Radiotherapy for lung cancer/thoracic cancer

There are two types of lung cancer: small cell and non-small cell lung carcinoma. Small cell lung carcinoma tends to be a more aggressive type of cancer, with a much higher risk of metastases. Treatment for both versions varies.

We will run diagnostics to find out which type of lung cancer you have, what size your tumor is and where it is located, and whether your lymph nodes are affected or if the tumor has spread outside of the body. Once we have mapped everything out, we can assess the stage of the tumor. We will discuss your case during a multidisciplinary team meeting (involving various specialists who treat lung cancer) to find a treatment plan that best suits you. Your overall health and personal wishes are important to us when looking for a suitable treatment.

If your tumor is small and the cancer cells have not spread to the lymph nodes, stereotactic treatment may be an option, which has a high success rate. This treatment involves a small number of sessions during which you will receive a high dose of radiation with great precision.

If your lung cancer has spread through the body and causes pain or bleeding, or if your tumor might block the airways of blood vessels, we can give you radiotherapy to alleviate these symptoms. This will shrink the tumor and stop it from growing. We call this a palliative radiation treatment. This will not cure your cancer.

Non-small cell lung cancer

We can offer radiation treatment if your tumor has not spread outside of the chest. You will receive 17 to 30 treatment sessions.

Radiotherapy can be combined with chemotherapy. The chemotherapy can make the cancer cells more sensitive to the radiation. You will receive a small dose of chemotherapy before your radiation sessions.

Small cell lung cancer

If your cancer has not spread outside of the lungs, we will treat you with 4 chemotherapy sessions and 30 radiation sessions. We can deliver radiation twice a day, although in some cases, one session a day is preferred.

We may want to deliver preventive radiation to the brain, even if we did not find metastases in the brain. This will lower the risk of tumor cells in the brain.

Newest techniques and latest advancements

Our Radi ation Oncology department is constantly working on the development of new techniques using the most advanced technology currently available - both in diagnostic imaging, preparation, and radiation itself. This allows us to deliver the most effective treatment possible to you, while sparing as much healthy tissue as possible.

Consultation with your radiation oncologist or physician assistant

You will meet with your radiation oncologist or physician assistant to discuss your situation and the treatment that best fits you, its goal, expected outcome preparation, execution, and side effects.

Multidisciplinary team meeting

Your situation, test results and medical history will be discussed in a multidisciplinary team meeting consisting of specialists such as gastroenterologists, surgeons, and radiation oncologists, in order to find the treatment that best fits you. Your radiation oncologist will discuss the results with you.

Research

We are constantly working to improve and develop radiation treatment through research. if your radiation oncologist knows of a trial that you may qualify for, he or she will let you know. You will receive more information to make an informed decision. Your participation is voluntary. if you decide not to participate, you will be treated according to the latest protocols and developments.

Preparation

You will get a CT as a preparation for the treatment. You will be taking the same position you would during radiation treatment: on your back. You will wear a small mask covering your nose and mouth so we can monitor your breathing. This allows us to visualize the tumor movements while you are breathing. We will use these images to find the radiation field that will receive the beams. Your radiation oncologist will project laser lines on the skin. You will receive small tattooed dots on these lines in order to deliver the radiation to the same spots during your next session.

We will provide information about the treatment during your preparatory consultation. There will be plenty of room to ask questions.

Radiation treatment planning

Your radiation oncologist will draw the placement of the radiation field on these CT and/or MRI scans. He or she will calculate the optimal external beam radiation using special software: the treatment planning. It is important to ensure that the field receives the correct dose and that the surrounding tissue is spared as much as possible.

Radiation

Radiotherapy lab technicians ensure that you are positioned correctly on the table. The beams on your body will overlap with the tattooed dots on your body.

We will often check whether your position is still correct by using a CT scanner attached to the machine. This allows us to make small adjustments to your position in order to ensure that the radiation matches the tumor shape as closely as possible. The lab technicians will follow the treatment on monitors.

The radiation machine can revolve around you to find the right angle for the treatment.

The delivery of the radiation itself will take a few minutes. The total time of the treatment will be approximately 15 minutes. The beams won’t hurt, although you will start to notice the effects of the radiation.

Check-ups with your radiation oncologist or Physician Assistant

During your treatment you will regularly meet with your radiation oncologist to discuss the progress and ask any questions you may have. Your radiation oncologist will offer advice on how to deal with the side effects you are experiencing and prescribe medication if needed. You will also hear about the next step after your treatment.

Side effects

The side effects you will experience depend on your personal situation, overall shape and health, and the area that is receiving the treatment. Your practicing physician will discuss the side effects you can expect with you. If you are receiving chemotherapy before your radiotherapy, you will experience more side effects. If your lymph nodes are receiving treatment as well, you may experience problems with your esophagus and the passage of food into the esophagus. You may also experience fatigue.

You may notice the acute side effects after two or three weeks of treatment. These will increase in severity over the course of your treatment and may linger for months after its end. Some side effects may be permanent. Your practicing physician will discuss which side effects you can expect.

What you can do

If your symptoms, situation, and overall health allow, we recommend daily exercise to improve your recovery. You could consider walking or biking, or exercise under the supervision of a physical therapist. We also recommend continuing your day to day activities as much as possible.

General nutritional guidelines apply during treatment.

Please consult your practicing physician if you wish to continue taking additional vitamins or supplements during your treatment.

Follow-up care

If you would like extra care during or after your treatment, please ask your radiation oncologist or physician assistant to the NKI Survivorship Center. Our physical therapists, occupational therapists, social workers, and psychologists are experienced in care for cancer patients and would love to offer additional support during and after your treatment.