Side Effects of Treatment

Lung cancer patients not only must contend with symptoms from the disease itself such as breathlessness, chest pain, reoccurring infections like bronchitis or pneumonia, exhaustion and loss of appetite, but also with the side effects of treatment for lung cancer [35]. The length of treatment, dosage and your overall health will influence your reaction to chemotherapy, radiation or other targeted treatments. Side effects can vary in length, some are short term but some last throughout the treatment and even for a time afterwards. Side effects can be exhausting and painful, but there now exist ways to reduce and even prevent them from occurring [36].

Side effects of lung cancer chemotherapy

Chemotherapy will affect people in different ways; some people may be able to continue on in their day-to-day routines while others may suffer from side effects that cause them to slow down [37]. Chemotherapy kills cells that are dividing, which usually targets cancer cells as they divide more quickly than normal cells. This means however that quickly dividing normal cells also get killed; this includes those in your skin, hair, nails, the lining of your digestive system and your blood cells. This is why you are given breaks between chemotherapy, so normal body tissues can recover from the treatment [38].

Frequent infections

During chemotherapy you are more prone to being tired, having nosebleeds and other bleeding problems and getting infections because chemotherapy lowers the number of healthy white blood cells, red blood cells and platelets you have. Avoiding infection is not always practical, but avoiding crowded place or people you know are sick or infected will help minimise your risk. If you develop a temperature above 38°C or think you have an infection, get in contact with the hospital immediately. You may need to be treated with antibiotics [39].

Exhaustion and nausea

Some patients can become very tired because of chemotherapy, it’s natural and encouraged to take day-to-day activities more slowly and have frequent rests when you need them. It’s also a good idea to do small amounts of physical activity and continue eating regularly to alleviate some of the tiredness and give your body the needed energy. Chemo-induced exhaustion can last some months after your treatment has ended [40]. This will depend on your general health, the length and dosage of the treatment and any other treatments you have had. Asking for family members or friends to help with household chores or shopping can help you rest and make your loved ones feel needed [41].

Sickness and nausea is a common side effect of chemotherapy. Chemotherapy drugs will have varying effects on the person; some may only make you feel mildly sick while others can cause you to vomit and feel very nauseated. Chemo-induced nausea and vomiting can usually be controlled with anti-sickness drugs [42].

Eating can be very hard when you are feeling nauseated, to reduce sickness from any drug you can [43]:

  • Avoid eating or preparing food when you feel sick
  • Avoid fried foods, fatty foods or foods with a strong smell
  • Eat cold or slightly warm food if the smell of cooked or cooking food makes you feel sick
  • Eat several small meals and snacks each day and chew your food well
  • Drink plenty of liquid to stop you from becoming dehydrated
  • Avoid filling your stomach with a large amount of liquid before eating.
  • Relaxation techniques help control sickness for some people
  • Ginger can help – try it as crystallised stem ginger, ginger tea or ginger ale
  • Fizzy drinks help some people with nausea

With chemotherapy sickness

  • If you think it will be easier than eating, your doctor can recommend high calorie drinks
  • Have a small meal a few hours before chemotherapy but not just before
  • Avoiding your favourite foods when having chemotherapy may help, so you don’t associate them with treatment and then go off them. This can be very important for children

Other side effects

  • Sore mouth and mouth ulcers – Some chemo drugs cause mouth ulcers or soreness in the month. It is important to keeping your mouth clean, using a soft toothbrush can help avoid damaging the lining of your mouth.
  • Mouthwashes may be used to help prevent infection.
  • Diarrhea – Some chemo drugs can cause diarrhea, ranging from more mild cases to those that are more severe. If the diarrhea persists for more than 2 or 3 days, tell your doctor or nurse. Becoming dehydrated is a risk you may need anti-diarrhea tablets or medicines.
  • Hair loss or thinning – Some chemo drugs cause hair loss, some cause hair thinning and some don’t cause any hair loss at all. Many patients wear heats, scarves or wigs or some cut or shave off their hair before it starts to fall out.
  • Eye changes – Certain chemotherapy drugs can affect your eyes or eyesight. The effects are usually temporary and go away when treatment ends, but some effects may be longer term. Eye changes can include blurred or dulled vision, dry, sore eyes or watery eyes.
  • Hearing changes – Sometimes chemotherapy for lung cancer can cause ringing in the ears. This is called tinnitus. You may also find you have difficulty hearing high pitched noises. Some patients may feel dizzy and lose their sense of balance.

[44] Information taken from Cancer Research UK

It’s important to keep in touch with your cancer care team and notify them of any new symptoms or side effects you are experiencing. This way you can stay on top of managing disease and treatment side effects. Researching things on your own can also lead you to side effect management strategies that might not be otherwise suggested by medical professionals.

Side effects of lung cancer radiotherapy

Side effects from radiotherapy will come on slowly and depend on the type of radiotherapy you have. A few consecutive weeks of treatment will bring on more side effects than a treatment given in one or two doses. Side effects subside once the treatment is over but a small number of patients experience long term side effects, which develop up to two years after treatment has finished [45].

Some side effects of radiotherapy are caused by its effect on normal issue in your body. These may include [46]:

  • Tiredness and feeling run down
  • A sore throat and trouble swallowing
  • A cough
  • Hair loss
  • Chest pain
  • A temperature and shivering
  • Feeling sick
  • Sore skin in the treatment area


Like with chemotherapy, radiotherapy can take a toll on your body and cause tiredness. As treatment continues, you may find yourself becoming more and more tired, this is normal. The tiredness can last for a few weeks after the end of treatment. Taking it easy and resting when you feel like it is the key to recovery [47].

