Radiation Therapy for Lung Cancer
Overview
Radiation therapy works by using high-energy X-rays to kill cancer cells. MSK offers precise radiation therapy that kills lung cancer cells with fewer side effects from radiation. This keeps the healthy tissue safe.
You may have radiation treatment for lung cancer on its own. Or, you may have it before, during, or after surgery or chemotherapy.
To understand how lung cancer radiation therapy fits into your treatment, this is a good place to start.
MSK Care Advisors are available 24 hours a day, 7 days a week to answer your questions.
How is radiation therapy used to treat lung cancer?
Radiation therapy can treat lung cancer that’s only in the chest but cannot safely be removed with surgery.
Radiation therapy uses very precise, powerful, high-energy beams to kill cancer cells. Radiation oncologists are cancer doctors with special training in using radiation to treat cancer.
MSK’s radiation therapy experts deliver radiation just to the lung tumor while keeping nearby healthy tissue safe. Radiation therapy aims to kill off lung cancer cells with as few side effects as possible.
Lung cancer may not respond to surgery or chemotherapy. If so, we use radiation therapy to relieve symptoms and improve your quality of life.
At MSK, we use stereotactic body radiation therapy (SBRT) called MSK Precise®. It lowers the number of treatments you’ll need. MSK Precise lets you get back to your daily life faster because of the shorter treatment schedule. It can control 9 out of every 10 lung tumors, with few side effects.
Types of radiation therapy
There are 2 kinds of radiation therapy, internal and external:
External radiation therapy takes place outside your body. This kind of therapy uses high-energy rays to harm cancer cells so they can no longer grow.
External radiation therapy for lung cancer includes external beam radiation therapy and proton therapy.
Internal radiation therapy is when we put something, such as radioactive seeds, inside your body very close to the tumor.
Brachytherapy (BRAY-kee-THAYR-uh-pee) is an example of internal radiation.
Doctors at MSK are national experts in all methods of radiation therapy. They’ll recommend which is best for you, based on the cancer and your preferences.
External radiation therapy
External beam radiation therapy (EBRT) is the most common type of radiation therapy for lung cancer. It uses a treatment machine called a linear accelerator. It aims beams of radiation right at the tumor.
The beams pass through your body and harm cancer cells in their path. You will not see or feel the radiation.
The radiation is in the form of X-rays, protons, or other types of energy.
MSK uses a treatment called MSK Precise.® It lets you get back to your daily life faster because of a shorter treatment schedule. It can control 9 out of every 10 lung tumors, with fewer side effects.
SBRT delivers more precise, higher doses of radiation than standard therapy. You’ll have fewer treatments over a shorter time. SBRT often takes 1 to 8 treatments.
You’ll have an imaging scan before each treatment to make sure the high radiation doses go to the right place. This keeps nearby healthy tissue safe.
Intensity-modulated radiation therapy (IMRT) lets us change the radiation beams’ power during treatment. IMRT uses a special computer program to make a dose plan that delivers radiation right to the tumor.
IMRT can give high doses of radiation to lung tumors. It works well on tumors on central structures in the chest, such as the lymph nodes.
IMRT also has fewer side effects. Because it’s very precise, it keeps healthy tissue safe by limiting the amount of radiation.
Many of our non-small cell lung cancer are treated with IMRT to the chest. We also use it for lung cancer that has spread to other areas of the body. Each year, MSK treats about 920 lung cancer patients and 266 people with lung metastases.
MSK uses proton therapy, also called proton beam therapy, for some cases of lung cancer. This type of radiation therapy uses charged particles called protons to kill cancer cells. A device called a cyclotron sends tiny, high-energy beams of protons to the tumor.
With proton therapy, the beams do not go past the tumor. It can cause fewer side effects because healthy tissue near the tumor is more likely to be safe.
Internal radiation
An example of internal radiation therapy is brachytherapy (BRAY-kee-THAYR-uh-pee). This is an outpatient (outside the hospital) treatment.
