Radiotherapy to the Chest/ Lung area

Radiotherapy to the Chest/ Lung area

Introduction

This leaflet is to explain possible side effects that may develop when receiving radiotherapy to your chest or lung area.

These effects are individual and will depend on the dose of radiotherapy you receive, length of treatment, your medical background and if you are undergoing chemotherapy as well. Everyone reacts to radiotherapy differently and they will not necessarily experience all of the side effects described. Acute (early) side effects may start at varying times during treatment and disappear in the weeks after the end of treatment. Late side effects may not occur for a long time after treatment has finished. 

The Radiographers will explain your possible expected side effects in more detail and answer any questions you may have before you start treatment. They will also give you lots of support and advice to care for and manage side effects throughout your treatment. 

Acute (early) side effects 
These may occur whilst you are undergoing Radiotherapy and in the weeks immediately afterwards.

Skin Changes
Generally, these are minimal for this treatment, but you may notice possible reddening of skin in your treatment area. This is a normal reaction to treatment. The treatment radiographers will be able to advise you further on skin care. The skin reaction can actually peak 5-10 days after the end of treatment.

Cough
You may experience an increase in a dry or productive cough and possibly cough up sputum (spit) which could contain a little blood. If you smoke and continue to do so this may make your symptoms worse.

Chest pain
You may develop aches and discomfort in your chest area while on treatment. If you have been prescribed painkillers already by the doctor, you may need to take these regularly to help manage the discomfort.  

Breathlessness
The symptoms of breathlessness will vary depending on the dose of radiotherapy and the number of treatments that you receive.

If you are receiving a course of radiotherapy to your chest you may already be feeling breathless before treatment starts. When treatment starts you may find the shortness of breath increasing. This is initially due to the radiotherapy and should improve within a few days to a week. If you experience this, rest as much as possible and try not to do any unnecessary strenuous tasks.

If you are receiving a longer course of radiotherapy you may also develop breathlessness towards the end of your treatment.

Some weeks after your Radiotherapy has finished you may experience a recurrence of your initial treatment related breathlessness. This is called pneumonitis, and is a side effect of the radiotherapy. If you are worried, or if it continues or gets worse please contact your Consultant, Specialist Nurse or the Acute Oncology Service. (Contact number below) This should improve within a few weeks; however, some patients may need treatment with a short course of steroids.

Hoarse voice
You may also experience a sore throat and/or hoarseness (a gruff sounding voice), particularly if the treatment area includes the throat.

Fatigue
This can be a common effect of radiotherapy. If you feel tired you should listen to your body and rest at regular intervals if you need to but continue your normal activities if possible.  Research has found that gentle exercise such as a short daily walk can help the symptoms of tiredness and fatigue. Some people are able to continue working throughout treatment but others find that they are too tired. 

Eating and swallowing
You may experience a loss of appetite, indigestion; heartburn and difficulty on swallowing. These are all common side effects of treatment. If this happens it may help to eat softer foods and avoid spicy foods and alcohol (particularly spirits). Not smoking during radiotherapy will also help. 

Feeling sick
You may feel sick and sometimes be sick, particularly if the treatment area is near the stomach. If you are feeling nauseous you may not feel like eating. You may be prescribed anti sickness tablets if needed.

Loss of appetite
Some people find that radiotherapy treatment may change their sense of taste and they can lose their appetite during treatment. Eating little and often can help. 

If you experience these effects or require extra nutritional support we can arrange for you to see our Dietitian who can offer advice, support and supplements. 

Hair loss
Some people may lose chest hair, the hair loss will only occur in the area being treated. This hair loss can be temporary; however, in some cases this may be permanent depending on the dose of radiotherapy that is given. 

If you experience any of these possible side effects your Radiographers’ will be able to give you advice, information, support and medicines that can help.

Late Side Effects
These may occur months or years after your radiotherapy treatment.

Scarring of lung tissue
Radiotherapy may leave some scarring on the lung (fibrosis), which may cause shortness of breath and/ or cough. Symptoms will vary depending on how well the rest of your lungs are working. Please see your GP if this becomes a problem as breathing exercises and medication can help.

Damage to bones
In rare cases, radiotherapy can make your rib bones brittle and more likely to break.

Narrowing food pipe (oesophagus)
Narrowing of the food pipe is called a stricture, which can cause difficulty swallowing. The stricture can usually be relieved by a small procedure to stretch the narrowing and allow food to pass through easily again.

Nerve damage
If your cancer is in a certain area you may have a small risk of nerve damage. Your consultant will discuss this with you if it is relevant.

Heart damage
Occasionally, radiotherapy to the chest can cause tightening of the covering of the heart (the pericardium). The tightening may need surgery to reduce it. Again your consultant will discuss this if it is relevant to you. 

Support
Any side effects you may have experienced will continue after radiotherapy and can last a few weeks after radiotherapy has finished. 

If you are concerned about the late effects of radiotherapy treatment, or would like more information, please speak to your consultant, the Acute Oncology Service 01905 760158 or the Macmillan Review Radiographer on 01905 761420.

You may also contact your GP or your Clinical Nurse Specialist. 

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.  

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