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Mesothelioma Radiation

Radiation for mesothelioma is commonly used to shrink or stop the growth of tumors, which can improve life expectancy and reduce painful symptoms of pleural mesothelioma. It’s often combined with other treatments to achieve the best patient outcomes. The Mesothelioma Hope team can help you find a doctor to recommend and oversee your radiation treatment plan.

Medically reviewed by: Mark Levin, MD

Last updated:

Radiation Therapy for Mesothelioma

Mesothelioma radiation therapy can stop tumors from growing, which can extend patients’ length and quality of life. Mesothelioma radiation may also be used in cases where surgery is not an option because of the patient’s age, cancer stage, health, or other factors.

Key Facts on Mesothelioma Radiation

  • What it is: A common cancer treatment that aims high-energy rays directly at the site of tumors to shrink them or slow their growth
  • When it’s used: To treat pleural mesothelioma patients in combination with surgery or chemotherapy, or to manage symptoms (such as breathing issues or pain)
  • Common side effects: Fatigue, hair loss, and sunburn-like skin irritation
  • Session info: The standard course of radiation treatment is 5 days a week for 5-6 weeks, with each session lasting 15-30 minutes on average

How Does Radiation Therapy Work?

Radiation therapy (also called radiotherapy) uses high-energy rays — typically gamma rays or X-rays — aimed directly at the site of the mesothelioma tumor. These rays damage the DNA of cancer cells, causing them to die off by removing the instructions that tell them to grow and divide.

Imaging tests help pinpoint the cancer’s exact location, so mesothelioma radiation is focused only on the tumor and any damage to healthy surrounding tissues is limited.

Our Free Doctor Match tool can help you connect with a doctor who specializes in radiation therapy for mesothelioma. Get started today.

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Goals of Mesothelioma Radiation Therapy

Radiation therapy is considered one of the standard mesothelioma treatment options recommended for pleural mesothelioma patients. It is typically used with surgery or chemotherapy to improve treatment success or during palliative care to reduce symptoms and improve quality of life.

Radiation therapy for mesothelioma has four main goals:

  • Shrinking tumors before surgery so mesothelioma cancer is easier to remove
  • Preventing mesothelioma from spreading to new sites during surgery
  • Killing off mesothelioma cells left behind during surgery (adjuvant radiotherapy)
  • Shrinking tumor size to alleviate painful symptoms of cancer spread (metastasis)

Radiation kills all cells it comes in contact with, not just the cancerous ones. This is why imaging tests are so important. They can identify exactly where the tumor is located to prevent damaging any vital organs during treatment.

Newer radiation techniques allow for better control of radiation beams, making mesothelioma radiation treatment safer and more beneficial for patients.

Radiation in Multimodal Treatment

Mesothelioma develops and spreads by covering delicate tissues and organs rather than as a single large mass like some other cancers. For this reason, the American Cancer Society (ACS) notes that radiation is rarely used as a standalone treatment but instead as part of a multimodal treatment plan.

Multimodal therapy refers to using two or more different methods to treat mesothelioma more thoroughly. Mesothelioma radiation therapy may be used alongside chemotherapy or administered before or after surgery.

Radiation can help shrink tumors to make surgery more effective, or to sterilize any remaining disease after mesothelioma surgery. The most common surgeries for pleural mesothelioma are pleurectomy with decortication (P/D) and extrapleural pneumonectomy (EPP).

Benefits of Radiation Treatment for Mesothelioma

Mesothelioma radiation therapy won’t be the right choice for everyone, but your oncology doctor may recommend it as part of your treatment plan. In these situations, the main benefits of radiation are improved treatment outcomes and quality of life.

According to a study published in Thoracic Cancer, the life expectancy for pleural mesothelioma patients who received a type of radiation called IMRT following chemotherapy and a pleurectomy with decortication was 23.6 months.

Additional benefits of radiation therapy may include:

  • Breathing improvements. Pleural mesothelioma radiation can help make it easier for patients to breathe. This improves quality of life for those with mesothelioma in the pleura (lung lining).
  • Improved surgery outcomes. Radiation can help stop the rapid division of cancer cells, slowing down the growth of tumors or even shrinking them. Radiation administered before surgery is called neoadjuvant therapy and can make surgery to remove the tumors more effective.
  • More effective chemotherapy. As part of a comprehensive care plan, radiation can improve outcomes from chemotherapy treatments.
  • Pain relief. Mesothelioma radiation is often used as palliative care, which focuses on symptom management and quality of life. Radiation can help relieve some of the pain caused by tumors pressing on the lungs and chest.

