When is radiotherapy recommended for squamous cell skin cancer?

Surgery is often considered first when the cancer can be removed while preserving useful function. Radiotherapy may be discussed for a tumour in a difficult site, for example near an eye, nose, ear or other structure where removal could cause major functional or cosmetic change. It may also follow surgery when the edge of removed tissue is involved, the tumour has grown deeply or along a nerve, or nearby lymph nodes contain cancer. A specialist may use it for a tumour that has returned, cannot be removed safely, or is causing pain, bleeding or pressure. The plan considers skin condition, tumour depth and position, previous treatment, general health and the goal of treatment.

Ask whether a skin-cancer surgeon, radiation oncologist and, when needed, a head-and-neck team have reviewed the case. Discuss the biopsy wording, surgical margins, nerve involvement and lymph-node findings. Before treatment, tell the team about previous radiation, autoimmune conditions, medicines and implanted devices. Ask how the treated skin will be protected, whether nearby eyes, ears, mouth or brain need special shielding, and how follow-up will check healing and new skin changes. Protect the area as instructed and avoid applying products that the team has not approved.

Arrange prompt medical assessment for a skin sore that does not heal, a crusted or bleeding area that enlarges, new numbness or weakness, a rapidly growing lump, or swelling in nearby lymph nodes. Seek urgent care for uncontrolled bleeding, sudden eye or facial swelling, or difficulty breathing or swallowing. These findings require examination and do not by themselves show that a skin change is cancer.

Why is radiotherapy being considered instead of, or after, surgery? Which risk feature affects the recommendation? What area will be treated, and how might the skin, hair, eye, ear, mouth or nerves be affected? How will recurrence and new skin cancers be monitored?