Cancer treatment using light
This page is about cancer treatment using light. There is information about
Treating cancer using light is called phototherapy. First you have a drug that makes your skin or your cancer cells sensitive to light. Once this has been absorbed, your doctor shines a light on the treatment area and the sensitised cells are killed. There are two ways in which this treatment is used for cancer
If you have PUVA or PDT, the doctors and nurses at the hospital will give you guidelines to follow after you have treatment. This includes information about protecting yourself from the sun. It is important that you follow the guidelines to prevent serious side effects.
PUVA is sometimes used to treat a type of lymphoma that affects the skin, called cutaneous T cell lymphoma (CTLC). It is also used for other skin conditions such as psoriasis. Clinical trials are looking into PUVA for cutaneous T cell lymphoma, including a particular type called mycosis fungoides. While these trials are running, they will be listed on our clinical trials database. Choose 'lymphoma' from the dropdown menu of cancer types. Or type 'PUVA' into the free text search.
If you have PUVA for CTLC, you may have treatment 3 times a week at first. Over a year or so this is gradually reduced to once every 2 or 3 weeks. You will probably have PUVA regularly for 4 or 5 years altogether. There is more information about PUVA in the section about cutaneous T cell lymphoma. As with all treatments, PUVA has some side effects. Psoralen, the drug used, is a type of drug called a photosensitiser. This means it makes your skin very sensitive to light. Each time you have PUVA treatment, you take a psoralen tablet. Between one and two hours later you have an ultraviolet A (UVA) light shone onto your skin. Because psoralen makes the skin more sensitive to light, you will burn more easily than usual in the sun, especially on the day you have treatment. It is important that you remember to protect yourself from the sun.
Psoralen also makes your eyes more sensitive to UV light. You may need some eye protection – your own doctor or nurse will be able to advise you on this. If you need eye protection, you can either
- Wear sunglasses that are marked UV400
- Have your normal glasses treated with a clear protective coating at your opticians
- Buy or borrow some protective glasses from the hospital
It's important if you wear sunglasses that they do say UV400. This tells you that they will block both UVA and UVB light.
Psoralen may make you feel sick for a few hours after you take it. You may feel less sick if you take psoralen with some food. Doctors think the psoralen could cause birth defects, so you must not have PUVA treatment if you are pregnant. And you should use contraception if there is any chance that you could become pregnant.
Long term side effects of PUVA include ageing of the skin, skin darkening, and an increased risk of developing skin cancer. A study in North America showed that patients with psoriasis who had treatment of a type of PUVA called PUVA13 had an increased risk of developing a type of skin cancer called squamous cell cancer (SCC). All treatments have some side effects. Your doctors will discuss the side effects of the treatment with you, and you will need to look at both the risks and the benefits before you decide what you want to do.
PDT (photodynamic therapy) is another type of treatment that uses light. If you have PDT for a skin condition such as acne or psoriasis or skin cancer, you are likely to have a cream that you put on your skin (a topical photosensitiser). You then wait for 4 to 6 hours and have a light shone onto the area for about 15 to 45 minutes. After this you will have a protective dressing put over the area. You may only need one treatment or you may have 2 or 3 treatments.
If you have PDT as a treatment for a cancer other than skin cancer, you will probably have an injection of a photosensitising drug into a vein. Examples include drugs called Photofrin and Foscan. A few days after the injection, the doctors will shine a light over your cancer cells. How they do this will depend on where you need the treatment. If the cancer is in your food pipe (oesophagus) for example, you will need to have a tube put down your throat that can carry the light to the cancer. This is called an endoscopy. If you do have an endoscopy, you will have a sedative first. Make sure there is someone with you who can take you home afterwards. You won't be able to drive yourself and should have someone with you on public transport. This type of PDT is usually just a single treatment.
The main side effect of PDT is that you will be more sensitive to light. This may last for a few weeks. During this time you will have to gradually build up your exposure to light. Otherwise your skin will burn.
The National Institute for Health and Clinical Excellence (NICE) has approved PDT for some types of skin cancer. It is available as an alternative to surgery for basal cell skin cancer, Bowen's disease and actinic keratosis. The link takes you to information in our skin cancer section.
PDT is still an experimental treatment for most other cancer types, and we don’t know yet how well it will work. Clinical trials are in progress looking at PDT as a treatment for a number of cancers including cancer of the bile duct, pancreatic cancer, gallbladder cancer, cancer of the food pipe (oesophagus), prostate cancer and brain tumours. It will be several years before we know the results of these clinical trials. There is information about them on our clinical trials database. Pick the type of cancer you are interested in from the dropdown menu of cancer types. Or type 'PDT' into the free text search.
There is a page about photodynamic therapy on CancerHelp UK. There is also information about both PUVA and PDT on the British Association of Dermatologists website.
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