When battling cancer, an oncologist’s primary goal is to identify how to attack the cancer cells and destroy them while preserving the surrounding healthy cells. Choices for treatment will depend on a variety of factors. Here is an overview of radiotherapy’s role in the treatment of lung cancer.
Non-small cell vs small cell growth in lung cancer
Lung cancer treatment plans primarily depend on the size and type of cancer cells and whether the growths are small and localised or spread to other parts of the body. In most non-small cell lung cancer cases, the disease is detected in a small spot and during its early stage. Non-small-cell cancer treatment options might include surgery combined with radiation and chemotherapy.
Small-cell lung cancer is often more aggressive than non-small types. After the spread of small-cell cancer, it is often too late to treat with surgery alone. The preferred approach is either chemotherapy solely or a combination of chemotherapy and radiation.
Radiotherapy usually involves the use of small but intense doses of X-rays or gamma rays to kill cancer cells, and also:
- Slow the growth and spread of the cancer
- Prevent damage to surrounding healthy cells
- Alleviate cancer symptoms such as pain and bleeding
Radiation can be the sole treatment or used with chemotherapy for lung cancer. It is often recommended for people with congestive heart failure and blood thinning, who are not good candidates for surgery. Radiation is also a preferred treatment for elderly patients.
Radiation delivery methods
There are several radiation delivery methods used for cancer treatment. Conventional external beam radiotherapy or radical radiotherapy is the most common non-surgical initial treatment for lung cancer. External beams of radiation are aimed at the cancer-affected areas of the body. This approach is often recommended for patients with non-small cell lung tumours who are not healthy enough for surgery.
For patients with microscopic tumours in early-stage lung cancer, oncologists might pursue stereotactic body radiation treatment or SBRT. For this method, numerous focused rays of high-dose radiation are aimed at the site of the lung tumour while the patient is breathing. The external beams used in SBRT are highly accurate, which helps to pinpoint the affected area while avoiding damage to surrounding healthy tissue.
Internal radiotherapy, aka brachytherapy, is a cancer treatment used for palliative care mostly in patients who have tumours blocking their airways. For temporary brachytherapy, a catheter is inserted directly into the lung, then a radioactive patch travels through the tube and is placed directly on the tumour. The radioactive material stays in briefly, then it is removed. There is also a permanent internal method that involves the surgical insertion of a radioactive ‘seed’ placed next to the cancer growth.
Frequency of cancer treatment sessions
The number of radiation treatments depends on many factors and the treatment schedule will be customised according to your needs. The goal is to provide enough daily radiation to eliminate the fast-growing cancer cells while preserving the normal cells. On average, patients receive the following dosage schedules:
- Conventional external beam radiation. 5 visits per week (Monday to Friday) for a total of 20–32 sessions.
- Stereotactic body radiation treatment (SBRT). 3–10 sessions total
- Internal radiation (for palliative care). 1–5 sessions
Radiation treatments are painless, but you could have some side effects including fatigue, skin issues (similar to a sunburn), chest pain and cough with bloody phlegm. Most of these will subside after treatment ends.
Radiotherapy remains a highly effective weapon for fighting lung cancer. When considering your treatment options, talk to your oncologist or any other members of your treatment team to get answers to any questions you have.
Ellen Diamond did her degree in psychology at the University of Edinburgh. She has an ongoing interest in mental health and well-being.