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Lung cancer

Brachytherapy for treating lung cancer

There are two main types of cancer that start inside the lung: Non-Small Cell Lung Cancer (NSCLC; >80%) and Small Cell Lung Cancer (SCLC; ~15%). There is one rare type of cancer that starts in the pleura,  Mesothelioma, that is associated with Asbestos exposure. If the cancer started somewhere else in the body and spread to the lungs, it is called metastatic cancer to the lung.1

Lung cancer is the leading cause of cancer death in both men and women. More people die from lung cancer than from any other type of cancer. Lung cancer is the second most common cancer in the United States, after skin cancer.1

Risk factors associated with the development of lung cancer include: current or previous smoking of cigarettes, pipes or cigars, exposure to second-hand smoke, exposure to asbestos, exposure to radon, arsenic, chromates, chloromethyl ethers, nickel, polycyclic aromatic hydrocarbons, radon progeny, and other agents, exposure to air pollution, radiation therapy to the breast or chest, having previously had lung cancer and certain genetic changes.2

Knowing the risk factor implies that we also know what we could do to try to avoid getting lung cancer. Preventive actions include: stop smoking, avoid second-hand smoke, reduce exposure to workplace risk factors, such as asbestos, avoid high radon level zones and eat a well-balanced diet and do regular physical activity.1, 3

Several signs and symptoms are known to be associated with lung cancer, both NSCLC and SCLC, such as: chest discomfort or pain, persistent cough or cough that progressively worsens, breathlessness, blood in sputum (haemoptysis), hoarseness or wheezing, difficulty swallowing, unexplained weight loss, loss of appetite, fatigue and swelling in the face and/or veins in the neck.4

Surgery is normally the first option when treating lung cancers. However, brachytherapy has been used for treatment of lung cancer since the early 1920s.5

Brachytherapy can be used for both early and more advanced stages of lung cancer, or to shrink a tumor when it is blocking an airway and help improve breathing.  Brachytherapy can also help stop bleeding caused by the cancer and open up blocked lobes of the lung.  Brachytherapy can be used together with other treatment methods.6

Brachytherapy for lung cancer involves radiation being delivered from the inside of the body. A tube called a bronchoscope is placed into the windpipe via the nose or mouth. A thin tube known as a catheter is then passed through the bronchoscope and into the lung. The radiation is then delivered to the lung via the catheter. The radiation is left in place for a few minutes and then removed.

This method of treatment means that the radiation is delivered directly to the tumor and surrounding healthy tissues are minimally exposed to radiation. This minimizes the risk of side effects.  You may have a sore throat for a couple of days after treatment, or a cough, and you may produce more phlegm, but this should only be temporary.6

Learn more about the principles of brachytherapy.

References

1. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0032583; accesssed 13 July 2015

2. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-risk-factors; accessed 13 July 2015

3. http://www.who.int/mediacentre/factsheets/fs291/en; accessed 13 July 2015

4. Collins LG, Haines C, Perkel R, et al. Am Fam Physician. 2007; 75(1): 56-63

5. Yankauer, S. NY Med J 1922; 21: 741.

6. Cancer Research UK. Available at: http://www.cancerhelp.org.uk/type/lung-cancer/treatment/radiotherapy/internal-radiotherapy-for-lung-cancer; accessed 13 July 2015.