Radiotherapy is a painless procedure uses very powerful x-ray (radiation) to destroy cancer cells or stop them from growing any further. There are three main indications for radiotherapy in Lung cancer:
- To cure cancer if the patient is not healthy enough for surgery or patient declines surgery.
- After lung surgery to prevent cancer returning.
- To relieve symptoms and slow the spread of Lung cancer when a cure is not possible (palliative radiotherapy)
Radiotherapy is usually given in daily fraction, five days a week, with a break at weekends. Each session of radiotherapy lasts 10-15 minutes and the whole course usually lasts two to five weeks. When radiotherapy is used to relieve symptoms smaller number of fractions is usually used.
Radiotherapy is delivered using a machine called linear accelerator (LINAC) which moves quietly around patients delivering precisely calculated doses of radiation. There is nothing to see or feel during the treatment. – just a slight buzzing noise from the machine.
During treatment, patients can wear a gown or their own clothes; however, clothing needs to be removed from the area receiving the radiotherapy. Once the radiographers have positioned patients onto the couch, they will leave the room, but they can see and hear patients at all times via a CCTV camera. They can also communicate with them through an intercom. Patients are not ‘radioactive’ after treatment and there is no risk to people around them.
Radiotherapy works by damaging the DNA within cancer cells causing them to stop growing or die. This will also affect normal cells causing side effects. Normal cells, however, are better at repairing themselves than cancerous cells and side effects usually pass once the course of radiotherapy has been completed.
This is a special form of radiotherapy which has recently become available locally for patients in Kent area and south-east London. SABR uses a small number of very precisely targeted treatments to destroy tumours whilst minimising damage to surrounding tissues. It is now accepted as the standard of care for patients with early peripheral lung cancer as an alternative to surgery, or where surgery is not an option, for example, if a tumour is located in an area which is difficult to operate on.
Common Radiotherapy side effects
- Tiredness: patients are likely to feel tired during their treatment. It tends to get worse as the treatment goes on. They might also feel weak and lack energy. After a while, they may need to sleep after each radiotherapy session. Tiredness can carry on for some weeks after treatment has finished, but it usually improves very gradually. Various things can help to reduce tiredness, for example, exercise. Some research has shown that taking gentle exercise can give more energy. It is important to balance exercise with resting.
- Feeling or being sick: anti-sickness medication is very useful and should stop sickness.
- Difficulties swallowing: patients may find that having a soft diet is easier to swallow until a few weeks after their treatment is over. Foods such as soups and stews are easier to swallow than more solid foods such as grilled meats. We can give patients an information sheet to help advise them or we can a dietitian to see them.
- Redness and soreness of the skin, which looks and feels like sunburn or darkness in the skin over the area being treated. Patients may also get redness or darken on the other side of their body where the radiotherapy beams leave the body. The red or darker areas can also feel sore. Radiographers give patients creams to soothe the skin. The soreness usually goes away within 2 to 4 weeks of ending the treatment.
- A persistent cough that may bring up blood-stained phlegm.
- Breathlessness: Shortness of breath can happen during and after chest radiotherapy.
- Loss of hair over the chest
- Chest pain: This may start within 24 hours of treatment.