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Lung cancer radiotherapy side effects

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This page tells you about the side effects of radiotherapy for lung cancer. There is information about

 

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Lung cancer radiotherapy side effects

The side effects you have from radiotherapy depend on your treatment plan. A few weeks of treatment will have different side effects from treatment given in 1 or 2 doses. Radiotherapy side effects usually come on slowly and last for a few weeks after your treatment ends. 

General side effects

Side effects of radiotherapy for lung cancer can include

  • Tiredness and feeling run down
  • A sore throat and difficulty swallowing
  • A cough
  • Hair loss
  • Chest pain
  • A temperature and shivering
  • Feeling sick
  • Sore skin in the treated area

Tell your doctor, radiographer or nurse if you have side effects. Often they can prescribe medicines to help.

Possible long term side effects

A small number of people have long term side effects, which develop up to 2 years after treatment has finished. Serious long term side effects are rare. If you have radiotherapy just to treat symptoms, you are very unlikely to have side effects. Long term side effects are caused by the development of fibrous tissue which is less stretchy than normal tissue. This is called fibrosis. It may affect your lungs and make your breathing get worse. Sometimes fibrosis can narrow your food pipe. This can usually be relieved by a small operation. Rarely, your spine or the covering of your heart can be damaged by radiotherapy.

 

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Side effects of lung cancer radiotherapy

The side effects will depend on the type of radiotherapy you have. A few weeks of treatment will usually give more side effects than treatment given in 1 or 2 doses. The side effects of radiotherapy for lung cancer usually come on slowly. They may last for a few weeks after your treatment has ended. Once the treatment is over, the side effects will gradually get better. A small number of people have long term side effects, which develop up to 2 years after treatment has finished.

 

General side effects

Some side effects of radiotherapy are caused by its effect on normal tissue in your body. These may include

Tiredness and feeling run down

You are more likely to feel tired if you have treatment over a few weeks. You may find that you become more and more tired as your treatment goes on. This is normal with radiotherapy. It may be partly due to travelling back and forth to the hospital. And it may partly be an effect of the treatment itself. The tiredness may last for a few weeks after the end of treatment.

Try to rest as much as you can. If you feel that you want to have a lie down, then you probably need to do just that.

A sore throat and trouble swallowing

Your throat may become sore about 2 to 3 weeks into your treatment. It may happen sooner if you are having chemotherapy and radiotherapy together. This soreness can start quite suddenly, which can be a bit alarming. Do tell your doctor or radiographers if you are having problems swallowing. They can advise you on ways to reduce this.

It may be uncomfortable to drink very hot, or very cold, drinks. Let hot drinks cool a little before you drink them and don't keep cold drinks in the fridge. Very rarely, doctors may give extra fluids by a drip if you aren't able to drink enough.

If you have difficulty swallowing you may find that having a soft diet is easier until your treatment is over. Foods such as soups and stews are easier to swallow than more solid foods such as grilled meats. Radiotherapy departments often have diet sheets to help advise you. We have information about soft diet, which you may find useful.

Your doctor may be able to give you medicines such as anaesthetic mouthwashes and antacids to help reduce the soreness. If you have severe pain when you swallow, you may need to take strong painkillers. The soreness will get better by itself, but this often takes a couple of weeks after the treatment has finished.

A cough

It is quite common to develop a cough during or after radiotherapy for lung cancer. You may have a sticky cough with mucus to bring up. Or you may have a dry, tickly cough. You can ask your doctor or nurse for cough medicine but this may not help much. The cough should go away when the treatment is over. You need to tell your doctor if you have a cough or if you cough up coloured sputum. It is especially important to tell them if you also feel feverish or unwell. The cough might be due to an infection, rather than the treatment. You may then need to take antibiotics.

Hair loss

You will only get hair loss in the area being treated. So you may lose hair on your chest. Or if you are having radiotherapy to the brain you may lose some hair on your head. The hair usually grows back within a few months, but it can be patchy.

