Radiotherapy may be an effective treatment option for patients with mesothelioma. It is often used in combination with other treatment methods such as chemotherapy or surgery.
Mesothelioma Radiation Treatment
Mesothelioma is a rare, highly-aggressive and malignant cancer that results in about 3,000 new diagnoses each year. It is the result of asbestos exposure which causes needle-like fibers of the mineral to lodge in body cavity and organ linings. After a long period of time, commonly 20 to 50 years, these fibers cause inflammatory changes and DNA mutations which result in uncontrolled cell division and the development of mesothelioma tumors.
Radiation Therapy at Different Mesothelioma Stages
Radiation therapy is one of three traditional treatment options for the treatment of mesothelioma. It may be considered as an option for all stages of mesothelioma cancer.
In earlier stages, it may be used as a curative treatment along with surgery and / or chemotherapy. In later stages it may be used as a palliative method to reduce symptoms by shrinking tumor size or preventing additional tumor growth.
Radiation Therapy is often a highly effective option for mesothelioma treatment and may have benefits such as:
- Improved life expectancy – radiotherapy may improve a patient’s prognosis and may result in a longer life expectancy.
- Decreased pain and discomfort – radiation treatments used to shrink tumors and prevent additional growth and may relieve severe symptoms and improve quality of life.
- Targeted therapy – radiotherapy may be an effective way to target mesothelioma tumors without significant threat to healthy tissues.
- Reduced spread of cancer – radiotherapy may help to prevent cancer spread after surgery. It may prevent “seeding” which happens when surgery causes cancer cells to break off and travel to distant areas of the body to begin new tumors.
About Mesothelioma Radiation Treatment
Radiation therapy focuses concentrated beams of energy such as X-rays or Gamma rays on the malignant cells of mesothelioma tumors. These energy beams work to destroy cancer cells which will reduce the size of tumors.
There are different options for radiation therapy treatment which will be considered and chosen based on the mesothelioma type, location and stage. Options may include:
External Beam Radiation
External Beam Radiation is used at all stages of mesothelioma and is “traditional” radiation treatment. It may significantly improve life expectancy, particularly when combined with chemotherapy and / or surgery. It may also result in significant relief of symptoms and pain. In most cases, computer imaging such as through CT scan or 3D imagery will be used to accurately pinpoint radiation targets.
Intensity-Modulated Radiation Therapy
A newer external beam targeting method known as Intensity-Modulated Radiation Therapy (IMRT) is more effective at targeting specific tumor areas while minimizing damage to healthy tissues. IMRT allows for changes or “modulation” of the concentration of the energy waves to be made during the treatment through computer programing. This has increased the potential for radiotherapy use, in cases where the mesothelioma tumors are close to vital organs.
Intraoperative Radiation Therapy
Intraoperative Radiation Therapy (IORT) involves the application of radiation, directly to tumors during a surgical procedure. IORT is used in early stages of mesothelioma and allows doctors to treat the tumor directly without risk to covering tissues which are healthy.
IORT applies radiation directly to tumors during surgery. This allows doctors to avoid passing radiation through healthy tissue. IORT is used in early stage patients who are eligible for surgery. The use of IORT during surgery has contributed to increased survival times in many patients.
Surgery for Mesothelioma After Radiation Therapy
Surgery for Mesothelioma After Radiation Therapy (SMART) is a combination or “multi-modal” treatment method which combines IMRT and extrapleural pneumonectomy (EPP), a radical surgery to remove the pleura and complete lung of a pleural mesothelioma patient. It is a highly aggressive treatment procedure but has been effective in increasing the life-expectancy of patients who are eligible for the procedure.
IMRT is performed over a period of five days prior to surgery, rather than after surgery as has been traditionally done. It allows for a higher concentration of radiation to be used as treated tissue will be removed during surgery. As tumor cells are killed with the IMRT treatment, they will not be viable as new tumor “seeds” from surgical disruption. Though the procedure is radical and unconventional, it may increase the survival rate by up to seven fold.
Getting Radiation
Other than SMART, which involves surgery, radiation treatment for mesothelioma is non-invasive. The radio-oncologist will prepare for the treatments by “mapping” the patient’s body with imaging, similar to a CT scan procedure. This “teaches” the computerized system where the radiation beams are to be focused.
The patient’s skin will often be marked or tattooed so that “landmarks” will be available to ensure that positioning for therapy sessions is accurate. In some cases, protective molding may be formed to protect surrounding tissues. If needed, the molding will be used at each session.
Treatment sessions are usually short, often only 5 to 10 minutes but appointments may take longer. Treatment sessions are often scheduled daily for five days of the week, and may be repeated for three or more weeks, though some treatment regimens vary.
Most patients do not experience any pain during the treatment but side effects after treatment can include:
- Nausea
- Fatigue
- Localized redness or irritation
Each week, additional imaging such as CT scan may be performed to check progress of the treatments.
Mesothelioma Radiation Specialists
Radiation treatments can dramatically improve a patient’s prognosis and life expectancy, particularly when used at early stages and in combination with other treatment methods including surgery and / or chemotherapy. The actual increase in life-expectancy will depend on the patient’s unique characteristics but some patients have lived for years beyond the initial expectations.
As mesothelioma is such a rare cancer, it is essential that a patient with a mesothelioma diagnosis seek assistance from a physician who is an expert in mesothelioma treatment.
Mesothelioma specialist are skilled at treating the disease and will be able to confirm disease type, stage and prognosis, while determining what mesothelioma radiation therapy procedures may be appropriate for each patient.
Developing technologies
Mesothelioma treatment is fairly new and still developing. New treatment options may be available as part of investigational studies or clinical trials.
Some examples may include Radiotherapy “sensitizers” or medication given to increase tumor cell susceptibility to radiation and Radiotherapy “protectors” which may decrease the risk of damage to healthy tissue.
A mesothelioma specialist is often the best source of new information and availability of progressive treatment options.
