Having radiotherapy to the chest can cause shortness of breath during and after radiotherapy. Shortness of breath will usually improve a few weeks after treatment but for some people it can continue long term.
Short term effects on the lungs
Radiotherapy to the chest area can cause:
- a cough
- shortness of breath
If you have lung cancer you may have an increase in your cough and sputum which may contain a small amount of blood. This is normal. Coughs can sometimes get worse once your treatment has finished. If you are worried, let your specialist nurse or doctor know.
Coughing up blood
If you have lung cancer, you might notice a small amount of blood in your sputum. Your specialist nurse will tell you what to do about this.
If your tumour is located close to blood vessles there is a risk of coughing up fresh blood, which rarely could be life-threatening. Your specialist will discuss this with you. If you notice any unusual bleeding, tell a member of your health care team straight away.
Shortness of breath
Radiotherapy to the chest causes inflammation of the lungs, which is called acute radiation pneumonitis (pronounced new-mon-eye-tiss). This can make you feel more breathless. Always let your doctor, radiographer or nurse know if you are short of breath. You may be prescribed some medication for this. This condition should improve a few weeks after treatment.
Rarely shortness of breath might be because of a more serious condition, such as a chest infection or a blood clot in the lung. In rare circumstances, this may need urgent assessment and could become life-threatening without any treatment.
Radiotherapy can cause many different side effects, such as tiredness. The side effects you get will depend on the area you're having treatment to but there are some general side effects you might experience regardless of where your cancer is. This video is about the side effects you might have when having radiotherapy to the chest.
On screen text: Difficulty swallowing
Martin (Radiographer): Radiotherapy can irritate the lining of your oesophagus, also known as your food pipe, which can cause soreness and swelling and make it more difficult to swallow.
David: After about two weeks it started to get more difficult to swallow. The more it progressed, the worse it got and ended up couldn't eat anything solid at all so it was virtually down to liquids.
Laurel: I wasn't physically able to swallow anything whatsoever and that was quite challenging because I was thirsty and I was hungry, but, you know, nothing was happening.
Martin (Radiographer): Eating foods which are softer and easier to swallow can be helpful. Things such as soup and porridge or mashed potatoes.
Laurel: Yoghurt or custard were easier because I don't need to chew on anything.
David: Soups, trifles, tiramisus. It's down to trial and error and keep trying to eat what you can because you really have to keep your body up to scratch.
Martin (Radiographer): I'd recommend avoiding very spicy foods and avoiding foods which are very hot or very cold.
Laurel: Spicy food, definitely avoid the peppers and stuff like that.
Martin (Radiographer): For chest radiotherapy, we would recommend that you avoid alcohol as this can cause more irritation in the area we're treating.
Laurel: I had a dietitian and either on the phone or they'd pop in.
David: So they noticed that my weight was coming down so they got a dietitian in and she prescribed all these protein drinks.
Martin (Radiographer): You can replace the calories by swapping foods for high calorie alternatives, or your dietitian can recommend high calorie drinks and food supplements. If you're experiencing pain or heartburn during treatment, speak to your team and they can prescribe medication that can help with that.
On screen text:
- Try different foods to find out which are easiest to swallow
- Avoid eating foods that may irritate your throat
- Avoid smoking and alcohol, particularly spirits
- You might need high calorie drinks to boost your calorie intake
- Drink lots of water
- Let your team know if you need painkillers
- Ask to see a dietician
On screen text: Feeling or being sick
Laurel: Yes, being sick was one of the worst things happening.
David: I was just constantly being sick. I would have my porridge in the morning, wait a couple of minutes and it would be up again so it was just one of these things.
Martin (Radiographer): What you eat and drink can affect how sick you feel during treatment. You can drink fizzy drinks and eat ginger, which can help reduce sickness and we'd recommend avoiding fatty foods or big heavy meals, which can make you feel more sick.
Laurel: But I didn't realise, okay, you can get medication for the anti-sickness until the medical team realises that's what was needed. It's helped me slowing not being sick as often as I would have done because a lot of things I would just be gagging.
Martin (Radiographer): If you are having problems eating and drinking during your treatment, there are dieticians available which can help you.
On screen text:
- Your doctor can prescribe anti sickness medication
- Relaxation techniques such as mindfulness and visualisation might help
- Avoid certain foods
- Eating a few hours before treatment can help
- Drink lots of liquid, taking small sips slowly throughout the day
- See a dietician for advice – there is help available
On screen text: Shortness of breath
Martin (Radiographer): Having radiotherapy to the chest can affect your breathing. This may come on about two weeks after treatment begins and will continue throughout the rest of treatment. Once you've finished treatment, the breathlessness may continue for a couple of weeks, but then recovers after that. Depending on your diagnosis and treatment you may experience long term breathing problems and your doctor will discuss that with you before you start treatment.
David: So I've been constantly shortness of breath and I take inhalers twice a day now. I just have to be careful in what I do. I can walk for miles on the flat but as soon as an incline, that's when I start to get short of breath. I go out walking or cycling everyday, so that's just a constant to try and keep it going.
Martin (Radiographer): If you are experiencing shortness of breath, we would recommend speaking to your team as soon as you notice it, just to make sure there isn't something else going on, such as an infection or blood clots.
On screen text:
- Shortness of breath can happen during and after radiotherapy
- It usually improves after treatment finishes
- It can continue long term
- Always let your specialist or radiographer know if you are short of breath
If you're experiencing a side effect that hasn't been covered in this video, you can find more information on the Cancer Research UK website.
On screen text: For more information go to: cruk.org/radiotherapy/side-effects
Longer term effects
After radical radiotherapy to the chest, there is a risk of long term breathing problems. Radical radiotherapy means a long, intensive course of treatment that aims to try to cure your cancer.
Long term breathing problems are called chronic radiation pneumonitis. They cause a long term cough and sometimes breathlessness.
Let your doctor or nurse know if you notice changes in your breathing any time after your radiotherapy. It might be possible to learn breathing exercises or use medicine that can help to reduce your breathlessness, but in some rare cases breathing problems may be permanent.
You need to tell your radiotherapy doctors if you have a heart condition that makes you breathless or if you have a heart pacemaker. Radiotherapy can make heart conditions worse over many years for some people.