Lung Cancer

Lung cancer - radiotherapy

Radiotherapy is often used to treat people with lung cancer. It can also be used to shrink tumours before surgery. There two main types of radiotherapy;

  • external radiotherapy (the most common form) and
  • internal radiotherapy (also known as brachytherapy) 

External radiotherapy is aimed at your body from a machine and is similar to having an X-ray you may have between 20 -36 treatments depending on your treatment plan.

With Internal radiotherapy a narrow tube containing a radiation source is put inside your airway for a few minutes using a bronschoscopy. Internal radiotherapy may be given when the tumour is blocking one of the airways and has made the lung collapse. It's a simple way of opening up the airway. If you have this type of radiotherapy, you usually need only one session of treatment.
 None of the people we interviewed had internal radiotherapy so all references to radiotherapy refer to external radiotherapy. For non-small cell lung cancer it may be used as the main treatment, particularly if the cancer cannot be removed with an operation.

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Before radiotherapy starts a simulator (a special X-ray machine), is used to plan the treatment. One woman said that it felt like being in a space ship. People recalled that they were measured and marked with little tattoos in preparation for the treatment.

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Radiotherapy is painless, though the treatment table may be a bit hard and uncomfortable, and the machines used for radiotherapy can sometimes be a bit noisy. One man, who had non-small cell lung cancer, said that during radiotherapy he felt some discomfort due to the position of his arms, which he had to keep above his head. One woman said that during radiotherapy she felt a hot sensation.

In some cancer centres patients with non-small cell lung cancer are offered an accelerated regime called CHART (continuous hyperfractionated accelerated radiotherapy). Radiotherapy is given three times a day, over a shorter period of time. One woman recalled the time she spent in hospital while she was having CHART. She said that radiotherapy was not frightening in the least.

In small cell lung cancer, radiotherapy may be given with or after chemotherapy to improve results or to reduce symptoms. Most people said that despite expectations the radiotherapy was painless and nothing to worry about. However, one person said that the tattoos were quite painful, and that during treatment she felt rather exposed and freezing cold (see also 'Side effects of radiotherapy for lung cancer').

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People with small cell lung cancer may also be given radiotherapy to the head to prevent the disease spreading there. It is important that people do not move during treatment. Therefore before treatment starts a plastic mask (or shell) is usually made to fit each person's head. The masks are made using dental alginate, gauze, plaster of Paris and Perspex. They are worn during treatment and fixed in position to prevent movement.

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When the masks are made the staff should explain each stage of the procedure, which is painless. However, one person had a bad experience because she wasn't informed of what was happening.

Head masks may also be made out of a thermoplastic material. A flat sheet of this material (which has plenty of holes in it for breathing), is heated in a water bath or hot air oven until it goes floppy. It is then placed over the patient's head to make a mask. As it cools it goes rigid. One man described his experience and demonstrated how his mask fitted his face.

Radiotherapy can also help in treating lung cancer that has spread to the brain, or if there is a possibility that it has spread to the bones (metastases), and is causing pain.

In the case of mesothelioma radiotherapy may be given to alleviate symptoms.

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There is some research looking at treatment of very early stage lung cancers with a form of radiotherapy using a machine called Cyber knife. This machine delivers a high dose of radiation, but it uses multiple radiation beams instead of just one. This means doctors can aim very precisely at a tumour and give a lower dose to surrounding normal tissues. 

We have not yet been able to interview anyone who has had radiotherapy using a internal radiotherapy or Cyber knife machine. If you have experience of this treatment and you would like us to include your story on this website, please email info@healthtalk.org

Last reviewed May 2016.
Last updated May 2016.

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