Radiation Therapy Process

While radiation therapy may vary from patient to patient, it often follows the same basic steps. Below are some examples of what you may experience during radiation therapy for mesothelioma.

  1. Initial consultation: When you first meet with the radiation oncologist, be sure to bring documentation such as any previous imaging and diagnostic test results. The doctor will provide a thorough examination and answer any questions you have.
  2. Imaging scans: Your care team may recommend a computed tomography (CT) scan to get an accurate picture of the tumor’s location. CT scans are painless procedures that can be performed in a hospital or outpatient facility and usually take about 30 minutes in total, according to Mayo Clinic.
  3. Treatment preparation: Your doctor may start with a faint marking to identify where the radiation should be focused, avoiding as much healthy tissue as possible. They may also create molds to protect your face or other areas of your body during radiation.
  4. Treatment: According to the National Cancer Institute (NCI), radiation treatment is typically performed 5 days a week and continues for 5-6 weeks. The average duration of daily radiation treatment is 15-30 minutes.
  5. Follow-up care: Follow-up appointments usually involve your doctor addressing any side effects the radiation therapy may cause. They’ll also order imaging scans to see if the tumor is shrinking in response to the radiation.

Learn more about radiation and mesothelioma treatment in our Free Mesothelioma Guide, shipped to your door overnight.

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Side Effects of Mesothelioma Radiation Therapy

Although radiation oncologists do everything they can to protect surrounding tissues during radiation therapy, damage to healthy cells may cause side effects. Some patients experience many side effects, while others have very few.

Radiation side effects mesothelioma patients may experience include:

  • Fatigue
  • Hair loss
  • Inflammation of the intestines
  • Loss of appetite
  • Lung inflammation
  • Nausea
  • Skin problems
  • Vomiting

Side effects can happen during therapy or immediately after, but some side effects don’t develop until weeks after treatment.

The type and extent of side effects may also vary based on factors, including:

  • Location and size of the area being treated
  • Radiation dosage level
  • Treatment frequency

Be sure to tell your doctor about any side effects you experience from radiation. Your medical team can help you manage them using oral medications, topical creams, or other methods.

Mesothelioma Hope’s on-staff medical team can help provide insights on how best to prepare for and manage side effects. Call (866) 608-8933 any time to speak with us for free and ask any questions you have about radiation or treatment.

How to Prepare for Mesothelioma Radiation

If you and your doctor decide radiation treatment for mesothelioma is right for you, it’s important to know what to expect.

You’ll likely go through a test run, or simulation, at your mesothelioma cancer center before receiving your first round of radiation. During the simulation, your doctor may fit you with a mold to help you stay comfortably in place and protect your healthy organs from the radiation. You’ll also likely get a small tattoo to identify exactly where the tumor is.

Here are some things to consider when preparing for mesothelioma radiation:

  • Sessions will be frequent. You’ll need to clear your schedule as much as possible, because many radiation treatment plans include 5 sessions a week for 5-6 weeks.
  • Fatigue is common. The most commonly reported symptom of radiation is fatigue. Know that you will likely be tired after your sessions, so it’s important to have an open schedule and someone to drive you to and from treatments.
  • Bring something to entertain or relax yourself. Plan to bring something that will comfort or distract you during your sessions, such as a book, podcast, stress ball, or essential oils.
  • Your skin may become raw and irritated. Ask your care team for approved lotion or skincare products to help ease the pain and discomfort you may experience. You’ll also want to avoid any sun exposure to the affected area after your treatment.

Prepare yourself for the journey ahead with our exclusive Questions to Ask Your Doctor Checklist. This resource will help ensure you’re fully informed and ready to navigate radiation therapy with confidence.

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Patient Experiences With Radiation Therapy for Mesothelioma

Every mesothelioma patient’s experience with radiation will be a little different depending on their unique situation. However, it can be helpful to hear what others have gone through to give you an idea of what to expect.

John Panza’s Mesothelioma Radiation Story

John Panza, an Ohio professor and musician, was diagnosed with stage 3 malignant pleural mesothelioma in 2012. In John’s experience, as with many others, radiation was part of a multimodal treatment plan.

His treatment involved a series of surgeries and procedures, including an EPP, chemotherapy, and radiation. In all, John underwent 27 radiation sessions to help keep his cancer in check.

“You might even surprise yourself with how strong you are. I’ve been fighting nonstop for more than a decade.”

- Quote from John Panza, 11+ year mesothelioma survivor

Types of Radiation Therapy for Mesothelioma

The most common type of radiation therapy for mesothelioma is external beam radiation therapy (EBRT), but other types may be used as well — particularly in clinical trials.

