What do we mean by 'Skin Cancer'? Skin Cancer can be found on any part of the body. It is the most common cancer diagnosed in Australia. Skin Cancers are either Melanoma or Non-Melanoma Skin Cancers (NMSC). Our focus is Skin Cancer on the head and neck, especially the face, nose and lip. Information about other types of Head and Neck Cancers can be found here.

All the information in this section is available in a PDF.
Download it here.

1. Treatment options for Skin Cancer

The most appropriate treatment of Skin Cancer depends on many factors. These include:

  • type, size and location of the cancer and whether it has spread

  • personal factors (e.g. age, general health and treatment history)

  • types of treatment available  

  • your preferences for treatment

Most common Skin Cancers (e.g. non melanoma Skin Cancer) will be treated by a local excision only.

Skin Cancers become invasive when they breakthrough the bottom layer of the skin (dermis) and invade into the deeper tissues.

Ideally, Skin Cancers are treated when still within the skin - “in situ cancer”.

Treatment of in situ Skin Cancer can be with surgery (including excision or curettage also called scooping), radiation therapy or other treatments including liquid nitrogen therapy (freezing), cautery (using heat) or topical medications (e.g. creams or ointments).

How can I prepare for the surgery? 

Your doctor will explain details of the surgery, general risks and side effects of surgery. Ask your doctor if you have questions. They may recommend:

  • stopping blood thinners (e.g. aspirin) before surgery to reduce the risk of bleeding
  • special stockings to reduce the risk of blood clots
  • early mobilisation (i.e. not staying in bed) to reduce the risk of blood clots and chest infection
  • antibiotics to lower the risk of wound infection.

Before starting treatment, it is important that you consider stopping smoking to reduce the risk of infection and help you fully recovery after your treatment.

2. Surgery for Skin Cancer

Surgery is an important treatment for many Skin Cancers. For people, where the cancer has invaded the skin, there is a chance that the cancer may invade deeper structures and spread.

The different operations that can be used for Skin Cancer are​:


This operation involves cutting out the Skin Cancer with a margin of healthy tissue to ensure all of the cancer is removed. It may require cutting away skin, or other soft tissue and bone. 
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This is an investigation that may be done at the time a Skin Cancer is treated. It is done when there is a high risk of the cancer spreading to lymph nodes, but no nodes are obviously involved. This is most often done in people with melanoma or MCC and rarely done for people with SCC or BCC.
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This may be considered if a large area of tissue is removed. This operation is done by your head and neck surgeon or a surgeon who specialises in reconstructive surgery. Reconstructive surgery may involve:
  • Skin grafting, which is taking skin from another part of your body (such as your thigh) and transplanting it to cover the area where you had surgery.

  • Flap repair, which is taking tissue from another part of your body to rebuild the area where you have had surgery. You can have local flap or a free flap surgery. 

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This involves removal of lymph nodes from your neck. This is important even when there is no sign of cancer in the lymph nodes on your scan, because there is a risk of microscopic cancer in the lymph glands of the neck.
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This is the removal of your parotid glands (pair of major salivary glands located in front of each ear) and the surrounding tissue, because of direct invasion in to the gland or because of spread to lymph nodes lying within the salivary gland.
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This is the removal of your facial nerve, which controls changes in face or expressions. It is used when a cancer in the parotid gland has spread to the nearby facial nerve.
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This is the removal of some or all of the bone in the temple and behind the ear. It is used when a cancer in the parotid gland has spread into the nearby bone.
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This involves the removal of the eye or eye lid. It is used when the cancer has spread into the eye socket and cannot be treated any other way.
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Side effects of surgery 

Treatment for skin cancer may lead to late side effects. You may not experience all the side effects, however talk to your doctor if you are concerned.

3. Radiation therapy for Skin Cancer

Radiation therapy can be used to treat both melanoma and NMSC.

Most people with melanoma will have surgery but some people with widespread in situ melanoma, or with metastatic lymph nodes after surgery may be referred to a radiation oncologist to consider having radiation therapy.
The common type of radiation therapy for Skin Cancer is called external beam radiation therapy. This type of radiation therapy is applied from outside of the body. The machines used to deliver radiation therapy for Skin Cancer give less penetrating radiation that is because these Skin Cancers are on the skin surface. Some people will need deeper treatment with deeply penetrating x-rays called megavoltage photons.

Radiation therapy can be used in the following ways: 


Definitive radiotherapy can be used on its own (without surgery) to cure Skin Cancer.

It may be recommended if surgery is not appropriate because of the size and location of the Skin Cancer or an operation is not safe for the person involved. This therapy is more common for people with a NMSC.

