Definitive radiotherapy is like surgery in that they are both local treatments. They have similar cancer control ability, although further prospective comparative study is required. Radiotherapy is different from surgery in a number of ways. Surgery always removes tissue. Radiotherapy always conserves tissue. Tissue conservation leads to a better functional and cosmetic effect. Tissue conservation leads to better survivorship. Radiotherapy is therefore particularly useful when tissue conservation is important eg face, nose, ears, eyelids, genitals, fingers and toes. RT has no pain on delivery so there is no need for anesthetic. There is no tissue removal, and so no need for grafting, and so no need for an in-patient stay with the leg up for the surgery to heal. As there is no cutting, anticoagulation does not need to be stopped prior to treatment. However, RT is delivered over time and may require many visits. As no tissue is removed there is no histopathology report. There are short term side effects, usually, at the end of treatment, that may require temporary nursing care until healed.

RadiotherapySurgery
Tissue ConservationYesNo
Need for anestheticNoYes
Inpatient stay to healNoYes
Stopping Anticoagulation RequiredNoYes
Number of TreatmentsMoreLess
Histopathology ReportNoYes
Table comparing Radiotherapy and Surgery