NCCN Guidelines for Patients
Mycosis Fungoides, Version 1.2016
Overview of cancer treatments Phototherapy
much so partly depends on how often and how much
radiation you receive. For local treatment, side effects
depend on the treatment site. Ask your doctor if you
will receive low- or high-dose treatment and what side
effects you should expect.
Depending on the dose, your treated skin may look
and feel as if it is sunburned. It may also become dry,
sore, and feel painful when touched. Open sores may
occur and may become infected. Short-term loss or
thinning of your hair at the treatment site is common.
Your nails may come off or stop growing for a while.
You may also sweat less.
Not all side effects of radiation are listed here.
Please ask your treatment team for a complete list of
common and rare side effects. If a side effect bothers
you, tell your treatment team. There may be ways to
help you feel better. There are also ways to prevent
some side effects.
Phototherapy is a treatment that uses UV (
radiation. UV radiation is light energy that can’t be
seen. Think of sunlight that can be seen versus
unseen UV light from the sun that can cause
sunburns. UV radiation does not travel as far as
electrons and x-rays that are used in radiation
therapy. UVA is long-wave light and UVB is short-
wave light that is used in phototherapy.
UVB phototherapy is a skin treatment of mycosis
fungoides. It is used to treat patches and thin plaques.
Either narrowband or broadband UVB can be
used, but narrowband is advised by most doctors.
Narrowband consists of a 311 to 312 nm wavelength
of UV radiation. Broadband consists of 290 to 320 nm
Treatment often occurs at a dermatology office. You
will stand undressed in a cabinet with fluorescent light
tubes for about 30 minutes. Some parts of your body,
such as your eyes, will be shielded. The dose of UVB is
increased at each visit. Visits occur 3 to 5 times a week.
Skin lesions often start to fade in 20 to 40 visits. Once
the lesions are gone, the number of visits will be
reduced slowly then will be stopped. UVB will cause
your skin to turn red. Sometimes, skin feels painful as
if it got sunburned. High exposure to UVB increases
the chance of getting skin cancer.
PUVA is a skin treatment that consists of psoralen
and UVA. UVA travels deeper into the skin than
UVB. Thus, PUVA damages skin more so than UVB
phototherapy. PUVA is used to treat thick plaques. It
is also called photochemotherapy.
About two hours before UVA exposure, you
will receive psoralen. Psoralen sensitizes your
skin to UVA. You may take psoralen in pill form
(methoxsalen) or soak in it during a bath. To treat
most of your skin, you may stand in a cabinet that has
many UVA bulbs. Otherwise, there may be devices
to treat smaller skin areas. Some parts of your body,
such as your eyes, will be shielded. Exposure to UVA
is about 30 minutes.
PUVA is given three times a week until the lesions are
gone. This can take between 2 and 6 months. Once
the lesions are gone, PUVA is reduced very slowly
down to once every two weeks.
Shortly after treatment, your skin may look red, feel
itchy and dry, and may be blistered. You may also
feel nauseated. Protect your skin from the sun for at
least 24 hours after treatment. Long-term side effects
include cataracts. PUVA increases the chance of
getting another skin cancer, especially if you received
PUVA over a long period of time.