Radiation therapy for lung cancer is used in the treatment of both non-small cell and small cell lung cancers, the two most common types of lung cancers. Although surgery is the primary treatment for carcinoid tumors, a rare form of lung cancer, radiation therapy also may be used if surgery is not possible or following surgery if not all of tumor is removed. It also can be used to relieve painful symptoms caused by the tumor.
Non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) make up more than 95 percent of lung cancer cases. Because these two categories of lung cancer are very different, radiation therapy is used differently.
Non-Small Cell Lung Cancer
NSCLC is the most common form of lung cancer, accounting for 85 percent of all lung cancer diagnoses. NSCLC includes squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. Radiation therapy is a frequent component of treating NSCLC, most often along with surgery and sometimes chemotherapy. Radiation therapy for NSCLC is used in the following ways:
- Radiation can be used after surgery, sometimes along with chemotherapy, to kill any remaining cancer cells that were not removed during surgery.
- Radiation therapy for NSCLC also can be used before surgery to shrink the size of the tumor.
- Radiation therapy, usually in conjunction with chemotherapy, can be used as the main treatment for locally advanced non-small cell lung cancer that has not spread outside the lungs for patients who are not surgical candidates.
- Radiation therapy, in the form of stereotactic body radiation therapy (SBRT) can be used for early non-small cell lung cancer in patients who are not surgical candidates.
- Radiation therapy is used alone to relieve symptoms for advanced NSCLC that has spread outside the lungs.
- Radiation therapy, specifically a form called brachytherapy, is used internally, usually to relieve obstruction after previous external radiation.
Small Cell Lung Cancer
SCLC is an aggressive form of lung cancer that spreads quickly. Radiation therapy can help in many different ways, including:
- Concurrent chemoradiation: Radiation therapy is given at the same time as chemotherapy to treat the tumor and lymph nodes in the chest of patients who have limited stage SCLC confined to the chest.
- Sequential treatment: Radiation therapy is given after chemotherapy is completed. This sequence may be used for patients with extensive stage SCLC. It also may be used for patients who cannot tolerate chemo and radiation at the same time due to side effects.
- Prophylactic cranial irradiation: Because SCLC often spreads to the brain, radiation can be administered to the brain to help prevent it for spreading there.
- Palliative radiation: Radiation may be used to shrink tumors to relieve symptoms such as cough, shortness of breath, bleeding, or pain.
Types Of Radiation Treatment For Lung Cancer
Lung cancer is typically treated using external beam radiation therapy (EBRT), a process in which a machine is used to aim high-energy beams at the cancer tumor from outside the body. External beam radiation, EBRT, is performed completely outside of your body and feels similar to getting an X-ray.
Treatments are usually administered once or twice a day, five days a week, for five to seven weeks, depending on your cancer’s stage and treatment goal.
Rocky Mountain Cancer Centers uses two types of external beam radiation therapy, EBRT, depending on your type of cancer and many other factors. These technologies help minimize damage to surrounding health tissue. The two EBRT technologies used at Rocky Mountain Cancer Centers are:
3-dimensional conformal or Intensity-modulated radiation therapy (IMRT) uses specialized computer equipment to break radiation beams into smaller beamlets that can be individually adjusted for intensity. They’re then aimed at the tumor from various angles as the machine moves around your body in order to deliver the most possible radiation per treatment while limiting the dose to healthy tissue, especially that of important nearby structures, such as the spinal cord.
Stereotactic body radiation therapy (SBRT) uses computed tomography (CT) and magnetic resonance imaging (MRI) to pinpoint the exact location and shape of a lung cancer tumor during radiation therapy. Microbeams, focused to within a fraction of a millimeter, are then aimed at the tumor from various angles while the patient lies in a body frame to reduce the movement of the tumor during breathing. Using this technique, our radiation therapy experts can deliver very high doses of radiation to the lung cancer tumor in just a few treatments. SBRT is most often used in patients who are not eligible for surgery and can be administered in just one to five treatments. Read more about SBRT in this Rocky Mountain Cancer Centers blog post.
Internal Radiation Therapy for Lung Cancer
In addition to external radiation therapy, another form of radiation, called brachytherapy, may be recommended to treat advanced lung cancer cases that are causing distressful symptoms, particularly airway obstruction. Brachytherapy is called internal radiation therapy because radioactive seeds are implanted through catheters directly into the tumor. Read more about brachytherapy and the way in which Rocky Mountain Cancer Centers use it.
Side Effects Of Radiation Therapy
Most patients will experience some side effects caused by radiation treatment; however, most patients will experience only some side effects and severity is different for each patient. It’s important to remember that most side effects will end shortly after treatment ends.
The most common side effects of radiation therapy experienced by lung cancer patients are cough, shortness of breath, sore throat and trouble swallowing. Radiation therapy for lung cancer may damage your lungs, which can cause a cough or difficulty breathing. These side effects usually improve when treatment ends.
Patients also may experience a sore throat or trouble swallowing during treatment if their esophagus, which is close to the lungs, is exposed to radiation. Patients may need to eat a liquid diet during phases in their treatment if this occurs, which is very important as good nutrition is essential to healing and combatting other side effects. These symptoms improve after the end of treatment.
Other side effects common to radiation therapy for cancer of any type include:
- Nausea and vomiting
- Skin irritation or tenderness where the radiation is administered
Adequate rest along with good nutrition and light physical activity have been proven to help with radiation-related fatigue. Your Rocky Mountain Cancer Centers radiation therapy team will help prepare you for likely side effects and teach you ways to minimized these.
If you are a patient and are experiencing worsening symptoms from your treatment, such as those listed below, our medical professionals are available 24 hours a day, 7 days a week to help. We can assess signs and symptoms, schedule you for an in-office, same or next day appointment and help you avoid a trip to the Urgent Care, ER or unplanned hospitalization. In the event of a life-threatening emergency always call 911. Call us if you are experiencing:
- Chills or fever greater than 100.4
- Burning with urination , frequency, urgency, lower back pain (UTI)
- Productive cough with green, yellow, red, brown sputum
- Unmanaged diarrhea, constipation, nausea, vomiting
- Unmanaged pain
- Swelling, redness and pain on extremities
- Shortness of breath/chest pain
- Dizziness with changing position or lightheadedness
- Dark urine, less urine than normal, thirst, dry mouth (dehydration)
- Mouth sores, difficulty swallowing, frequent or sever heartburn
- Severe fatigue