness, or trouble swallowing or breathing. Seek emergency care for severe breathing difficulty, fainting or sudden neurological changes. Use the contact number supplied by your centre if symptoms appear at night.

Why is radiotherapy recommended after or instead of surgery? Will lymph nodes be included? How should I protect the treated skin? When can I wash, shave or resume usual activities? Which changes are expected, and whom do I contact about a wound?