Having radiotherapy for non small cell lung cancer
Radiotherapy uses high energy x-rays to treat cancer cells. You have the treatment in the hospital radiotherapy department.
When you might have radiotherapy
Radiotherapy on its own
You might have radiotherapy on its own for stage 1, 2, or 3 non small cell lung cancer if you can’t have surgery because:
- you are not fit enough for surgey
- you are not fit enough for chemotherapy at the same time as radiotherapy (chemoradiotherapy) or choose not to have it
- you have other medical conditions such as heart or lung disease
- your cancer is hard to reach with surgery
Stage 1 to 2A
You usually have 
for stages 1 to 2A. If you can’t have SABR, you might have traditional radiotherapy or radiotherapy that is divided into small doses and given more often. This is also known as continuous hyperfractionated accelerated radiotherapy (CHART).
Stage 3A and 3B
For stages 3A and 3B, you have traditional radiotherapy or radiotherapy that is divided into small doses and given more often (hyperfractionated accelerated radiotherapy or also called CHART).
Traditional radiotherapy is most often given 5 days a week for between 4 to 7 weeks. But this can vary depending on your cancer. Your specialist will tell you how often you will need to have the treatment.
You usually have 3 to 8 stereotactic radiotherapy treatments You have it 2 to 3 times a week.
Radiotherapy after surgery
You might have radiotherapy after surgery if your surgeon couldn’t completely remove all of the cancer. This is usually for stage 1, 2 and 3A cancers.
Radiotherapy after chemotherapy
You may have radiotherapy after chemotherapy for stage 2 and, in some situations, stage 3 non small cell lung cancer. This is called sequential radiotherapy.
Radiotherapy and chemotherapy (concurrent chemoradiotherapy)
You might have radiotherapy at the same time as chemotherapy for stage 3 non small cell lung cancer. Having both treatments at the same time can increase side effects. You need to be fit and well to have this treatment.
Radiotherapy to control symptoms
You might have radiotherapy for non small cell lung cancer that has spread to other parts of your body (stage 4). This is called metastatic lung cancer. Radiotherapy in these areas can relieve symptoms.
The radiotherapy room
Radiotherapy machines are very big and could make you feel nervous when you see them for the first time. The machine might be fixed in one position. Or it might rotate around your body to give treatment from different directions. The machine doesn't touch you at any point.
Before your first treatment, your will explain what you will see and hear. In some departments, the treatment rooms have docks for you to plug in music players. So you can listen to your own music while you have treatment.
Before each treatment session
The radiographers help you to get onto the treatment couch. You might need to raise your arms over your head.
The radiographers line up the radiotherapy machine using the marks on your body. Once you are in the right position, they leave the room.
During the treatment
You need to lie very still. Your radiographers might take images (x-rays or scans) before your treatment to make sure that you're in the right position. The machine makes whirring and beeping sounds. You won’t feel anything when you have the treatment.
Your radiographers can see and hear you on a CCTV screen in the next room. They can talk to you over an intercom and might ask you to hold your breath or take shallow breaths at times. You can also talk to them through the intercom or raise your hand if you need to stop or if you're uncomfortable.
Dan (radiographer): Before your treatment starts your doctor will need to work out exactly where the treatment needs to go and also which parts need to be avoided by the treatment. To have radiotherapy you lie in the same position as you did for your planning scans. We then line up the machine based on your tattoo marks. It is really important that you stay very, very still when you are having treatment it is also important to let the radiographers know right at the beginning if you are not comfortable so they can adjust your position
Radiographer: Ok all done, we’ll be back in a couple of minutes
Dan (radiographer): We leave the room and control the room from a separate room This is so we aren’t exposed to radiation. Treatment takes a few minutes and you will be able to talk to us using an intercom. We can see and hear you while you are having your treatment and will check that you are ok. When your treatment starts you won’t feel anything; you may hear the machine as it moves around you giving the treatment from different angles. Because we are aiming to give the same treatment to the same part of the body everyday then the treatment process is exactly the same everyday so you shouldn’t notice any difference. You’ll see someone from the team caring for you once a week while you are having treatment they’ll ask how you are and about any side effects.
Patient: They get you from one sitting area to another and then take you into the room where you undress to the waist and then lie down and line you up by either moving you or asking you to shuffle a little and they check the dimensions and they talk to one another and they say I am fine this side how are you ...yes fine...ok, stay where you are Jeff and that was it. There were a few little clicks and lights go on and off and you can see a green laser beam which line sup with certain things on your body uh so no, no real noise and no discomfort.
You won't be radioactive
This type of radiotherapy won't make you radioactive. It's safe to be around other people, including pregnant women and children.
Travelling to radiotherapy appointments
You might have to travel a long way each day for your radiotherapy. This depends on where your nearest cancer centre is. This can make you very tired, especially if you have side effects from the treatment.
You can ask your radiographers for an appointment time to suit you. They will do their best, but some departments might be very busy. Some radiotherapy departments are open from 7 am till 9 pm.
Car parking can be difficult at hospitals. Ask the radiotherapy staff if you are able to get free parking or discounted parking. They may be able to give you tips on free places to park nearby.
Hospital transport may be available if you have no other way to get to the hospital. But it might not always be at convenient times. It is usually for people who struggle to use public transport or have any other illnesses or disabilities. You might need to arrange hospital transport yourself.
Some people are able to claim back a refund for healthcare travel costs. This is based on the type of appointment and whether you claim certain benefits. Ask the radiotherapy staff for more information about this and hospital transport.
Some hospitals have their own drivers and local charities might offer hospital transport. So do ask if any help is available in your area.
Side effects of treatment
Radiotherapy to the lung can cause side effects. You can read more about what they are and how to cope with them.