External Beam Radiation Therapy (EBRT)

As the name suggests, EBRT is administered through the skin from outside the body. Thanks to technological advancements, EBRT is increasingly more effective at targeting tumors.

Before beginning radiation therapy, doctors must determine precisely where to aim the radiation and how much to administer. To do this, they examine the patient closely by performing imaging tests.

Mesothelioma tumors are often irregularly shaped and form in separate areas, so cancer targeting can be complicated.

Doctors now use an intensity-modulated radiation therapy (IMRT) technique to target a tumor fully. The IMRT method varies the strength, pattern, and shape of radiation beams to apply radiation more directly and protect the surrounding tissue.

This technique allows doctors to conform the radiation beam to the precise shape of the tumor and fine-tune the radiation doses.

Intraoperative Radiation Therapy (IORT)

Intraoperative radiation therapy (IORT) is an EBRT radiation therapy approach used alongside surgery. IORT is administered inside the body while the tumor site(s) is directly exposed during surgery.

By applying radiation therapy directly to the open mesothelioma site, doctors can increase surgical success by preventing mesothelioma cells from spreading.

The IORT approach also prevents damage to healthy tissues since radiation does not pass through the skin from the outside.

Only used on early-stage mesothelioma patients, IORT can further increase life expectancy from surgery-based treatment plans. Depending on a patient’s diagnosis, doctors may recommend the IORT approach with pleural or peritoneal mesothelioma surgeries.

Brachytherapy

Brachytherapy, or internal radiation, is a type of radiation therapy that works by inserting a radioactive device inside a patient’s tumor. Brachytherapy lets doctors use higher doses of radiation in more specific places than traditional radiation therapy would allow.

Doctors may apply brachytherapy in many ways, including:

  • Inserting the radioactive source during surgery
  • Inserting the radioactive source through an imaging scan
  • Applying it temporarily after surgery to prevent cancer from spreading

Brachytherapy is rarely used to treat mesothelioma, but its effectiveness in treating lung cancer gives some doctors hope that it may help in future mesothelioma treatment.

We Can Help You Get Mesothelioma Radiation Therapy

Radiation therapy is often used in conjunction with other treatments to fight mesothelioma. New cancer research is giving doctors better insight into how radiation can be used most effectively.

Whether your doctor has already recommended radiation treatment, you’re seeking a second opinion, or you’re interested in pursuing a clinical trial, the team at Mesothelioma Hope is here to help.

Get started with our Free Doctor Match service to find an oncologist near you.

Mesothelioma Radiation Therapy FAQs

Does radiation work on mesothelioma?

Yes, radiation therapy is effective at killing mesothelioma cancer cells, shrinking tumors, and limiting cancer cell spread during surgery.

It is commonly used with other treatments, such as chemotherapy, and can also be used for palliative care (relieving symptoms).

What are the side effects of radiation therapy for mesothelioma?

Radiation therapy for mesothelioma has a number of common side effects, including:

  • Fatigue
  • Hair loss
  • Loss of appetite
  • Nausea
  • Vomiting

If you experience side effects from radiation, make sure to tell your doctor. The medical team at Mesothelioma Hope can also provide support and recommend ways to reduce side effects. Call us for free any time at (866) 608-8933.

What type of radiation is used to treat mesothelioma?

There are three types of radiation used to treat mesothelioma:

  • External beam radiation therapy (EBRT) is most commonly used to treat mesothelioma cancer. EBRT uses technology to target tumors more effectively.
  • Intensity-modulated radiation therapy (IMRT) is another type of radiation used to target tumors more fully by varying the strength, pattern, and shape of radiation beams.
  • Intraoperative radiation therapy (IORT) is administered during surgery, preventing cancer cells from spreading and increasing surgical success. It’s only recommended for early-stage mesothelioma patients and may increase life expectancy when combined with surgery.

Is radiation used as end of life care?

Yes, radiation therapy is often used as a type of palliative treatment to relieve uncomfortable symptoms of late-stage mesothelioma.

These symptoms may include difficulty breathing and persistent pain, both of which radiation can alleviate.

Does pleural mesothelioma radiation work?

Yes, radiation therapy for pleural mesothelioma can shrink or stop the growth of tumors, which can extend life expectancy.

It can also be used to reduce symptoms of pleural mesothelioma, such as shortness of breath.

Does peritoneal mesothelioma radiation work?

Radiation therapy is not commonly used for peritoneal mesothelioma.

Because of the location of the cancer (in the abdomen), radiation aimed at peritoneal mesothelioma could potentially damage vital organs nearby. Instead, most treatment plans for peritoneal mesothelioma include surgery and/or chemotherapy.

