Radiation Oncology for Lung Cancer

Thanks to the expertise of our radiation oncologists and our unsurpassed technology, radiation treatments at the Halvorson Cancer Center destroy your cancer cells while protecting your healthy tissue and surrounding organs.

And if your lung cancer is on the left side, we are among the leaders in a specialized approach to radiation that helps avoid potential heart problems.

How will radiation therapy be used?

For lung cancer, radiation therapy can serve several purposes:

  • it can be the primary treatment (used alone or in combination with surgery and chemotherapy)
  • it can be used to shrink your tumor prior to surgery
  • it can be used after surgery to eradicate any remaining cancer cells

Advanced radiation technology

Our radiation oncology center's linear accelerators are equipped with state-of-the-art technology for treating lung cancer, including Image Guided Radiation Therapy (IGRT) and Intensity Modulated Radiation Therapy (IMRT).

While most linear accelerators have the ability to wrap the radiation beams around your tumor, IGRT and IMRT technology brings even more precision to your radiation treatment.

How image guided radiation therapy works

Therapy planning begins with your radiation oncologist creating the target for your tumor. The target is then reviewed and approved by a second radiation oncologist. Once the target is set, the computer planners, radiologists and physicists use the software to create the custom dose cloud for your tumor.

The custom dose cloud means your tumor gets the full force of the radiation, while your esophagus, heart, major airway and spinal cord are protected as much as possible.

Before your very first radiation treatment, a custom mold will be made that will allow you to lie down on the treatment table in the same position each time for each treatment.

Our Varian TrueBeam linear accelerator is equipped with onboard imaging that takes a high resolution CT scan, known as a cone-beam CT, prior to each treatment. Highly-skilled radiation therapists then overlay that cone-beam CT with the original treatment-planning CT, to see if there are any changes in the position or the size of the tumor.

If adjustments need to be made, you don't need to move or shift your body in any way. Breakthrough computer software auto-corrects the treatment table to ensure you are in the correct position. You'll feel the table shift ever so slightly until everything is lined up exactly right.

Once the linear accelerator begins its arc around you, the IMRT computer software allows for a continuous flow of radiation beamlets from all angles that create a three-dimensional dose cloud of radiation which is highly contoured to your tumor and lymph nodes. That customized cloud spares surrounding tissue from the radiation's harmful effects, while blasting the cancer with a dose high enough to kill it.

The result is:

  • a high dose of radiation
  • exactly on target
  • every single time

Patient Story: EvergreenHealth radiation oncologist talks about his treatment for lung cancer

Preventing damage to your heart with respiratory gating

Another treatment advantage is a specialized technique called respiratory gating - the ability of EvergreenHealth's state-of-the-art linear accelerators to track the position of your tumor as you breathe.

Respiratory gating is critical if the tumor is in your left lung, because of its proximity to your heart. The technique can spare your heart from radiation during treatment, which gives you a better chance of avoiding any cardiac complications down the road that could interfere with a long, active and healthy life.

It’s a treatment technique that our radiation oncologists helped pioneer in Washington State.

How respiratory gating works

Respiratory gating uses the linear accelerator's onboard four-dimensional CT scanner to measure your range of motion during breathing. It then customizes the treatment field to you.

Two state-of-the-art technologies – the GE 16 slice wide-bore CT scanner (used for treatment planning) and the linear accelerator's onboard image guidance system – are used before every radiation treatment to accurately measure your range of motion and the daily position of the tumor as you breathe.

During treatment, you’ll be asked to hold your breath, which moves your heart back into your chest cavity and out of the way of the radiation beams. The beams are fired while you hold your breath, then cycled off as you breathe.

Patients, such as Paula Chiles, have told us this helps them feel like an active participant in their treatments, with a little more control over their cancer.

How long will my radiation treatments take?

Each radiation treatment itself lasts only a minute or two, depending on the size and location of your tumor. But the preparation work to make sure the radiation beams are exactly on target with the correct dosage of radiation can take up to 15 or 20 minutes.

You can expect to receive a radiation treatment every day, Monday through Friday, for about five to six weeks, depending on the location and size of your tumor. The two days you don't receive treatment help your healthy cells recover, while the cancer cells continue to die.

What are the side effects of radiation treatments?

Side effects from radiation treatment vary from patient to patient, and can begin during treatment, or become noticeable after radiation treatment is finished.

You may notice:

  • mild to moderate fatigue, especially during the later weeks of treatment
  • skin irritation, such as redness, peeling or blistering; it may be similar to what you experience during a sunburn
  • changes in skin sensation

Your radiation oncologist can help with strategies to alleviate your symptoms and make you more comfortable during the course of your treatment.


Radiation treatments can also cause temporary esophagitis, an inflammation of the esophagus, because of how close the treatment is to the lungs.

It feels like an internal sunburn. You might also feel a sharp, burning pain, or a feeling like food is getting stuck in your chest when you swallow.

Esophagitis typically develops two to three weeks after your radiation therapy starts, and resolves fairly quickly after your radiation treatments end.

Our top-of-the-line linear accelerators help minimize the chances that you'll get esophagitis, because our Image Guided Radiation Therapy (IGRT) and Intensity Modulated Radiation Therapy (IMRT) help deliver precise doses of radiation to your tumor while sparing nearby healthy tissue.


Another side effect you may experience is lymphedema, which is swelling caused by a build-up of fluid in your body's tissues. It commonly affects the arm, but it can also affect the breast, chest, shoulder or the area behind your armpit.

Should lymphedema be a side effects of your treatment, your navigator can refer you to the lymphedema program at EvergreenHealth Rehabilitation Services. Our certified lymphedema therapists are trained in massage techniques, bandaging and exercises and have specialized equipment to reduce your discomfort.  Learn more about lymphedema therapy.

Treatment in a tranquil setting

Radiation treatment is advanced science, but we also make sure your emotional needs are met during treatment.

The Radiation Oncology Center is a serene space, with lovely art, a babbling fountain and a relaxing waiting room with a wall of windows that open to a Japanese garden. Your family and guests can wait here comfortably during your treatment.

There are free beverages available, including coffee, tea, cocoa and a variety of juices.

You'll also find information for resources and support groups, along with books and magazines, and a jigsaw puzzle to work on while you and your family wait for your appointment.

What you won't find is a television. The decision not to include one is intentional, to encourage conversations with family members or others waiting for their appointments near the same time. Some patients tell us, since they often see the same people during the course of their treatment, they've found support, encouragement, and even friendship as they bond over their cancer journeys.

You'll have a private dressing room where your clothes can stay during treatment.

You are welcome to bring a special blanket or cozy quilt from home for warmth and comfort on the treatment table.

Above the treatment table, you'll find a ceiling of twinkling stars.

Learn more about your treatment options for lung cancer:

Medical Oncology
Gene Therapy
Clinical Trials