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Small Cell - Radiation:

Radiation treatments are usually given to "consolidate" or make sure that areas of known disease have the best possible chance of going into remission. Most commonly this will take place after several cycles of chemotherapy and re-evaluation with x-rays. Usually your radiation treatment will last about five to six weeks. The same types of daily treatments are used.

You will also have many of the same side effects. They include increased secretions, which usually begin in the second week. These secretions can cause a feeling of nausea because they are often very thick and hard to spit out. It helps to sleep on a slight incline to help avoid having them pool in the back of the throat. This can cause severe nausea problems secondary to gagging. Also the sipping of carbonated water during the day will help, as will the use of a humidifier in the bedroom, especially for those people in climates where there is a need for furnaces to be used.

You may also have a lowering of both the red and white blood cells with the same problems as noted with chemotherapy. Your skin may get red. You may notice that it is hard or sore to swallow food. This is due usually to both an increase in thick secretions and irritation of the lining of the esophagus or food pipe. You can also feel very tired at the end of treatment.

Later, after treatment has been completed, you may have shortness of breath due to lung scarring. You may have episodes in which it is painful to take deep breaths, as well as fever and sweats. This is known as pneumonitis and is something that will go away on its own, although medicines can be given for symptoms.

Another type of radiation that is offered is prophylactic whole brain irradiation (PWBI), usually as part of the initial treatment for small cell cancers, and it may be part of the treatment offered to you. It is known that small cell cancers often can spread cells to the brain, and that these small deposits often do not show up on brain scans done at the time of diagnosis. It is hard for chemotherapy to get into the brain because of a defense barrier known as the blood brain barrier. Because it was noted with some regularity that this occurs, some clinical studies have used whole brain radiation in an effort to reduce this from happening. If you do receive whole brain radiation, you will likely get between two and three weeks of daily treatment to the whole head.

Side effects include hair loss and the thickening of secretions that can build up in the tubes that go between the ears and back of nose (the same one that you have to clear when you get on a plane or go under water). You may possibly have some skin irritation behind the ears. Anywhere from two to eight months later you may have some flu-like symptoms that are due to the radiation you received to your brain. It is called the "somulance syndrome" and is frequent in people who receive higher doses of radiation, but can also happen following whole brain radiation.