Small cell lung cancer: Can brain radiation prevent spread?

My husband has small cell lung cancer and has just finished his fourth round of chemotherapy. His doctors have suggested preventive radiation therapy to his brain. Is this something that is commonly done? What is the benefit?

- Karin / Texas

Answer

Unfortunately, individuals who have a complete remission of small cell lung cancer have a high risk of the cancer eventually spreading (metastasizing) to the brain. Giving radiation to the brain before this happens — referred to as prophylactic cranial irradiation — significantly reduces this risk.

However, radiation to the brain is not without its risks. Common short-term side effects include fatigue, hair loss, nausea and vomiting, and memory loss. Long-term side effects may include memory loss, confusion and difficulty concentrating.

Your husband and his oncologist must weigh the potential risks and benefits of such treatment in your husband's specific situation. For some people, radiation is worthwhile to prevent disease from spreading to the brain. Others may want to avoid the side effects of preventive brain radiation and take a wait-and-see approach to the need for such treatment.

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