Chemotherapy vs. Radiation for Lung Cancer

Radiation therapy and chemotherapy are two forms of lung cancer treatment. They may be used individually, together, or with other treatments such as surgery. How lung cancer is treated depends on the type of lung cancer, how localized or advanced it is, and the person's overall health.

While both radiation therapy and chemotherapy are used to kill cancer cells, they have important differences. Radiation is a localized treatment that targets a tumor itself. Chemotherapy is a systemic treatment that aims to kill cancer cells throughout the body.

This article will review the options of chemotherapy and radiation for lung cancer treatment and how they are different from each other. Your cancer care team will advise you which is appropriate for your cancer care plan.

What to Know About Chemotherapy

Chemotherapy for lung cancer involves administering chemotherapy medications. There are many types of chemotherapy drugs. Which are prescribed depends on factors such as the type of lung cancer and whether it has spread (metastasized).

How Does It Work? 

All cells in the body go through a specific process of cell division. Cancer cells are abnormal and can divide more quickly than they are supposed to. Chemotherapy is medication that works by stopping cells as they are dividing. As cell division is interrupted, the cancer cells can’t continue to grow.

Chemotherapy is absorbed into the entire system. It can affect cancer cells throughout the body, not just one localized area.

Chemotherapy Delivery

Many chemotherapy medications are given in combination with another chemotherapy medication. This combination can sometimes be more effective in treating cancer.

The most common way chemotherapy medications are given for lung cancer is intravenously (IV), through a vein. This infusion is usually given in an outpatient cancer center or infusion center.

The exact schedule of chemotherapy can vary, depending upon the chemotherapy medications used and if any other treatment, such as radiation, is given at the same time. It is generally given in cycles, which can repeat themselves at different intervals, such as once a week, or every three weeks.

Side Effects 

Side effects of chemotherapy vary based upon what medications are given. As a reminder, chemotherapy affects cells as they are growing and dividing. Unfortunately, chemotherapy can’t tell the difference between healthy cells and cancer cells. The healthy cells being damaged by chemotherapy is what can cause side effects.

Some of the most common side effects from chemotherapy include:

• Nausea, vomiting
• Feeling tired
• Hair loss
• Low red blood cells, white blood cells, or platelets
• Changes to appetite
• Mouth sores
• Diarrhea
• Dry skin
• Brittle nails
• Constipation
• Fertility issues

Prices and Where to Get It 

Chemotherapy is given by prescription only. Your healthcare provider will recommend the form and schedule of treatment. IV chemotherapy is typically given at specialized infusion centers. Expenses can include travel costs and costs of disrupting your schedule (such as child care or time away from work).

Because there are so many possibilities on what chemotherapy medications can be given, and how often, a set price is difficult to determine. The out-of-pocket cost of chemotherapy can be different for everyone, beginning with whether or not they have health insurance.

For those who have health insurance, the cost of copays (an amount you pay for each service), coinsurance (a percentage you pay for service), deductibles (an amount you pay before insurance covers the cost), and maximum out-of-pocket costs can be different for each person.

What to Know About Radiation

Radiation therapy is applied to the body by specialized equipment during treatment sessions.

How Does It Work?

Radiation therapy works by using high-energy beams to target cancer cells in the body. These high-energy beams break up the DNA strands in the cancer cells. This prevents them from being able to continue to divide and make new cells.

Radiation only affects the cells in the direct area where the beams are targeted, but healthy tissue near the cancer may receive some radiation as well.

Radiation Delivery

The most common delivery of radiation therapy for lung cancer is called external beam radiation. During this procedure, a patient is positioned on a table with the radiation machine.

Treatment consists of the radiation beam being directed at the cancer cells usually once a day, though sometimes it is given twice a day. Most radiation treatments only last a few minutes but need to be given multiple days in a row for several weeks.

Another type called stereotactic body radiation therapy (SBRT) may be used for small lung tumors. It sends beams of radiation from many different angles. SBRT can treat cancer with a higher dose of radiation in a shorter time while decreasing the amount of radiation the healthy tissue receives.

Side Effects

The side effects from radiation therapy may be a bit different for each person, depending upon the area of the body being treated by radiation. However, some common side effects of radiation can include:

• Feeling tired
• Irritation to the skin, including redness, swelling, or blistering
• Hair loss
• Low blood counts

Prices and Where to Get It 

Radiation therapy is given at cancer centers that have radiation machines. The cost can vary, with an average cost of $8,600 per Medicare patient treated in one study from 2015. The exact amount someone may pay for their radiation treatment can vary, especially if they have different out-of-pocket costs through their insurance plan.

Which Treatment Is Best for You? 

How lung cancer is treated depends upon the stage, or how advanced the cancer is. The stages of lung cancer go from stage 0 (caught very early) to stage 4 (cancer has spread outside of the lung to other areas of the body).

Possible options for the treatment of lung cancer include surgery, chemotherapy, targeted therapy (drugs that act on cancer cells with specific characteristics), and radiation therapy.

The best treatment for you is decided upon discussion with your cancer care team. This can include a medical oncologist, who would administer chemotherapy, as well as a radiation oncologist, who administers radiation.

Surgery is often part of a lung cancer treatment plan. At times surgery won't be recommended due to the location of the tumor, the spread of cancer, or the ability of the person to tolerate surgery. Before or after surgery, treatments such as chemotherapy and radiation therapy may be given as well.

At times, radiation or chemotherapy may be the main treatment given. Some early stage lung cancers may be able to be cured with stereotactic radiation alone. Metastatic stage 4 lung cancer may not be treated with radiation, but instead, chemotherapy may be given. 

Can Chemotherapy and Radiation Be Used Together? 

Chemotherapy and radiation can be used together and often are when used to treat lung cancer. Generally, stage 3 lung cancer is treated with radiation and chemotherapy together. Stage 3 lung cancers can’t usually be removed completely by surgery, and a combination treatment plan is suggested.

In fact, some chemotherapy medications make cancer cells more sensitive to radiation, allowing the radiation to work better at killing the cancer cells when they are given together.

Coping With the Side Effects

Talk to your care team about ways to manage side effects from chemotherapy and radiation therapy.

Chemotherapy

Just because a chemotherapy medication has the potential of causing side effects doesn’t mean every side effect will be experienced. However, it is important to talk with your cancer care team about any side effects that you may have. They can be an excellent resource to help you with ways to improve or decrease side effects.

For example, if you’re experiencing nausea from chemotherapy, your cancer care team can prescribe antinausea medication or may use other medications to prevent nausea from happening.

Radiation

Getting rest and taking care of yourself is important when getting radiation treatments.
If you ever have any questions about ways to keep your skin moisturized and prevent injury from radiation, talk to your radiation team. Specific creams and lotions might be recommended. 

Maintaining a healthy diet can help the body as it is healing from radiation as well.

Summary

Chemotherapy and radiation are two commonly used treatments for lung cancer. They are both given in cancer centers that contain special infusion rooms and radiation treatment rooms. Depending upon the stage of cancer, they can be used either alone or in combination with each other and other treatments such as surgery.

A Word From Verywell

Lung cancer is the second most common cancer in the United States. It is estimated that over 230,000 people will be newly diagnosed with lung cancer each year.

It is very important to have open communication with your cancer care team about the treatment plan that’s best for you. You may have multiple treatment options available, and making an informed decision is important. Discuss any possible side effects from therapy with your cancer team, and ask any questions you may have.