Every lung cancer treatment plan is different based on the type, such as small cell or non-small cell lung cancer. It’s also important for the oncologists to consider the cancer’s location, size, number of tumors and whether it’s spread to lymph nodes or other areas of the body.
The specific treatments used may also be based on the patient’s overall health and personal preferences. It’s common to have more than one type of treatment as part of the overall plan. This is so that the cancer can be removed and any remaining lung cancer cells left in the body are killed.
Sometimes a patient will receive treatments consecutively – one therapy after the other. And other patients will have chemotherapy and radiation therapy scheduled in the same general time period. We will discuss various types of treatments and the side effects:
- Lung cancer radiation therapy
- Lung cancer surgery
- Lung cancer chemotherapy
- Lung cancer targeted therapy
- Immunotherapy for lung cancer
Each type of treatment can cause different side effects. Not everyone experiences the same side effects of the same treatments. It can be helpful to know what to expect and what you can possibly do for some relief. And remember, always reach out to your oncologists office to discuss the side effects. They can often offer specific advice or prescribe medications that can bring relief.
Most patients don’t have too many side effects from lung cancer treatment until they’ve had a few treatment sessions. They can gradually worsen until treatment ends and begin to lessen two to three weeks later. But keep in mind that while the side effects might be rough for a short period of time, they can produce a lasting effect on the patient’s life.
Lung Cancer Radiation Treatment Side Effects
Some patients receive radiation therapy as part of their treatment process. This can be used when surgery is too difficult or if the cancer has spread to other areas of the body. It works by directing intense, high-energy beams at the lung to kill the cancer cells. It’s a highly targeted treatment focused on the specific area being treated.
It may be used before surgery to shrink tumors or after surgery to kill remaining cancer cells. When lung cancer surgery is not an option, radiation may be combined with chemotherapy. It may also be used to relieve pain caused by the cancer in the lung or other areas of the body.
Side effects of radiation therapy can include:
- Fatigue and weakness - This is more than feeling tired. A nap may not fix this type of exhaustion. Try to rest more often. Sit or lie down several times a day. You can also try some light exercise. As odd as it sounds, this can reduce fatigue. Also, don’t forget to try new energy-saving approaches, like online shopping/delivery instead of going to the store. Get help from family, friends, or a paid caregiving service.
- Redness or skin darkening - This can happen at the treatment area and on the other side of your body where the radiation beams leave your body. It might feel like a sunburn. Before treatment try to keep your skin moisturized. You may be able to use aloe or a scentless cream to help your skin feel better.
- Soreness in the area where radiation is being delivered - Be gentle with your skin, even if it’s not looking red or peeling like sunburn. Avoid talcum powder because it can contain tiny metal particles that aggravate the soreness. Gently pat dry after washing. Don’t rub the area and keep it free from irritants, such as perfume, deodorant, shaving, hair removal treatments, or a heating pad.
- Shortness of breath or cough - This can result from radiation to the chest that causes lung inflammation. You may have already been coughing as a symptom of lung cancer. But if you notice this, talk to your radiation oncologist.
- Sore mouth or throat - Depending on where you receive radiation therapy you might notice a sore throat or mouth. Avoid hot beverages. Try to drink things that are room temperature. Gently brush teeth after meals with a soft-bristle toothbrush. Keep your mouth and lips moist. This can be done with a gentle, alcohol free mouthwash.
- Difficulty swallowing - Because radiation may be needed near your esophagus, it can be difficult to swallow food because of irritation in the area. Try to eat soft foods and drink plenty of fluids. Eat slowly; avoid eating three to four hours before bedtime. High-calorie or high-protein drinks can help maintain nutrient levels.
- Nausea - In some cases patients may have some nausea or vomiting. It can usually be relieved with anti nausea drugs.
- Loss of neck and chest hair. It usually grows back after treatment.
Lung Cancer Surgery Side Effects
Surgery to remove the cancerous tumor is an option if the cancer has not spread beyond the lungs. If the tumor is large, you may have chemotherapy or radiation to shrink it before surgery and/or after surgery to kill the remaining cancer cells.
After surgery you may notice:
- Chest pain results from the surgeon cutting into your chest and spreading your rib cage to remove the tumor. This major operation can take weeks or months to recover from, and you may need pain medications. Give your body time to heal.
