Radiation therapy for lung cancer
Also known as radiotherapy, radiation therapy is the use of targeted radiation to kill or damage cancer cells so they cannot grow, multiply or spread.
For lung cancer, the radiation is usually in the form of x-ray beams that come from a machine outside the body. This is called external beam radiation therapy (EBRT). It can be delivered in different ways depending on the type of lung cancer.
Learn more about:
- Standard EBRT
- Stereotactic body radiation therapy (SBRT)
- Planning radiation therapy
- Having radiation therapy
- Side effects of radiation therapy
- Video: What is radiation therapy?
This is usually given every weekday over several weeks.
Treatment aimed at making the signs and symptoms of cancer go away (curative course) may involve 20–33 treatments over 4–6 weeks. Palliative radiation therapy usually involves 1–15 treatments.
This is also called stereotactic ablative body radiation (SABR). It is a way of giving a very precise high dose of radiation therapy to small NSCLCs. It is sometimes used instead of surgery.
SBRT is often given as 3–4 treatment sessions over a couple of weeks. It is suitable only for tumours that are not close to major airways or major blood vessels.
When is radiation therapy used?
Radiation therapy may be given on its own, with surgery or with chemotherapy (called chemoradiation).
It may be recommended:
- if you are unable or choose not to have surgery
- to treat locally advanced (stage 3) NSCLC or limited-stage SCLC
- after surgery if tests show cancer in the mediastinal lymph nodes, to reduce the risk of the cancer coming back in the mediastinum
- as palliative treatment to improve quality of life by relieving pain or other symptoms.
Planning radiation therapy
Before treatment starts, you will have a planning session at the radiation therapy centre to design a treatment plan for you. During this appointment, you will have a CT scan to pinpoint the area to be treated, and marks will be put on your skin so the radiation therapist treats the same area each time.
The radiation oncology team will explain the treatment schedule and discuss possible side effects.
Radiation therapy is delivered using a machine called a linear accelerator. Each treatment day, a radiation therapist will help you to lie on the treatment table and make sure you are in the correct position before leaving the room. Before the radiation therapy is given, you will have an x-ray or CT scan to make sure the correct area is being treated.
When the treatment starts, you will not feel or see anything, but you may hear a buzzing sound from the machine. The treatment itself takes only a few minutes, but a session may last 10–20 minutes because of the time it takes to set up the machine.
The side effects of radiation therapy vary depending on the dose of radiation and the number of treatments. Most are temporary and disappear a few weeks or months after treatment. Radiation therapy itself is painless, but the radiation may affect some tissues of the body and cause some of the side effects discussed below.
Discomfort when swallowing and heartburn
These side effects may occur during the treatment period and continue for up to four weeks after treatment ends. Until they improve, you may need to eat soft foods and avoid hot drinks, such as tea and coffee.
Feeling tired is common after radiation therapy. Plan your daily activities so you can rest regularly. You may find physical exercise helps to reduce fatigue. It may also help to talk to your family, friends or employer about how they can help you.
The skin on your chest and back may become red or dry, like sunburn. It is important to avoid getting direct sunlight on these areas. Apply a moisturising cream to the skin daily to help look after your skin – talk to your medical team about which products they recommend.
Shortness of breath and cough
Radiation therapy may cause inflammation of the lungs, known as radiation pneumonitis. This may cause shortness of breath, a cough or both. These side effects may happen during treatment, but they are more likely to appear 1–6 months after treatment ends. Radiation pneumonitis is usually temporary and can be treated with steroid (corticosteroid) tablets.
Side effects can change from one treatment session to the next and may build up over time. Tell the radiation oncology team about any side effects you have, as most can be managed.
Video: What is radiation therapy?
A/Prof Nick Pavlakis, President, Australasian Lung Cancer Trials Group, President, Clinical Oncology Society of Australia, and Senior Staff Specialist, Department of Medical Oncology, Royal North Shore Hospital, NSW; Dr Naveed Alam, Thoracic Surgeon, St Vincent’s Private Hospital Melbourne, VIC; Prof Kwun Fong, Thoracic and Sleep Physician and Director, UQ Thoracic Research Centre, The Prince Charles Hospital, and Professor of Medicine, The University of Queensland, QLD; Renae Grundy, Clinical Nurse Consultant – Lung, Royal Hobart Hospital, TAS; A/Prof Brian Le, Director, Palliative Care, Victorian Comprehensive Cancer Centre – Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, and The University Of Melbourne, VIC; A/Prof Margot Lehman, Senior Radiation Oncologist and Director, Radiation Oncology, Princess Alexandra Hospital, QLD; Susana Lloyd, Consumer; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Nicole Parkinson, Lung Cancer Support Nurse, Lung Foundation Australia.
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