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chest wall, diaphragm or lymph nodes in the chest. Depending on the exact location of cancer, radiation therapy may be given alone or combined with surgery and/or chemotherapy. Tumor that has spread to other parts of the body: Systemic therapy (chemotherapy, targeted therapy or immunotherapy) are the main treatments for patients whose tumors have spread beyond the chest or into the opposite lung. Surgery does not generally benefit people whose cancer has spread beyond the chest. Chemotherapy prolongs life and radiation therapy can be used to relieve symptoms caused by tumor. Sometimes brain surgery is recommended for patients whose NSCLC has patients whose NSCLC has spread to the brain. Any patient with lung cancer should consider taking part of a clinical trial to help find more effective treatments for lung cancer. How effective is treatment for inoperable lung cancer? It is extremely important to remember that "inoperable" does not mean "incurable" when it comes to lung cancer. In fact, an increasing number of patients are being treated with a non-surgical approach across all stages of this disease. The effectiveness of the treatment depends on the stage of disease. In early stage inoperable disease that is treated with radiotherapy alone, control of the local disease is typical. In more advanced disease, a combination of chemotherapy and radiation is delivered with curative intent. Cure rates are lower, but still possible with disease spread to the lymph nodes within the chest. The medical or radiation oncologist may propose a combination of chemotherapy and radiation therapy for a patient who is active. When cure is not a possibility, palliative treatment is recommended. This is the use of medications, chemotherapy, radiation therapy or other measures to relieve symptoms of lung cancer without actually eliminating the tumor. The doses of radiation therapy used are smaller in order to avoid side effects. At some point, if you and your oncologist or primary care physician agree that active treatment is no longer advisable, hospice care can provide comfort and support. Pain relief is a very important part of treating lung cancer. Although many effective treatments are available and there are devices for delivering medication on demand without overdosing, many cancer patients still do not receive adequate pain relief. If the needs of the patient are clearly expressed, the treating physicians can better provide appropriate care. What happens during radiation therapy? Radiation therapy is the delivery of focused high-energy x-rays (photons), gamma rays or atomic particles. It affects cells that are rapidly dividing—such as cancer cells—much more than those that are not. Most cancers, including lung tumors, are made of cells that divide more rapidly than those in normal lung tissue, holding out the hope that the tumor can be eliminated without damaging surrounding normal tissues. Radiotherapy acts by attacking the genetic material—or DNA—within tumor cells, making it impossible for them to grow and create more cancer cells. Normal body cells may also be Lung Cancer Treatment Page 5 of 8 Copyright© 2019, RadiologyInfo.org Reviewed: Jul-17-2019 damaged—though less markedly—but they are able to repair themselves and function properly once again. The key strategy is to give daily doses of radiation large enough to kill a high percentage of the rapidly dividing cancer cells, while at the same time minimizing damage to the more slowly dividing normal tissue cells in the same area. What are possible side effects of radiation therapy? Most patients tire easily after receiving their first radiation treatments. This fatigue gradually increases as treatment continues and may become severe, seriously limiting the ability to engage in normal daily activities. Typically, fatigue lessens one to two months after radiotherapy is completed. If you experience fatigue it is important to get enough rest, but at the same time your physician may suggest that you stay as active as possible. Some patients experience hair loss in the area of the chest wall included in the radiation field. Depending on how much radiation is delivered, this may be temporary or permanent. Skin irritation is common after a few weeks of radiation