Lung cancer

These may include a persistent cough, frequent hoarseness, increasing shortness of breath, repeated pneumonia and bronchitis, coughing up blood, constant pain in the chest, swelling of the face or neck, extreme fatigue, or loss of appetite and weight.

These symptoms may occur individually or in combination and are not sufficient to confirm cancer. Similarly, other, rarer symptoms may be present, so it is not possible to make a diagnosis based on these symptoms alone. Sometimes, cancer is discovered without any symptoms, during a chest X-ray or CT scan.

Depending on the type of cancer and its stage of development, your radiation oncologist will prescribe the treatment best suited to your clinical situation: radiation therapy, with or without chemotherapy.

External radiotherapy

This treatment uses X-rays directed through the skin to the area to be treated. These rays are produced by a linear accelerator and gradually destroy the cancer cells.

Your treatment will begin with a scanning session (called virtual simulation) to identify the areas to be treated (target volumes) and the healthy organs around them that must be preserved as much as possible.

Your treatment plan will be tailored to your individual needs (taking into account your specific characteristics and those of your disease) and scheduled over several weeks. Sessions take place from Monday to Friday and last approximately 15 minutes.

The radiation is invisible and painless and does not make you radioactive.

Case of stereotactic radiotherapy (Cyberknife)

Stereotactic body radiation therapy (SBRT) delivers high doses to very small areas with millimeter precision. This type of treatment is offered to certain patients based on specific criteria; it requires the implantation of gold seeds, called fiducials, which help to better locate the tumor during treatment.

The fiducials are placed transbronchially or transthoracically, depending on the accessibility of the tumor. Fiducials are permanent implants that have no effect during or after treatment. 

Chemotherapy in combination with radiotherapy

Chemotherapy is a treatment based on drugs. Chemotherapy drugs act on the mechanisms of cell division.

It is a general treatment (called systemic treatment) that acts throughout the body. This allows cancer cells to be reached regardless of their location in the body, even if they are isolated and cannot be detected by diagnostic tests.

Chemotherapy drugs are administered by infusion. At Centre François Baclesse, chemotherapy is administered concurrently with radiotherapy to sensitize the cells and enhance the action of the radiation on the areas being treated.

Side effects are predictable but not systematic; each situation is unique and each patient reacts differently. We invite patients to report any adverse effects to their referring physician at the CFB during weekly follow-up consultations. Nowadays, the most common acute side effects are very well managed with symptomatic treatments. These will be prescribed by your radiation oncologist if necessary.

During radiotherapy

• Fatigue: Fatigue is a common side effect but is not exclusively due to treatment.
• Difficulty swallowing: Patients may have difficulty eating and feel discomfort or an obstruction when swallowing food (dysphagia) due to irritation of the esophagus.
• Skin redness: Skin redness similar to sunburn, called skin erythema, associated with a burning sensation may occur if the tumor is close to the skin.
• Pneumopathy: Radiation pneumonitis (related to radiation therapy) manifests as difficulty breathing (dyspnea), coughing, and fever that does not respond to antibiotic treatment.

During chemotherapy

Side effects will depend on the choice of drugs and the doses required to treat the tumor.

• Hair loss: Hair loss may occur with chemotherapy treatment.
• Nausea and vomiting: These side effects are increasingly well managed with other associated treatments.
• Brittle nails: Nails may become brittle, break easily, or become soft.
• Mouth sores: Sores, which may be painful, may appear inside the mouth (mouth ulcers, redness, etc.). This is known as mucositis when there is inflammation of the mucous membrane. This type of sore requires regular use of mouthwash.
• Kidney problems: Some drugs can affect kidney function, requiring medical monitoring during treatment.
• Sensory disturbances (paresthesia): These disturbances may occur with certain chemotherapy drugs. Symptoms include numbness, tingling, or pins and needles in the fingers and toes. These same treatments may cause tinnitus or hearing loss.
• Decreased white blood cell, red blood cell, and platelet counts: Chemotherapy drugs often decrease the number of cells produced by the bone marrow. A decrease in the number of white blood cells can lead to an increased risk of infection because they are involved in the body's defense system. A significant decrease in the number of red blood cells, which are responsible for transporting oxygen in the body, may require a transfusion. This manifests as paleness, shortness of breath, dizziness, and fatigue. Platelets are responsible for blood clotting, and a significant decrease in their number can lead to a risk of bleeding or bruising. This decrease may require a platelet transfusion.

The effects observed during treatment generally fade a few months after the end of treatment. Some signs may appear after several months or years; these are known as "late effects." In rare cases, they may be related to the treatments received. We encourage you to report any side effects, even late ones, to your radiation oncologist.

The following side effects may occur:

• Pain in the area treated with radiation
• Difficulty swallowing
• Pneumonia occurring three to six months after treatment
• Pulmonary fibrosis: The lung tissue eventually hardens, similar to a scar. This effect is now rare thanks to individualized dose adjustments and monitoring during treatment.
• Respiratory failure
• Heart conditions (ischemia and heart failure, ischemia being a decrease in the supply of oxygenated blood to the heart).