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therapy. The affected area may be red, dry, tender and itchy. This reaction can become quite severe during a long course of treatment. It helps to keep the skin clean with gentle soap and warm water, to dry it well and to avoid very hot water while bathing. Sunscreen should be used when skin in the treated area is exposed to sunlight. Perfumes, cosmetics and deodorants should not be used in the area of treatment. After daily treatments you may apply an unscented cream or lotion. Temporary loss of appetite is a possibility. Esophagitis or inflammation of the esophagus (the tube that conveys food from the mouth to the stomach) is common if radiotherapy is directed at the lymph nodes in the central chest or if the tumor is near the esophagus and can be severe. The esophagus is very sensitive to radiation, and the symptoms are worse occurs in patients who also receive chemotherapy. Esophagitis can make it difficult to swallow and some patients need pain medications or fluids delivered by vein to get through the full course of radiation treatment. Some people experience esophagitis as the sensation of a lump or discomfort before it becomes overtly painful. Some foods (like spicy or acidic foods or bread) feel worse than others. It is important to remember that though certain foods may cause pain with swallowing, eating these foods will not cause damage. You should avoid foods that cause pain until about one month after the final day of radiation. The inflammation generally plateaus toward the end of treatment and starts to resolve within two to three weeks after treatment in most patients. An inflammation of the lungs called radiation pneumonitis may develop three to six months after radiotherapy is over. It causes coughing and shortness of breath as well as fever but in most cases calls for no specific treatment and gets better within two to four weeks. It can occasionally happen earlier and require steroids and/or oxygen. What kind of treatment follow-up should I expect? Lung Cancer Treatment Page 6 of 8 Copyright© 2019, RadiologyInfo.org Reviewed: Jul-17-2019 Once a course of radiotherapy comes to an end your physician usually will want to see you after four to six weeks and then every three to six months for the first two years. After this you may be seen every six months for three years and then once a year. Often your medical or radiation oncologist will recommend that you have a computed tomography (CT) scan or a positron emission tomography (PET) scan approximately four to eight weeks after completion of treatment, when the response is expected to be the greatest. These images will help to assess response and make it possible to do comparisons with images obtained in the course of follow-up. In this way treatment-related complications can be found at an early stage and it will be possible to tell the difference between recurrent cancer and lung scars produced by high-dose radiation treatment. By obtaining chest imaging on a regular basis, (generally no more than two to four times per year) recurrent cancers may be discovered in time to be successfully re-treated. In addition to x-rays, other tests such as blood cell counts and bronchoscopy may be a routine part of the follow-up exam. Other testing, such as bronchoscopy may be performed for particular symptoms or findings on chest imaging. If new symptoms develop at another part of the body, tests may be done to detect any potential problem. After treatment, tumor may be permanently gone (cured) or can regrow in an area of the original tumor (recur) or can remain after treatment (residual tumor). Patients who have had one cancer may develop a second unrelated primary lung cancer. This happens at a rate of approximately 3 percent of patients per year. Are there any new developments in treating my disease? Less invasive surgical methods are under study. They require a much smaller incision and allow the patient to be up within hours after surgery ends. Immunotherapy uses drugs that boost the patient's immune system to help control cancer. Some studies, but not all, have shown better survival rates when these drugs are given after surgery. Gene therapy may kill cancer cells or slow their growth when healthy genes are delivered
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