Sometimes hair loss is permanent after radiotherapy. It depends on the dose of radiotherapy you have. If you are worried about this, ask your doctor or nurse about how likely hair loss is in your case.

Chest pain

You may have chest pain after having radiotherapy to the chest in 1 or 2 doses. It usually occurs within 24 hours of having the treatment. It is not harmful and goes away by itself. But it is important to let your doctor or nurse know in case the pain is caused by something else. They can prescribe painkillers for you.

A temperature and shivering

You may have a raised temperature and feel shivery if you have treatment in 1 or 2 doses. You can ask your doctor if it is all right to take a couple of paracetamol if this happens. It should pass quite quickly. Paracetamol will usually stop the shivering and bring down your temperature. Let your doctor or nurse know if you have these symptoms because they can sometimes be due to a chest infection. If you have a chest infection, you may need antibiotics to clear it up.

Feeling sick

You may feel sick while you are having radiotherapy for lung cancer, but this is unusual. It depends on which part of the lung is being treated. If you feel sick let your doctor, nurse or radiographer know. You can have anti sickness drugs to control it.

If you don't feel like eating, try drinking high calorie drinks. You can get a prescription for these from your doctor. Or you can buy the drinks at the chemist.

Sore skin in the treatment area

Radiotherapy can make the skin sore in the area being treated. It might happen if you are having radiotherapy for a pancoast tumour, but for other types of lung cancer it is rare.

The most common skin reaction is like a mild sunburn, with redness and irritation. Having radiotherapy with, or soon after, chemotherapy may make the skin reaction worse. To help stop your skin getting sore you need to wash the treatment area with plain water only. Don't use perfumed soap or washing products unless you have discussed this with your cancer specialist, radiotherapy nurse, or radiographer.

If your skin is getting sore, tell your radiographers so they can keep an eye on it. People have different reactions to radiotherapy. Your radiographers can take steps to reduce your soreness and discomfort if they know there is a problem.

 

Possible long term effects

Long term side effects from radiotherapy can develop many months after your treatment has finished. Serious long term side effects are rare. If you have radiotherapy just to treat symptoms, you are very unlikely to have any long term effects. Even with intensive radiotherapy over 4 to 6 weeks to get rid of the cancer, long term side effects are still quite rare.

Unfortunately, doctors can't tell beforehand who is going to get long term side effects and who isn't. People vary quite widely in their reactions to radiotherapy. A few people seem to be more than usually sensitive. It is important to remember that treating your cancer is the priority. But your radiotherapy specialist team will do all they can to try to make sure long term side effects don't happen. And they will discuss any possible side effects with you before you agree to have the treatment.

Long term side effects happen because radiotherapy can make fibrous tissue develop. This is called fibrosis. Fibrous tissue is less stretchy than normal tissues. You may have breathlessnessnarrowing of your food pipe (oesophagus), or effects on the heart and spinal cord.

Breathlessness

Your doctor will talk to you about the risks of breathlessness before you have treatment. It is possible that your breathing may get worse after radiotherapy. But this risk needs to be balanced against the need to treat your lung cancer. Your doctors will do all they can to minimise the side effects, while giving the best treatment possible for your cancer.

Narrowing of your food pipe (oesophagus)

Doctors call a narrowing in a tube a stricture. In the food pipe, this can cause difficulty swallowing. Your doctor may be able to relieve this with a small operation to stretch the narrowing in your oesophagus. The operation allows food to pass through easily again.

Effects on the heart and spinal cord

Occasionally, radiotherapy to the chest can cause tightening of the covering of the heart (the pericardium). The tightening may need surgery to reduce it. 

Because the treatment area for radiotherapy to the lung is often very close to the spine, there is a very rare chance of spinal cord damage. Your doctor will talk to you about these possible side effects before you have treatment but remember that they are extremely rare.

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Updated: 28 March 2014