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Radiotherapy for non small cell lung cancer

Radiotherapy uses high energy x-rays to treat cancer cells. You have the treatment in the hospital radiotherapy department. 

When do you have radiotherapy?

Radiotherapy on its own

You might have radiotherapy on its own for stage 1, 2, or 3 non small cell lung cancer if you can’t have surgery because:

  • you have other medical conditions such as heart or lung disease
  • you have a stage 3 cancer that is close to your heart
  • your cancer is hard to reach with surgery

Radiotherapy is most often given 5 days a week for between 4 to 7 weeks. However this can vary depending on your cancer. Your specialist will tell you how often you will need to have the treatment.

For a small cancer on the outer part of the lung you might have stereotactic radiotherapy treatment. You usually have it 3 to 8 times over 2 to 3 weeks.

Radiotherapy after surgery

You might have radiotherapy after surgery if your surgeon couldn’t completely remove your cancer or if it has spread to lymph nodes in the centre of your chest.

Radiotherapy after chemotherapy

You may have radiotherapy after chemotherapy for stage 2 or 3 non small cell lung cancer. This is called sequential radiotherapy.

Radiotherapy and chemotherapy (concurrent chemoradiotherapy)

You might have radiotherapy at the same time as chemotherapy for stage 2 or 3 non small cell lung cancer. Having both treatments at the same time can increase side effects. You need to be fit and well to have this treatment and might have it as part of a clinical trial.

Radiotherapy to control symptoms

You might have radiotherapy for non small cell lung cancer that has spread to other parts of your body (stage 4). This is called advanced lung cancer.

The radiotherapy room

Radiotherapy machines are very big. They rotate around you to give you your treatment. The machine doesn't touch you at any point.

Before you start your course of treatment your radiographers explain what you will see and hear. In some departments the treatment rooms have docks for you to plug in your music player. So you can listen to your own music.

Photo of a linear accelerator

The radiographers help you to get into position on the treatment couch. You usually need to raise your arms above your head.

The room is darkened and the radiographers line you up in the radiotherapy machine using laser lights and the marks on your skin. You will hear them saying measurements to each other to get you in the right position.

Then the radiographers leave you alone in the room for a few minutes.

During the treatment

You need to lie very still on your back. Your radiographers might take images (x-rays or scans) before your treatment to make sure that you're in the right position. The machine makes whirring and beeping sounds. You won’t feel anything when you have the treatment.

Your radiographers can see and hear you on a CCTV screen in the next room. They can talk to you over an intercom and might ask you to hold your breath or take shallow breaths at times. You can also talk to them through the intercom or raise your hand if you need to stop or if you're uncomfortable.

You won't be radioactive

This type of radiotherapy won't make you radioactive. It's safe to be around other people, including pregnant women and children.

Travelling to radiotherapy appointments

Tell the radiotherapy department if you prefer treatment at a particular time of day. They can try to arrange this.

Car parking can be difficult at hospitals. It’s worth asking the radiotherapy unit staff:

  • if they can give you a hospital parking permit
  • about discounted parking rates
  • where you can get help with travel fares
  • for tips on free places to park nearby

If you have no other way to get to the hospital, the radiotherapy staff might be able to arrange hospital transport for you. But it might not always be at convenient times. To see if you're eligible they usually work it out based on your earnings or income.

Some hospitals have their own drivers or can arrange ambulances. Some charities offer hospital transport.

Side effects

Radiotherapy to the lung can cause side effects. Find out what they are and how to cope with them.

Last reviewed: 
06 Nov 2019
  • Lung cancer: diagnosis and management
    National Institute for Health and Care Excellence, 2019

  • Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow up

    P.E. Postmus and others

    Annals of Oncology, 2017, 28 (Supplement 4)

  • Lung cancer: current therapies and new targeted treatments

    F.R.Hirsch and others

    The Lancet, 2017; Vol 389, 299-311

  • A critical review of recent developments in radiotherapy for non-small cell lung cancer
    S Baker and others
    Radiation Oncology, 2016. 11:115

  • Hypofractionated Intensity-Modulated Radiotherapy for Patients With Non-Small-Cell Lung Cancer
    E Pollom and others
    Clinical Lung Cancer, 2016 Nov;17(6):588-594

  • Radiotherapy dose fractionation, second edition
    Royal College of Radiologists, 2016

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