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About radiotherapy for lung cancer

Radiotherapy uses high energy rays to kill cancer cells. Cancer specialists use radiotherapy to treat all types of lung cancer. 

For non small cell lung cancer you may have radiotherapy on its own. Or you may have it with another treatment, such as chemotherapy or surgery. 

For small cell lung cancer, you may have radiotherapy with or after chemotherapy. And you may also have radiotherapy to your brain. Treatment to the brain aims to kill off any lung cancer cells that may have spread there.

External radiotherapy

Most radiotherapy for lung cancer is external radiotherapy. The radiation is aimed at your body from a machine. You have the treatment in the hospital radiotherapy department. Your treatment plan will depend on what you are having the treatment for. You may have 1 treatment, 2 treatments about a week apart, or daily treatments from Monday to Friday for a few weeks. Some people have 3 treatments a day for about 12 days, including weekends. Some people have treatment twice a day for small cell lung cancer.

If you are having radiotherapy to help control symptoms, you may have 1 treatment, 2 treatments about a week apart, or daily treatments for up to 3 weeks.

Internal radiotherapy

This uses a radiation source inside a narrow tube that the doctor puts inside your airway for a few minutes.

 

CR PDF Icon View a summary of treating lung cancer.

 

 

What radiotherapy is

Radiotherapy uses high energy rays to kill cancer cells. Cancer specialists use radiotherapy to treat all types of lung cancer. For early stage lung cancer, the radiotherapy may aim to get rid of the cancer completely.

For non small cell lung cancer you may have radiotherapy on its own. Or you may have it with another treatment, such as chemotherapy or surgery

We have detailed information about radiotherapy for non small cell lung cancer (NSCLC).

For small cell lung cancer, radiotherapy is sometimes used with or after chemotherapy. Chemotherapy makes the tumour in the lung shrink. Giving radiotherapy as well improves the results. You may also have radiotherapy to your brain, which aims to kill off any cancer cells that may have spread to the brain. It is called prophylactic cranial irradiation (PCI). 

We have detailed information about radiotherapy for small cell lung cancer (SCLC).

For more advanced lung cancer, the treatment aims to shrink the cancer and control it for some time. It also reduces symptoms such as coughing or breathlessness.

 

Breathing tests

Your doctors will usually ask you to have breathing tests before you have radiotherapy planning. You won't need to do this if your treatment is to reduce symptoms though. The breathing tests measure how much air you can breathe in and out. They may also test how much exercise you can do before you get breathless. The tests don't hurt but they can be a bit tiring.

 

External radiotherapy

Most radiotherapy for lung cancer is external treatment. The radiation is aimed at your body from a machine. You have the treatment in the hospital radiotherapy department. Your treatment plan will depend on what type and stage of cancer you have.

If you are having radiotherapy to try to cure your lung cancer (radical radiotherapy) you may have between 20 to 36 treatments. You might have one treatment each day, from Monday to Friday, over 4 to 7 weeks. Or you might have 3 radiotherapy treatments each day for about 12 days, meaning you have treatment at the weekends too. This type of radiotherapy is known as CHART – continuous hyperfractionated accelerated radiotherapy. There is detailed information about CHART radiotherapy for lung cancer in this section. Some people with small cell lung cancer have treatment twice a day.

If you are having radiotherapy to help control symptoms, you may have 1 treatment, 2 treatments about a week apart, or daily treatments for up to 3 weeks.

 

Internal radiotherapy

This is also called brachytherapy or endobronchial therapy. You have the treatment during a bronchoscopy. The radiation source is inside a narrow tube that the doctor puts inside your airway for a few minutes.

Doctors use this type of treatment to shrink a tumour that is blocking or pressing on your airway and making breathing difficult for you. 

There is detailed information about internal radiotherapy.

 

Planning your treatment

Before you begin your treatment, the radiotherapy team carefully plan your external beam radiotherapy. This means working out how much radiation you need to treat the cancer and exactly where you need it. Your planning appointment may take from 15 minutes up to a couple of hours. You will have a planning CT scan. The scan shows the cancer and the structures around it.

The 360° photo is of a CT scanner. You can use the arrows to look around the room.

You lie on the scanner couch with the treatment area exposed. The radiographers will put some markers on your skin. You need to lie very still. Once you are in position the radiographers move the couch up and through the scanner. The scanner is a doughnut shape. The radiographers leave the room and the scan starts. It takes up to 5 minutes. You won't feel anything. The radiographers watch from the next door room.

Before the planning appointment you may also have other scans, such as MRI scans or PET scans. Your treatment team can feed the other scans into the planning scanner.

Ink marks

Once the treatment team has planned your radiotherapy, they may put ink marks on your skin to make sure they treat exactly the same area every day. They may also make pin point sized tattoo marks in these areas. 

We have information about radiotherapy skin markings.

After your planning session

You may have to wait a few days or up to 2 weeks before you start treatment. During this time the physicists and your radiotherapy doctor decide the final details of your plan. Your doctor will plan the areas that need treatment and outline areas to limit the dose to or avoid completely. They call this contouring. Then the physicists and staff called dosimetrists plan the treatment very precisely using advanced computers.

 

Having lung cancer radiotherapy

Radiotherapy machines are very big. The machine may be fixed in one position or able to rotate around your body to give treatment from different directions. Before your first treatment your radiographers will explain what you will see and hear. The treatment rooms usually have docks for you to plug in music players. So you can listen to your own music.

You can't feel radiotherapy when you actually have the treatment. It takes anything from 1 minute to several minutes. It is important to lie in the same position each time, so the radiographers may take a little while to get you ready.

A photo of a linear accelerator, which gives radiotherapy

Once you are in the right position the staff leave you alone in the room for a few minutes. They watch you carefully through a window or on a closed circuit television screen. They may ask you to hold your breath or take shallow breaths during the treatment.

Our page about having external radiotherapy has a video about having radiotherapy that you may want to watch. 

External radiotherapy doesn't make you radioactive. It is perfectly safe to be with other people, including children, throughout your course of treatment.

Internal radiotherapy treatments are given in different ways. For detailed information about internal radiotherapy look at the page about internal radiotherapy for lung cancer.

 

More about lung cancer radiotherapy

You can look at the main radiotherapy section for detailed information about radiotherapy. It tells you more about

You can phone the Cancer Research UK nurses on freephone 0808 800 4040, from 9am to 5pm, Monday to Friday. They will be happy to answer any questions that you have.

Our lung cancer organisations page gives details of other people who can give information about lung cancer radiotherapy. Some organisations can put you in touch with a cancer support group

Our lung cancer reading list has information about books and leaflets about lung cancer treatments. If you want to find people to share experiences with online, you could use Cancer Chat, our online forum.

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Updated: 29 September 2014