You’ll have anesthesia (medicine to make you sleep). You can go home the same day. MSK doctors were among the first to offer this form of treatment.
Brachytherapy puts radioactive material close to or inside the tumor. The radioactive material is sealed inside a thin tube. The radiation does not travel far from the radioactive material. The tumor gets a high radiation dose while nearby healthy tissue gets little or none.
We also can deliver high doses of radiation to the airways in your respiratory system (where your lungs are). We use a special method called endobronchial (EN-doh-BRON-kee-ul) brachytherapy. It can help people with cancer that came back in the larger airways.
Side effects of lung cancer radiation therapy
What are the short-term side effects of radiation therapy?
Radiation treatments are very precise and cause little harm to healthy tissue. This treatment does not cause hair loss. Many people report few lasting side effects.
In general, you can keep doing your daily activities or keep working through treatment.
Some people do have symptoms after a few weeks, such as:
- Skin irritation
- Fatigue (feeling very tired)
- Pain when swallowing
- Dry cough
Our Integrative Medicine Service offers complementary, holistic, and natural therapies. They include acupuncture, meditation, massage therapy, yoga, and exercise. Without using prescription drugs, integrative therapies can help improve and control side effects of cancer treatment.
What are the long-term side effects of lung cancer radiation therapy?
Side effects can start months or years after treatment ends. These are called long-term or late effects. Late effects of lung cancer radiation are not common, but they can include:
- Inflammation in the lung, most often with people who also had chemotherapy or immunotherapy.
- Injury to the heart, where there was a lot of exposure from radiation.
How do we limit exposure to radiation during treatment?
MSK’s radiation experts do everything possible to lower the chances of harming the heart and lungs. They use the most precise ways to deliver radiation to treat lung cancer.
MSK doctors use imaging and complex computer systems to account for tumor movement while you breathe. Sometimes we’ll ask you to hold your breath while we deliver the dose of radiation.
For safety, we can take images each day to track the tumor and keep healthy tissue safe. This imaging shows the tumor’s exact location so we can target it with precise radiation.
These methods limit healthy tissue’s exposure to radiation.
Radiation therapy alone can work well to treat lung cancer. It also can be used along with other treatments, such as chemotherapy, targeted therapies, or immunotherapy.
MSK’s lung cancer team is a worldwide leader in clinical trials advancing radiation methods. We’re exploring how well a type of radiation therapy called stereotactic body radiation therapy (SBRT) treats lung cancer. We’re also studying how to combine radiation therapy with new targeted drug treatments.
Common questions
Before you start radiation therapy, you’ll have a treatment planning procedure called a simulation. This is done to make sure that:
- Your treatment site is mapped so the radiation is precise and targeted.
- You get the right dose (amount) of radiation.
- Nearby tissue gets the lowest amount of radiation possible.
Your simulation will take 1 to 2 hours. You’ll have a CT scan.
Your skin will be marked with little tattoo dots that tell us which area to treat. These tattoos are permanent (do not come off).
You’ll be lying in one position for a long time.
Some people must have a positron emission tomography-computed tomography (PET-CT) scan done during the simulation.
After your simulation, your radiation oncologist will work with a team to plan your treatment. They’ll use your simulation X-rays and CT scan to plan the angles and shapes of your radiation beams. This information is carefully planned and checked. Your lung cancer radiation treatments will take between 3 to 33 visits, scheduled on consecutive weekdays.
Your radiation therapy team will tell you what to expect for your treatment schedules.
You must come in each day you’re scheduled for your treatment. Treatment may not work as well if you skip or miss appointments. If you need to change your schedule for any reason, talk with your radiation therapist.
Before your appointment, it’s helpful to write down questions you want to ask. Here are some examples. Write down the answers during your appointment so you can review them later.
- Will radiation to my lungs make my breathing worse?
- What kind of radiation therapy will I get?
- How many radiation treatments will I get?
- What side effects should I expect during my radiation therapy?
- Will these side effects go away after I finish my radiation therapy?
- What kind of late side effects should I expect after my radiation therapy?