What is radiotherapy?

Radiotherapy is a general term for the treatment of cancer with x-rays. It works by killing cancer cells and is often used on its own to treat lung cancer. It may also be given as part of a combined treatment with surgery and/or chemotherapy.

It is usually given from outside the chest (external radiotherapy) by directing x-rays at the area needing treatment. The machines that are most commonly used for this are called linear accelerators. However, radiotherapy can also be given by putting a small amount of radiation directly inside the lung (brachytherapy).

Radiotherapy doctors (radiotherapists) will know which treatment is best for the patient. The following information in this section is referring to external radiotherapy. Radiotherapy is only given in specialist cancer centres because the treatment is very specialised and expensive. This may involve long journeys to the nearest cancer centre, depending on where the patient lives.

Common Questions

Why is radiotherapy used to treat lung cancer? Radiotherapy has been an effective treatment for lung cancer. It is the most common treatment for used for non-small cell lung cancers because in general, they are flow growing tumours. Small cell lung cancer can also be treated with radiotherapy when chemotherapy is not suitable. Radiotherapy can be particularly helpful for treating lung cancer that has spread outside of the lung. How will Doctors know how many treatments a patient will need? Doctors will look at the patients’ test results, the type of tumour, where it is and where it has spread. All this information will be carefully considered before doctors decide how many treatments a patient needs. This is called treatment planning and may involve: CT Planning Scan: This is a special type of scan where a number of pictures are taken. It helps doctors to plan the patient’s radiotherapy treatment accurately. The simulator is a special x-ray machine similar to the radiotherapy treatment machine and is used to plan the treatment to ensure that only the area that needs treatment will actually be treated. Treatment may be planned using either or both of these and sometimes it may take several visits before treatment is ready to start. Is receiving radiotherapy treatment painful? No, the treatment itself is completely painless, although patients may find the treatment table hard and slightly uncomfortable. How do doctors know if the radiotherapy is working? It is sometimes difficult to know immediately whether there has been a response because the treatment itself can cause changes to the lungs. However, in time the response will become clearer, at which time repeat measurements can be taken and compared to initial tests to help establish if there is any change. Should patients change their diet during radiotherapy? Patients should try to maintain a healthy diet but should avoid very hot drinks, rough foods and strong spices, particularly if the gut has become irritated. If swallowing is still difficult, mashing foods, adding additional sauces/gravies or liquidising food to remove lumps may help. If patients experience a burning feeling in their gullet, drinking alcohol, especially spirits, may make it worse. Cutting back will help if patients cannot cut it out completely.

Are there any side-effects of radiotherapy?

Yes, although they vary from person to person depending on the type of treatment and the patient’s general fitness. Here are some of the more common side-effects of radiotherapy along with some practical advice on how to manage them:

Some pain in the chest in the 24 hours after the treatment.  This is usually mild and settles down fairly quickly. Use an "over-the-counter" painkiller and if this doesn't work speak to a GP.
Skin in the treated area becomes a little pink or red. It may also feel a little dry or itchy Patients may bathe or shower during treatment, but do not have the water too hot. Use mild baby soap, but try not to rub the treated area particularly if it is red or itchy. It's best to pat the area dry with a soft towel. Avoid perfumed talcum powder or lotion.
Soreness when swallowing due to the gullet (oesophagus) becoming irritated by the treatment There are soothing liquid medicines which can be prescribed by a doctor. However, patients may find cool/luke-warm drinks or ice-cream soothing. In addition, eat food that is soft or mushy, such as porridge or soup.
Increase in patient’s cough and sputum (spit). Don't worry, this is quite normal, but if a patient is having difficulties they should let a doctor know.
Tiredness following treatment. This can last for a number of weeks after treatment has ended. Patients should make sure they take it easy and rest when they feel tired.
Scarring of the lung. Patients might notice a slight increase in breathlessness. If this becomes a problem see a hospital doctor or GP, as there are medicines and breathing exercises which can help.
Spinal cord/heart damage. As the treatment is often close to these areas there may be a very rare chance they may be damaged.

For more information on radiotherapy see our Radiotherapy for Lung Cancer Booklet

Alternatively watch our YouTube video here:

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