Dr. Mark LevinReviewed by:Mark Levin, MD

Certified Oncologist and Hematologist

  • Fact-Checked
  • Editor

Mark Levin, MD, has over 30 years of experience in academic and community hematology and oncology. In addition to serving as Chief or Director at four different teaching institutions throughout his life, he is still a practicing clinician, has taught and designed formal education programs, and has authored numerous publications in various fields related to hematology and oncology.

Dr. Mark Levin is an independently paid medical reviewer.

  • Board Certified Oncologist
  • 30+ Years Experience
  • Published Medical Author
Jenna TozziWritten by:

Director of Patient Advocacy

Jenna Tozzi, RN, is the Director of Patient Advocacy at Mesothelioma Hope. With more than 15 years of experience as an adult and pediatric oncology nurse navigator, Jenna provides exceptional guidance and support to mesothelioma patients and their loved ones. Jenna has been featured in Oncology Nursing News and is a member of the Academy of Oncology Nurse & Patient Navigators & the American Nurses Association.

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References
  1. American Cancer Society, “Radiation Therapy for Malignant Mesothelioma.” Retrieved May 20, 2024, from https://www.cancer.org/cancer/malignant-mesothelioma/treating/radiation.html
  2. Canadian Cancer Society, (n.d.). “Radiation therapy for mesothelioma.”  Retrieved May 20, 2024, from https://cancer.ca/en/cancer-information/cancer-types/mesothelioma/treatment/radiation-therapy
  3. Cancer Research UK, “Mesothelioma: Radiotherapy treatment.” R Retrieved May 20, 2024, from http://www.cancerresearchuk.org/about-cancer/mesothelioma/mesothelioma-treatment/radiotherapy/treatment
  4. de Perrot, M., Wu, L., Wu, M., & Cho, B. C. J. (2017). Radiotherapy for the treatment of malignant pleural mesothelioma. The Lancet Oncology, 18(9), e532-e542. Retrieved May 20, 2024, from https://doi.org/10.1016/S1470-2045(17)30459-X
  5. Journal of Thoracic Oncology, “A Feasibility Study Evaluating Surgery for Mesothelioma After Radiation Therapy: The “SMART” Approach for Resectable Malignant Pleural Mesothelioma.” Retrieved May 20, 2024, from http://www.jto.org/article/S1556-0864(15)30223-9/fulltext
  6. Mayo Clinic Staff. (2018). Brachytherapy. Retrieved May 20, 2024, from https://www.mayoclinic.org/tests-procedures/brachytherapy/about/pac-20385159
  7. Mayo Clinic, (n.d.). “CT Scan.”  Retrieved May 20, 2024, from https://www.mayoclinic.org/tests-procedures/ct-scan/about/pac-20393675
  8. Miles, E. F., Larrier, N. A., Kelsey, C. R., Hubbs, J. L., Ma, J., Yoo, S., & Marks, L. B. (2008). Intensity-Modulated Radiotherapy for Resected Mesothelioma: The Duke Experience. International Journal of Radiation Oncology*Biology*Physics, 71(4), 1143-1150. Retrieved May 20, 2024, from https://doi.org/10.1016/j.ijrobp.2007.11.011
  9. NCI Office of Communications and Public Liaison. (2016). Radiation Therapy and You: Support for People with Cancer [pdf file].  Retrieved May 20, 2024, from https://www.cancer.gov/publications/patient-education/radiationttherapy.pdf
  10. O’Rourke, N., Garcia, J. C., Paul, J., Lawless, C., McMenemin, R., & Hill, J. (2007). A randomised controlled trial of intervention site radiotherapy in malignant pleural mesothelioma. Radiotherapy and Oncology, 84(1), 18-22.  Retrieved May 20, 2024, from https://doi.org/10.1016/j.radonc.2007.05.022
  11. Price, A. What Is the Role of Radiotherapy in Malignant Pleural Mesothelioma?, The Oncologist, Volume 16, Issue 3, March 2011, Pages 359–365.  Retrieved May 20, 2024, from https://doi.org/10.1634/theoncologist.2010-0185
  12. Rosenzweig, K. E., Zauderer, M. G., Laser, B., Krug, L. M., Yorke, E., Sima, C. S., Rimner, A., Flores, R., & Rusch, V. (2012). Pleural Intensity-Modulated Radiotherapy for Malignant Pleural Mesothelioma. International Journal of Radiation Oncology*Biology*Physics, 83(4), 1278-1283.  Retrieved May 20, 2024, from https://doi.org/10.1016/j.ijrobp.2011.09.027
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