- Anesthesia side effects such as nausea, mild confusion, itching or shivering. Tell the nurse or doctor caring for you after surgery if you’re experiencing any of these so they can assist.
- Weakness after the operation requires time and rest to heal.
- Shortness of breath can result even if you get enough oxygen from normal breathing. This is how the brain processes chest pain. It gets better as you heal. If you’re given lung exercises after surgery, be sure you do them!
Chemotherapy Side Effects in Lung Cancer Treatment
Chemotherapy, which uses drugs to kill the cancer, can also be used before treatment to shrink the tumor and/or kill remaining cancer cells and keep the cancer from recurring. It’s also used to relieve pain and other side effects.
Side effects include:
- Pain and weakness can be relieved with pain medications and rest.
- Shortness of breath can be relieved with medications, breathing, and relaxation exercises.
- Hair loss can vary from slight to complete but is almost always temporary.
- Bleeding problems can occur if you don’t have enough platelets (blood cells that stop bleeding) to form a clot. Your blood count will be checked during treatment, and you may have a blood transfusion.
- Loss of appetite can be helped by switching to multiple small meals or snacks and avoiding greasy or spicy foods.
- Diarrhea lasting more than a day should be reported to your care team. It can cause dehydration very quickly.
- Constipation can increase your chances of having hemorrhoids or other problems. Increase fiber in your diet, drink plenty of fluids, and exercise.
- Fatigue is especially common in the days right after treatment.
- Infections can be life-threatening. Keep your hands clean, avoid crowds, and call your doctor if your temperature exceeds 100 degrees.
- “Chemo brain” includes forgetfulness and problems concentrating or finding your words. Make lists, take notes during appointments, and work on brain puzzles or crosswords.
- Peripheral neuropathy can cause pain, burning, tingling, weakness, or numbness in the hands and feet. Be careful when grabbing hot or sharp items, use handrails, and wear sensible, safe shoes.
- Depression or anxiety are common. If you feel suicidal, call your doctor immediately. Regular exercise, practicing deep breathing and relaxation techniques, using spiritual support like meditation or prayer, and talking to a mental health professional can help you cope.
Targeted Drug Therapy Side Effects
Targeted therapy, mainly available to patients with advanced or recurrent non-small cell lung cancer, uses drugs to target and stop the growth and spread of cancer cells. These are becoming more prominently used for gene mutations in advanced or recurrent lung cancer patients.
Side effects of targeted therapy will depend on which treatments are needed, but can include
- Joint pain
- Skin rashes or thickening
Your oncology team can help you with managing these side effects. Be sure you let them know what you’re experiencing.
Immunotherapy Side Effects in Lung Cancer Patients
Immunotherapy works with your immune system to help it fight cancer. It is reserved for advanced and metastasized cancers.
Side effects include:
- Flu-like symptoms including a fever. This can be the case because the body is using its immune system to fight off the foreign cells.
- Fatigue or feeling exhausted. Your body is working hard, give it some rest.
- Skin rashes may need medication and protection from the sun and wind
- Stomach issues such as nausea, diarrhea or constipation.
Long-Term Side Effects of Lung Cancer Treatments
While most side effects go away after treatment, some can continue or start months or years after treatment ends. Most patients don’t experience all of these. Long-term effects can include:
- Shortness of breath and cough happen to about 4% of patients who undergo chest radiation. Report changes in breathing or if you’re coughing up a lot of mucus. Steroids and other medication can help with breathing.
- Narrowing your throat and esophagus, although rare, can be helped with a procedure that widens the esophagus, making it easier to swallow.
- Inflammation of the heart lining can cause sudden chest pain or chest tightness.
- Anemia can make you feel tired and weak because you don’t have enough red blood cells to transport oxygen throughout your body. It can be caused by chemotherapy or radiation treatments. Medications and blood transfusions usually cure anemia.
- Tooth decay can develop because of dry mouth if radiation affects your mouth’s ability to make more saliva. Visit your dentist before treatment to care for any cavities or other issues so that they’re not made worse during treatment.
Talking to Your Oncology Team About Side Effects
Our radiation oncologists throughout the Atlanta area help patients manage side effects from lung cancer radiation every day. Don’t be embarrassed or feel like your case is unusual. Our team is here to help you beat cancer and feel your best. We’ll do all we can to relieve side effects of cancer treatment and help you recover.