There are several different approaches to treating lung cancer — and most patients receive multiple types of treatments as part of their personalized care plan. One of these treatments can be radiation therapy. Not every lung cancer patient will receive radiation therapy. And the reasons that radiation is used for lung cancer can vary by patient, depending on a few different factors.
Sometimes, it’s used to reduce the tumor size before surgery or to kill any remaining cancer cells in the body left after surgery. In other instances, it can be used to shrink lung cancer tumors that are causing pain or other symptoms in distant parts of the body. Your lung cancer specialist will take the specific type of lung cancer, the stage, and the location of the tumor into consideration when deciding if radiation therapy should be part of your treatment plan.
When is Radiation Therapy Used in the Lung Cancer Treatment Process?
In the case of early-stage non-small cell lung cancer, radiation therapy is commonly a part of the initial treatment plan. For advanced-stage patients, radiation may be used to target tumors that have emerged outside of the lungs in other areas of the body.
Before treatment begins, a collaborative oncology team, including a medical oncologist, radiation oncologist, and surgeon, will thoroughly assess various factors to recommend the best lung cancer treatment for you. Depending on your specific situation, radiation therapy might be used during one or multiple phases of the treatment process.
Radiation Therapy Before Lung Cancer Surgery
Radiation before surgery can make removing the tumor easier and reduce the chances of cancer coming back after surgery. The primary reason for radiation before surgery is to shrink the tumor size so that it’s easier to remove, resulting in less tissue loss. There is also a lower likelihood that cancer cells will spread out in the lung during the surgical procedure when it’s reduced beforehand.
Radiotherapy After Lung Cancer Surgery
Using radiation after lung cancer surgery can effectively kill any remaining cancer cells that could not be detected or removed during surgery. The more cancer cells are destroyed, the less likely they will grow after surgery.
The timing of radiation therapy depends on the type of lung cancer surgery you undergo. Typically, radiation therapy is given after surgeries such as lobectomy (removal of a lung lobe) or pneumonectomy (removal of the entire lung).
Radiation Therapy When Other Treatment Methods Are Not an Option
For patients unable to undergo surgery, radiation therapy may be used as the primary method for treating lung cancer. This approach is more common for people who cannot undergo chemotherapy or targeted drugs due to their health condition. SBRT can be a useful treatment method in this instance.
Treating Lung Cancer That Is Affecting Other Areas of the Body
Lung cancer is often found in a later stage when it’s spread (metastasized) to other areas of the body. Radiation can be used to shrink tumors outside of the lungs that may be causing pain or blocking an airway. When radiation therapy is used to manage cancer’s symptoms instead of cure it, this is sometimes referred to as palliative radiation therapy.
Help Prevent Lung Cancer From Recurring
Patients with small-cell lung cancer are more likely to have cancer appear in the brain after the initial lung cancer treatments are completed. These patients may receive radiation to the brain as a precaution to help prevent cancer from developing in that area. This is called prophylactic radiation therapy.
The lung specialist and radiation oncologist will develop a lung cancer treatment plan that will best meet the needs of your specific situation. You may or may not receive radiation in combination with other treatments, such as chemotherapy or targeted therapy.
Types of Radiation Therapy Used for Lung Cancer
There are two types of radiation therapy: external and internal. External beam is the type most often used for lung cancer, although internal radiation can be used in some cases.
External Beam Radiation Therapy for Lung Cancer
Both types of lung cancer, small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) can be treated with external beam radiation technologies (ERBT). A machine called a linear accelerator is positioned over the body to deliver radiation beams to the exact shape and size of the tumor or tumors.
There are several types of external beam radiation therapy, but two are used most often for lung cancer.
Intensity-Modulated Radiation Therapy (IMRT)
IMRT uses multiple radiation beams that conform to the tumor’s shape and adjusts the intensity of some of the beams to deliver radiation only to the targeted area. Precisely targeting the tumor helps avoid or reduce damage to healthy tissues.
Typically, IMRT treatments for lung cancer involve sessions five days per week for 5 to 7 weeks. Some patients may be eligible for hypofractionated radiation therapy, which delivers a higher dose of radiation during each session, reducing the overall treatment time to 3-5 weeks.
Stereotactic Body Radiation Therapy (SBRT)
SBRT is an advanced type of non-surgical radiation technology. It uses images from CT scans and delivers a very high radiation dose with great precision and limited damage to surrounding tissue. This type of external beam radiation is commonly used to treat early-stage lung cancer when surgery is not a safe option.
Because SBRT is mostly used for small, localized tumors, treatment may require only a few sessions over the course of a week or so.
Internal Radiation Therapy for Small Cell Lung Cancer
Internal radiation, commonly referred to as brachytherapy, is another option for treating lung cancer. It involves the placement of sealed radiation material — radioactive seeds, ribbons, or capsules — into the body. The material delivers radiation to the cancerous area for a short period of time, and then it’s removed. High-dose-rate (HDR) brachytherapy allows doctors to use a higher total dose of radiation to treat a smaller area in less time than conventional external beam radiation therapy.
Although this method is not widely used for lung cancer, it is sometimes used when the lung cancer is blocking the patient’s airway. Reducing the size of the tumor to free up the air passages can give the patient a better quality of life.
Side Effects of Lung Cancer Radiation Therapy
As with other cancer treatments, there are some side effects associated with radiation therapy. Side effects vary among patients, and some don’t experience any at all. Common side effects of radiation therapy can include:
Skin irritation similar to a sunburn
Cough due to irritation of the airways
Shortness of breath
Dry mouth because the radiation may be near your throat
Talk with your radiation oncologist about any side effects you are experiencing during and/or after treatment. In many cases, there are treatment options available that can help relieve them.
The Most Advanced Lung Cancer Treatments Available in Portland, Oregon, and Vancouver, Washington
If you or a loved one was recently diagnosed with lung cancer, the oncologists at Compass Oncology are here to help guide you through your journey. Our lung cancer specialists will take the time to discuss all of the treatment options available to you based on your lung cancer stage and specific type of lung cancer.
Our cancer centers are located across the Portland and Vancouver area. Find a location near you to request an appointment with our oncologists to discuss personalized lung cancer treatment plans. We also offer second opinions on diagnosis and treatment options.