Introduction To Radiation Therapy As An Adjunct To Lung Cancer Surgery

Radiation therapy (RT) is a local treatment measure used to kill cancerous cells and reduce the size of tumors

. Doses of ionizing radiation are focused upon cells that divide more quickly than normal. They damage portions of the cells' DNA structure, thereby preventing them from splitting and ultimately, killing them. Your doctor, with input from an oncologist, will decide whether RT is an appropriate form of treatment for your condition.

In this article, we'll describe when radiation therapy (sometimes called radiotherapy) is used as an adjunct to lung cancer (LC) surgery. There are two main approaches to delivering the doses; we'll briefly describe both of them. You'll also learn about the short-term and long-term side effects associated with the treatment.

Circumstances For Which Radiation Therapy Is Used

Radiotherapy is usually combined with lung cancer surgery, and can be done before or after the operation. In the former case, the purpose is to control the spread of diseased cells and reduce the size of the primary tumorous mass. This makes removal of the mass easier. In the latter case, the purpose is to kill residual diseased cells.

There are times when patients suffer small tumors, but are unable to tolerate surgery. In such cases, targeted radiation can potentially kill the diseased cells, and thus rid the patient of the tumors. This outcome, however, is rare. Radiotherapy is also occasionally delivered to the brain when lung cancer has metastasized.

Approaches To Delivering The Radiation

Earlier, it was stated there are two main approaches to delivering radiotherapy. There are actually several methods, but each fits within one of two categories: external or internal delivery. The former is the most common approach; it is known as external beam radiotherapy. Doses of radiation are delivered to a targeted site from a machine that is positioned near the patient's body.

Internal radiotherapy is known as brachytherapy. A bronchoscope is inserted through the nose or mouth, and advanced to the targeted site. Radiation is sent through the tube directly to the tumor. Because the doses are delivered internally, brachytherapy results in less harm to healthy tissue.

Temporary And Long-Term Side Effects

It's important to highlight that RT affects each person differently. Some experience mild side effects while others experience those that are more severe. Each of these side effects, however, can be cataloged as temporary or long-term. Temporary side effects include skin irritation near the treatment area (i.e. the chest), fatigue, hair loss, and a shortness of breath. In some cases, the patient may also experience mild irritation to his or her esophagus. These symptoms usually disappear within a few weeks following treatment.

Long-term side effects of radiotherapy are more serious. They include heart muscle damage, and inflammation and scarring of the lungs. In rare instances, exposure to high-dose radiation can cause other cancers. These conditions can potentially last for years, and reduce the patient's quality of life.

Minimally Invasive Lung Cancer Surgery

Surgery is performed when non-small cell lung cancer is still in stages 1, 2, and 3A. By the time the disease reaches stage 3B, it has metastasized to distant lymph nodes; surgery cannot cure the disease. If lung cancer is diagnosed early enough, a surgeon can usually resolve it by performing a wedge resection, lobectomy, or pneumonectomy.

Each of these surgeries were once done using invasive techniques; the patient's chest was opened and the ribcage was spread to provide access to the affected lung. This approach defined traditional thoracotomy. While this is still done today, a growing number of surgeons are becoming proficient with minimally invasive techniques, such as video-assisted thoracoscopic surgery (VATS).

Together, radiation therapy and minimally invasive surgery can cure lung cancer as long as the disease is diagnosed early. If you have developed lung cancer, check with your doctor to determine whether this is an appropriate treatment plan, given your condition.

by: Jennifer Holbein

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