Let’s start with the basics—what exactly is radiotherapy? In simple terms, it’s a treatment that uses high-energy radiation, usually X-rays, to destroy cancer cells. Think of it like a sniper, targeting the tumour while trying to spare as much healthy tissue as possible.
Radiation can be given in two main ways:
- External beam radiation therapy (EBRT) – This is the most common form, delivered from a machine outside your body.
- Internal radiation (brachytherapy) – Less commonly used in lung cancer, this involves placing radioactive material near the cancer site.
Radiotherapy doesn’t work instantly. It damages the DNA in cancer cells, which then die off over time. Healthy cells can also be affected, but they usually recover better.
When Is Radiotherapy Used in Lung Cancer?
Radiotherapy isn’t a one-size-fits-all solution. Its role depends on several things: cancer stage, tumour location, and your overall health.
Here’s how it fits in:
- As the main treatment: Especially for people who can’t undergo surgery or have early-stage lung cancer.
- Before surgery (neoadjuvant): To shrink the tumour and make it easier to remove.
- After surgery (adjuvant): To kill any leftover cancer cells and lower the risk of recurrence.
- Alongside chemotherapy: Often done in cases like limited-stage small cell lung cancer.
- Palliative care: To ease symptoms such as pain, bleeding, or breathing difficulty in advanced stages.
So, when does it apply to you? It’s all about matching the treatment to the situation.
Different Types of Lung Cancer Respond Differently
Did you know that there are more than one type of lung cancer? And they don’t all behave the same.
- Non-Small Cell Lung Cancer (NSCLC): This is the most common type. Radiotherapy is often part of treatment plans—either alone or combined with surgery and/or chemo.
- Small Cell Lung Cancer (SCLC): This aggressive type spreads quickly. Radiotherapy is usually paired with chemotherapy early in treatment. In limited-stage disease, it may be curative. In extensive-stage, it’s more about managing symptoms.
Your doctor will tailor the approach based on the specific cancer type.
Comparing Radiotherapy to Other Treatments
Let’s be honest—when facing lung cancer, you’re likely bombarded with options. Surgery, chemotherapy, immunotherapy, targeted therapy… so where does radiotherapy stand?
Here’s a quick breakdown:
- Surgery: Great for early-stage cancer that hasn’t spread. But not everyone is fit enough for it.
- Chemotherapy: Works throughout the body and is often combined with radiotherapy.
- Immunotherapy & targeted drugs: These newer treatments attack cancer in specific ways and are sometimes added to radiation.
Radiotherapy is unique because it focuses its attack locally—right at the tumour site. It’s especially useful when surgery isn’t possible or when you need fast relief from symptoms.
What Are the Benefits of Radiotherapy?
Why would someone choose radiotherapy? Let’s look at what it offers:
- Non-invasive: No knives, no stitches. You lie down, get the treatment, and go home.
- Targeted approach: Especially with new techniques, it aims at the tumour with precision.
- Fast symptom relief: Struggling with pain, coughing, or bleeding? Radiotherapy can provide quick relief.
- Can be curative or palliative: In early stages, it might cure the cancer. In advanced stages, it can still improve quality of life.
Of course, every treatment has trade-offs, but these benefits are why many patients find radiotherapy appealing.
What Are the Risks and Side Effects?
Let’s not sugarcoat it—radiotherapy can come with side effects. Most are temporary, but they can affect your daily life.
Here’s what to expect:
- Fatigue: Common, and it can linger for weeks.
- Skin irritation: Like a sunburn where the radiation hits.
- Cough or difficulty breathing: Especially if lung tissue is inflamed.
- Trouble swallowing: If radiation hits near the oesophagus.
- Long-term risks: Scarring, reduced lung function, and in rare cases, secondary cancers.
But here’s the thing—modern techniques have made radiotherapy much safer. You’ll be closely monitored, and adjustments can be made if side effects hit too hard.
Who Is the Best Candidate for Radiotherapy?
This is the big question: Is radiotherapy the right choice for you?
There’s no universal answer, but here are some signs it might be:
- You have early-stage lung cancer but can’t (or prefer not to) have surgery.
- You have symptoms like pain or coughing that need relief.
- You’re already on chemo, and adding radiation improves results.
- Your tumour is in a place where surgery would be risky.
Doctors consider your:
- Cancer stage
- Lung function
- Overall health
- Treatment goals
Still unsure? A multidisciplinary team (oncologist, radiologist, surgeon) usually helps weigh the pros and cons.
Advanced Techniques in Lung Cancer Radiotherapy
Radiotherapy has come a long way. If you’re picturing something old-school, it’s time to update your mental image.
- Stereotactic Body Radiotherapy (SBRT): High doses in fewer sessions. Great for small tumours.
- Intensity-Modulated Radiation Therapy (IMRT): Shapes radiation beams to match the tumour.
- Image-Guided Radiation Therapy (IGRT): Uses real-time imaging to track movement.
These techniques reduce damage to healthy tissues while boosting precision. The result? Better outcomes and fewer side effects.
What to Expect During Treatment
Feeling nervous? That’s totally normal. Knowing what to expect can help ease your mind.
- Planning session: Also called simulation. You’ll lie on a table while imaging scans are taken to map the treatment.
- Daily treatments: Usually 5 days a week for a few weeks. Each session takes just minutes.
- No pain during treatment: You won’t feel the radiation. It’s like getting an X-ray.
- Side effects appear gradually: Don’t panic if you don’t feel anything right away.
Most patients continue daily life during treatment—with some adjustments for fatigue or discomfort.
Questions to Ask Your Oncologist Before Choosing Radiotherapy
Feeling overwhelmed? Don’t be afraid to ask questions. Your care team is there for you.
Here are some good ones to bring to your next appointment:
- What’s the goal of radiotherapy in my case—cure, control, or comfort?
- Are there alternatives I should consider?
- How long will treatment take?
- What side effects should I watch for?
- How will this affect my quality of life?
Being informed puts you in the driver’s seat. After all, it’s your body, your life, your decision.
Final Thoughts
Choosing radiotherapy for lung cancer isn’t just a medical decision—it’s a personal one. The right choice depends on your type of cancer, your health, your values, and your goals. For some, it’s a powerful tool to shrink or destroy cancer. For others, it’s a way to breathe easier, sleep better, or live with less pain.
Whatever path you choose, make sure it’s your path—one that feels right for you.
References:
- “Radiation Therapy for Lung Cancer.” American Cancer Society, 2023. https://www.cancer.org/cancer/lung-cancer/treating/radiation.html
- “Lung Cancer Treatment (PDQ®)–Patient Version.” National Cancer Institute, 2023. https://www.cancer.gov/types/lung/patient/non-small-cell-lung-treatment-pdq
- Bradley JD et al. “Radiotherapy for non-small cell lung cancer: current status and future directions.” J Clin Oncol, 2014. https://ascopubs.org/doi/10.1200/JCO.2013.50.9423
- “Radiation Therapy for Small Cell Lung Cancer.” Cancer Research UK, 2023. https://www.cancerresearchuk.org/about-cancer/lung-cancer/types/small-cell/radiotherapy