Radiation Therapy for Lung Cancer
How does radiation work?
Radiation therapy is often used in the treatment of lung cancer. Tumors are made up of cells that are reproducing at abnormally high rates. Radiation therapy specifically acts against cells that are reproducing rapidly. Normal cells are programmed to stop reproducing (or dividing) when they come into contact with other cells. In the case of a tumor, this stop mechanism is missing, causing cells to continue to divide over and over. It is the DNA of the cell that makes it capable of reproducing. Radiation therapy uses high energy x-rays to damage the DNA of cells, thereby killing the cancer cells, or at least stopping them from reproducing.
The radiation used to destroy cancer cells can also hurt normal cells in the surrounding area. However, normal cells are growing more slowly, and are better able to repair this radiation damage than are cancer cells. In order to give normal cells time to heal and to reduce a patient's side effects, radiation treatments are typically given in small daily doses, five days a week, over a six-or seven-week period.
What should I expect on treatment?
The side effects from radiation treatment are directly related to the area of the body being treated. Side effects are caused by the cumulative effect of radiation on the cells; therefore most patients do not experience any side effects until a few weeks into their treatment. While side effects may be unpleasant, there are treatments to help deal with them. Most side effects are temporary, disappearing gradually after therapy is complete.
Most radiation oncologists see their patients at least once a week while the patient is receiving treatment. This visit with the healthcare team serves as an opportunity to ask questions, discuss any side effects, and implement any necessary interventions to help relieve the side effects. However, you can report concerning symptoms any time to your treatment team.
The following list includes some of the most common side effects of radiation therapy for lung cancer. Remember that the treatment can affect each patient differently, and you may not experience these particular side effects. Talk with your radiation oncologist and health care team about what you can expect from your specific treatment.
- Skin irritation. The skin in the treatment area may become red, irritated, dry, or sensitive. This may progress to look like a sunburn. Treat the skin gently to avoid further irritation, and bathe carefully, using only warm water and mild soap. Avoid perfumed or scented lotions or soaps, as these may cause further irritation. Avoid sun exposure, which can worsen the irritation.
- Esophagitis. This is an inflammation of the esophagus, which is the tube that connects the mouth to the stomach. This can cause pain when swallowing or difficulty swallowing. Your oncology team can prescribe pain medications and help with nutritional concerns. If the pain prevents you from eating and drinking properly, a small feeding tube may be used during treatment to maintain your nutrition and prevent weight loss. Esophagitis tends to begin 2-3 weeks into treatment and begins to improve about 2 weeks after treatment is complete.
- Changes in taste. This can include metallic taste and food aversions. Although the problem with taste changes typically resolves over time after therapy is ends, it can persist for a year or longer.
- Loss of hair. Also called alopecia, hair loss can occur on your chest. Hair typically starts to regrow a month or so after treatment. However, your hair might not grow back exactly as it was before treatment and for some, the hair loss becomes permanent.
- Fatigue. This is very common with radiation treatment and tends to begin a few weeks into therapy. Fatigue typically resolves slowly over the weeks and months following treatment.
Long-Term Side Effects
The side effects discussed thus far tend to occur during treatment up until a few months after treatment. Long-term effects can occur months to many years after cancer treatment and the risks vary depending on the areas included in the field of radiation and the radiation techniques that were used. Some of the potential long-term side effects of radiation to the lung include:
- There is a low risk of developing a second cancer in or near the radiation field. These are called secondary cancers, and they develop as a result of the exposure of healthy tissue to radiation. Modern radiation techniques are designed to limit this exposure, but it is not always possible to prevent all exposure and still achieve the desired outcomes.
- Radiation can result in the development of scar tissue in the esophagus months to years after treatment, which can lead to swallowing problems. Report any changes in swallowing or new or worsening heartburn to your oncology team.
- Radiation can cause inflammation (pneumonitis) and scarring (fibrosis) in the lung. Pneumonitis tends to occur within a few months of treatment, whereas fibrosis happens as a result of untreated pneumonitis. Symptoms of these conditions include cough, shortness of breath and wheezing. Fortunately, modern radiation techniques limit the risk of these complications.
After treatment, talk with your oncology team about receiving a survivorship care plan, which can help you manage the transition to survivorship and learn about life after cancer. You can create your own survivorship care plan using the OncoLife Survivorship Care Plan.