Done after surgery. It is used as an additional treatment to kill any cancer cells that may not have been removed during surgery.
Used to relieve symptoms of advanced Skin Cancer, such as pain and bleeding or if the cancer has spread to other parts of the body such as the bones.

How do I prepare for radiation therapy? 

You will meet with many members of the cancer care team, who will help you learn how to look after yourself through radiation therapy, recovery and long term follow-up. They will also talk to you about side effects and how to manage them. It may be helpful to write down questions as they come up, so you can ask anyone in your cancer care team when you see them.


Radiation therapy mask-making and simulation 

  • Radiation therapy is a precise treatment. In order to make sure, that the cancer is covered by the treatment, you will need to be very still during the treatment, usually for about five minutes. A radiation therapy mask that is made to fit perfectly to your shape, will be put on you during each treatment to help the machine target where the cancer is.

  • You will have a planning CT scan (and sometimes other scans) with the mask on. Your radiation oncologist and radiation therapists will use these scans with all your other clinical information to develop a radiation therapy plan just for you (a personalised plan). Your plan will be checked by the radiation therapy and radiation oncology physics team before it is ready to be used for your treatment. This whole process can take approximately 2-3 weeks.


Teeth and mouth care

You might need to have some of your teeth taken out, this will depend on the area being treated and the dose of radiation therapy. It is important to take out any broken or infected teeth before radiation therapy. Taking out unhealthy teeth after radiation therapy can cause problems with the jaw bone.  Further information about removing teeth and what to expect during and after the operation is available here



Diet, nutrition and the role of your dietitian

Your cancer and its treatment can make it hard to eat and drink. Your doctor will recommend you see a dietitian to maximise your nutrition during treatment as well as while you are recovering. Sometime feeding tubes may be recommended depending on the area being treated and the dose of radiation therapy.
There are two common types of feeding tubes: 

  • Gastrostomy tube (sometimes called a PEG tube): this type of tube is inserted through your abdominal wall into your stomach, with part of the tube staying outside the stomach.  A syringe can be attached to the tube to give you food this way if needed. The tube is inserted using a camera through the mouth into the stomach (gastroscopy) or using a CT scanner to guide insertion directly through the skin. If a PEG tube is needed, your doctor will organise this before starting your radiation therapy

  • Nasogastric tube: this type of tube goes through the nose down into the stomach and is usually used for short periods (days or weeks). A nasogastric tube can be inserted at any time (before, during or after treatment).

  There are many other aspects of supportive care that will available to you, ask your doctor if you have any specific needs  

Side effects

The side effects of radiation therapy can start during treatment and progress through treatment to peak at the end of treatment and the week after treatment. They begin to improve 2-3 weeks after the end of treatment.

Side effects associated with radiation therapy depend on:

  • the dose of radiation therapy

  • the area being treated

  • whether or not chemotherapy is added to the radiation therapy

  • how quickly the treatment is delivered.

Common early side effects of radiation therapy may include:

  • tiredness

  • skin irritation in the area treated- redness, dryness and itching, weeping skin, scaling or even skin breakdown by the end of treatment

  • local loss of beard (in men) or hair if the scalp are treated

  • nasal cavity crusting, congestion and bleeding of nose is treated.

Most side effects are short lived and may go away shortly after you finish radiation therapy. Some side effects may last for some time after you finish radiation therapy and some may be permanent.

Once your radiation therapy ends, you will have regular have follow-up appointments, so that your doctor can check your recovery and monitor any side effects that you may have.

Your doctor may recommend specific supportive care options to help you during your treatment and recovery. 

To learn more about Radiation Therapy and to watch
a video of an Immobilisation Maks being made click here


4. Chemotherapy for Skin Cancer

Chemotherapy for non-melanoma Skin Cancers is rarely used but is usually given into a vein through a needle with a cannula (tube) attached. Chemotherapy works by attacking rapidly dividing cells, such as cancer.

People with melanoma may be recommended types of systemic treatment called immunotherapy. Many people with melanoma may also be asked to take part in a clinical trial of different types of these drugs.
All the information in this section is available in a PDF.
Download it here.
  • What is Skin Cancer?
  • What is skin?
  • What does the skin do?
  • What causes Skin Cancer?
2. Symptoms, signs and tests of Skin Cancer
  • Signs and Symptoms of Skin Cancer
  • Tests for Skin Cancer
3. Treatment for Skin Cancer
  • Treatment options for Skin Cancer
  • Surgery 
  • Radiation Therapy
  • Chemotherapy
  1. Head and Neck Cancer Australia Resources 
  2. External Links to other Head and Neck Cancer Resources