A sore throat and trouble swallowing

A sore throat can pop up about two to three weeks into your treatment, although it may happen sooner if you are having chemotherapy and radiotherapy together. The onset of this soreness can be quite sudden and it’s important to your doctor or radiographers if you are having difficulty swallowing, as they can advise you on ways to reduce this [48].

A soft diet may be easier on your throat until your treatment is over, foods like soups and stews are easier to digest. Drinks that are very cold or hot can also be hard on your throat so it’s a good idea to let them get closer to room temperature before consuming them. Your doctor may give you anaesthetic mouthwashes and antacids to help reduce the soreness. You may need to take strong painkillers if the pain is bad enough. The soreness will improve a couple of weeks after the treatment has finished [49].

Sore skin in the treatment area

Radiotherapy can affect the skin in the area being treated by making it sore. It is much more likely to happen if you are getting treatment for a Pancoast tumour, but much rarer for other types of lung cancers. The most common skin reaction is similar to a mild sunburn with redness and irritation; having chemotherapy soon or after may worsen the skin reaction. Wash the treatment area with plain water; only use perfumed soap or washing products if you have discussed it with your cancer specialist, radiotherapy nurse, or radiographer [50].

A temperature and shivering

If you have treatment in one or two doses, you might experience a raised temperature and feel shivery. Acetaminophen, commonly used to treat fevers, can help bring down your temperature and stop the shivering. However, before you take any medication, be sure to consult with you doctor first. These symptoms can sometimes be caused by a chest infection and you may need antibiotics to clear it up, so it’s important to notify your doctor if the symptoms arise [51].

To find out more information about other short-term side effects of radiotherapy, check out Cancer Research UK.

Potential long term effects

On occasion, long term side effects can occur months after you have finished your treatment. This is quite rare, even if you are undergoing intensive radiotherapy over four to six weeks to destroy the cancer. The reactions to radiotherapy can vary, some people just seem to be more sensitive than others. There is no way to tell beforehand who is at risk for developing long term side effects [52]. You and your doctor should always discuss possible short and long term side effects or complications before you consent to any treatment. The priority of radiotherapy is to treat your cancer, but you have the right to be well informed before making any decisions.

Radiotherapy can cause fibrous tissue to develop, which is less stretchy than normal tissues. This can result in long term side effects like breathlessness, narrowing of your food pipe, and various effects on the heart and spinal cord [53]. Treatments and surgeries are available to treat these symptoms.

Read more about long term side effects at Cancer Research UK

Alternative and complementary treatments for lung cancer

According to the American Lung Association, what differentiates complementary therapy from alternative therapy is that the former is used with standard lung cancer treatment, whereas the latter is used instead of conventional treatment. The combined used of conventional treatment and complementary therapy is called integrative medicine. Most people with lung cancer use integrative medicine to control pain, reduce anxiety, lessen side effects and improve quality of life [54].

The American College of Chest Physicians recommends people with lung cancer consider the following as complementary therapies:


Acupuncture is traditional Chinese medicine where a practitioner inserts small needles into precise points on your body [55]. Research suggests that acupuncture may be helpful in relieving some symptoms of cancer or side effects of treatment. Cancer research on acupuncture focuses on investigating its effect on chemotherapy related sickness, tiredness and cancer pain [56]. There is no current evidence to suggest that acupuncture can help cure cancer. Consult with your doctor about using acupuncture as part of your treatment plan and finding a certified practitioner. Acupuncture should not be used if you have a low blood count or take blood thinners [57].


Massage therapy is a form of structured or therapeutic touch used to relax the mind and body, relieve tension, improve the flow of fluid in the lymphatic system and restore a sense of well-being. There are different types of massage therapy; some are gentler while other methods apply more pressure [58]. For safety reasons, medical professionals typically advise patients to avoid more vigorous, deep tissue massages [59].

Some patients are concerned that massage could cause cancer cells to spread to other parts of the body; fortunately, there is no current research that supports this. Massage therapists will also avoid any areas affected by cancer, such as tumour sites or lymph nodes, but talk your doctor or nurse if you have any concerns [60].

According to Macmillan, during your therapy it’s important to avoid massage:

  • directly over a tumour or lymph nodes (glands) affected by cancer (lymph nodes are part of the immune system and help to filter germs and disease)
  • to areas that are bruised or sensitive
  • to areas being treated with radiotherapy during and for a few weeks after it finishes
  • around intravenous catheters (such as central lines) and pain relief patches
  • to areas affected by blood clots, poor circulation or varicose veins.

It’s also important to be particularly gentle if:

  • cancer has spread to your bones
  • you have a low platelet count (platelets are cells that help the blood to clot).


Originating over five thousand years ago in India, yoga is a mental, spiritual and physical practice which incorporates breath work (pranayama), stretching exercises, postures (asanas) and meditation [61]. Upon its introduction the West, yoga was popularised as a form of physical exercise, but in Indian traditions more emphasis is put on its meditative and spiritual cores [62]. There are several different styles of yoga, some put more emphasis on the physical, while others are gentler and focus more on meditation and breath work [63].

Yoga is often recommended as a form of complementary therapy because patients say it helps them relax and feel good. Many emphasize it as a way to relax and cope with stress, anxiety and depression and enhance well-being [64]. Others say that it helps reduce symptoms and side effects of cancer and treatments such as pain, tiredness, sleep problems and depression. There is however no scientific evidence that proves that yoga can cure or prevent any type of cancer [65].

Considering alternative treatments

Aside from the ones mentioned above, a wide assortment of alternative treatments and therapies are available to cancer patients, such as meditation or hypnosis. When considering complementary and alternative medicine (CAM), some techniques can do more harm than good, so it’s important to be informed and do your research. Look for red flags when researching and be sceptical of places that promise to cure cancer, tell you avoid to regular medical treatment or is a ‘secret’ that requires you to visit certain providers to another country.