Day 11 –
RADIATION THERAPY for LUNG CANCER
Radiation therapy works by delivering focused high-energy rays or particles (x-rays, gamma rays or atomic particles) which make small breaks in the DNA inside specific cells. These breaks keep cancer cells from growing and dividing and cause them to die. It is usually a local or targeted treatment, unlike chemotherapy which exposes the whole body to cancer-fighting drugs while killing many “good” cells along the way. Radiation may come from a machine outside the body, or it may come from radioactive material placed in the body near cancer cells. These processes target and eliminate or shrink the tumor while minimizing adverse effects on nearby healthy organs and tissues. For advanced cancers that cannot be cured but controlled (‘stabilized’), radiation therapy can be used to lessen symptoms such as cough, shortness of breath, or pain.
What Types of Radiation Therapy Are Used for Lung Cancer?
- Intensity Modulated Radiation Therapy (IMRT): Using computer generated images, numerous external beam angles deliver doses of radiation carefully calculated to target the specific shape and size of each tumor.
- Image Guided Radiation Therapy (IGRT): Taking IMRT to the next level, this technique improves targeting accuracy, as pictures are taken prior to each radiation session to guide the radiation beam during therapy.
- Stereotactic Radiosurgery (SRS): This external radiation therapy is most commonly used to treat tumors in the brain; Gamma Knife surgery is an example SRS, and is actually not surgery at all but uses up to a couple hundred accurately focused external beams to kill the tumors without harming surrounding tissues. Stereotactic Body Radiation Therapy (SBRT) delivers radiation directly to tumors in the body and kills smaller tumors most commonly in the liver and lung. In both cases, the dose is spread over a period of time.
- Brachytherapy: Guided by an imaging machine, a small object containing radiation materials is surgically implanted directly inside the tumor.
Why Might Radiation Therapy be Chosen?
- Curative: If the cancer is considered curative (able to be cured), radiation therapy can sometimes augment or replace surgery and/or chemotherapy as it targets and breaks up the cancerous DNA, while protecting surrounding tissue.
- Preventative: Called PCI (Prophylactic Cranial Irradiation), can be used to radiate the entire brain to prevent cancer recurrence or lung cancer spread (metastasis) to the brain. The brain is often the first site of small cell lung cancer recurrence after successful treatment to the chest.
- Palliative: Radiation can be used even once the cancer has advanced to manage symptoms and side effects such as cough, bone pain and bleeding caused by cancers. Short term radiation can help stave off bowel and bladder control issues, or possible paralysis, when treating tumors in the spinal column. These paliate, or relieve, pain and other side effects, even when the goal of treatment is not to “cure”, because they can better quality of life.
What Should I Expect During my Radiation Treatment?
Radiotherapy machines usually rotate around YOU. The machine does not touch you at any point. You should expect to be very still for a period of time, sometimes even having an apparatus to secure your body in a single position, such as a mask secured to the table during brain radiation so the external beams can target with pinpoint accuracy. (You will be able to easily click out of the mask or restraint in an emergency!) You may hear a whizzing, machines clanking, and beeping from your machine and in your room, and you will be able to communicate with your care team in some manner.
You may experience some of these side effects from radiation, depending on your treatment location:
- Fatigue & Weakness
- Hair loss or changes to hair
- Skin irritation (reddened, dry, itchy, tender)
- Sun sensitivity
- Temporary loss of appetite
- Difficulty swallowing
- Nausea or Vomiting
- Trouble swallowing
- Dry mouth or mouth irritation
- Bowel changes
- Swelling and soreness
- Emotional effects
Longer term side effects of radiation vary significantly on the location irradiated; brain radiotherapy may lead to memory loss (you will likely be prescribed medication for dementia), swelling, etc. Radiation to the chest can increase the chance of secondary cancers. Osteoporosis and bone density changes, and changes to fertility or teeth/gums/mouth, may occur. Evaluation of the goals for your radiation (curative, preventive, palliative) will be key to evaluating if radiation is right FOR YOU!