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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 and is similar to having an X-ray. 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.

Having external radiotherapy does not make you radioactive. It is perfectly safe to be with other people, including children, throughout your treatment course.

 

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 more about internal radiotherapy in this section.

 

Planning your treatment

Radiotherapy treatment is carefully planned. Doctors use X-rays and scans to plan the treatment, which is called virtual simulation. They use these methods to work out exactly where to give the treatment so that

  • It kills the most cancer cells
  • It misses as much healthy lung tissue as possible

Marks are made on your skin during the planning session. You will have a few pinprick tattoos made during planning. The radiographers use them to line up the machine accurately when you have your daily treatment. They also draw some marks in ink on your skin. Don't worry if they wear off a bit as the radiographer can draw them on again. 

Picture of simulator machine

The lungs are very sensitive to radiation, and so are other areas in the chest, such as your spinal cord. Because of this, doctors are very careful when they plan radiotherapy to the lungs. Occasionally you may need to have several planning sessions.

 

Having lung cancer radiotherapy

External radiotherapy treatments only take a few minutes each time. The radiographer will position you on the couch (usually lying down) and make sure that you are comfortable. They may need to dim the lights while they are setting up so they can see the laser guidance beams. You won't have your treatment in the dark. Although you are left alone while you have your treatment, the radiographers can hear and see you.

Radiotherapy doesn't hurt. You won't be able to feel it, but you need to keep very still for a few minutes while you have the treatment. There may be special arm rests or cushions to help you to keep still. You may be asked to breathe in a certain way or hold your breath to reduce your chest movements during the 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. 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: 28 March 2014