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Mesothelioma Radiation

Radiation is a painless and non-invasive type of mesothelioma treatment. Radiotherapy uses powerful X-rays aimed at areas of the body affected by mesothelioma. These high-energy rays can shrink mesothelioma tumors and kill cancer cells by interfering with their DNA and preventing them from multiplying.

Medically Reviewed and Fact-Checked by: Dr. Mark Levin

Updated by: Laura Wright on

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Radiation Therapy for Mesothelioma

Radiation therapy is one of several mesothelioma treatment options that can extend a patient’s life expectancy and improve their quality of life by keeping tumors from being able to grow. It’s also effective in cases where a patient’s health makes surgery too risky.

How does Radiation Therapy Work?

Radiation therapy uses high-energy rays — typically gamma 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 losing the instructions that tell them to grow and divide.

Before starting radiation, doctors use imaging tests to pinpoint the cancer’s exact location, which helps doctors prevent damage to healthy surrounding tissues.

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Goals of Mesothelioma Radiation Therapy

Considered one of the standard mesothelioma treatment options recommended to mesothelioma patients, radiation is typically used during palliative care to reduce symptoms and improve quality of life.

However, it may also be used with surgery or chemotherapy to improve treatment success.

Radiation therapy for mesothelioma has several goals:

  • Shrinking tumors before surgery, so mesothelioma is easier to remove
  • Preventing mesothelioma from spreading to new sites during surgery
  • Killing off mesothelioma cells that were left behind during surgery
  • Shrinking tumor size to alleviate painful symptoms of metastasis

According to the American Cancer Society, mesothelioma is difficult to treat with radiation alone because the tumors do not usually grow as one large mass that mesothelioma doctors can target. Instead, mesothelioma tends to spread, covering delicate tissues and organs.

Radiation kills all cells — not just cancerous ones — so it can be difficult for mesothelioma specialists to hit cancer cells with radiation beams without damaging vital organs.

However, newer radiation techniques allow for better control of radiation beams, potentially making radiation therapy more helpful for some mesothelioma patients.

Types of Radiation Therapy for Mesothelioma

Mesothelioma is usually treated with external beam radiation therapy (EBRT), but there are other types.

External Beam Radiation Therapy (EBRT)

External beam radiation therapy is the most common type of radiation therapy. As the name suggests, EBRT is administered through the skin from outside the body. EBRT is becoming increasingly more effective at targeting tumors, thanks to technological advancements.

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 targeting the cancer can be complicated.

To fully target a tumor, doctors now use a technique called intensity-modulated radiation therapy (IMRT). 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.

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

Intraoperative radiation therapy (IORT) is a type of EBRT radiation therapy approach used to work 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.

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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:

  • 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 the future treatment of mesothelioma.

Radiation Therapy Process

While radiation therapy may vary from patient to patient, it follows the same basic steps.

  1. Initial Consultation
    The mesothelioma patient meets with a radiation oncologist — a cancer doctor who specializes in treating patients with radiation. The patient will bring documentation such as previous imaging and diagnostic test results.
    Once there, the radiation oncologist will thoroughly examine the patient and answer any questions.
    After the exam, the doctor will determine a radiation therapy treatment plan and explain it to the patient, who must sign a consent form before treatment can proceed.
  2. Imaging Scans
    Mesothelioma specialists must create accurate imaging to let them know where the target location will be for radiation therapy. They do this using a computed tomography (CT) machine, which takes roughly an hour to create a simulation of the patient’s body.
  3. Treatment Preparation
    Doctors may sometimes make a faint marking on a patient to ensure they achieve the most accurate radiation treatment possible and avoid as much healthy tissue as possible. They may also create molds to protect a patient’s face or other areas of the body during radiation.
  4. Treatment
    According to the National Cancer Institute (NCI), radiation treatment is typically performed five days a week and continues for 5-6 weeks. The average length of time for daily radiation treatment is 15-30 minutes.
  5. Follow-Up Appointment
    Follow-up appointments usually involve an examination for any signs of side effects the radiation therapy may cause. A mesothelioma patient’s doctor will also order imaging scans to see if the tumor is shrinking in response to the radiation.

Side Effects of Mesothelioma Radiation Therapy

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

Radiation therapy side effects depend on:

  • Location of the area under treatment
  • Size of the area being treated
  • Radiation dosage level
  • Treatment frequency

Side effects can happen during therapy or immediately after, but most side effects take weeks to develop following treatment.

Some radiation side effects mesothelioma patients may experience:

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

Fortunately, your medical team can help manage any side effects. For example, topical creams are typically used to treat skin problems, and inflammation is treated with oral medications.

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Get Mesothelioma Radiation Therapy

New research is helping doctors better understand how radiation therapy can be used to fight mesothelioma. This includes learning more about the most effective ways to administer radiation and which patients can benefit most from this treatment.

For more information about receiving radiation therapy from a mesothelioma specialist, contact Mesothelioma Hope today. Our Patient Advocates will answer any questions about radiation therapy and help you find a radiation oncologist.

Mesothelioma Radiation Therapy FAQs

What is the best treatment for mesothelioma?

The best treatment options vary for each mesothelioma patient. Each diagnosis is unique, and different patients can withstand different treatment options.

Many studies suggest that multimodal treatment plans combine multiple treatment options and incredibly benefit a patient’s life expectancy.

To determine the best treatment method for you, contact a mesothelioma specialist. If you need help finding a specialist near you, call us at (866) 608-8933. Our Patient Advocates are here to help you.

Is radiation therapy effective at treating mesothelioma?

Yes. While the best treatment options vary for each mesothelioma patient, radiation therapy is effective at treating mesothelioma. It is used to target and kill mesothelioma cancer cells.

Does radiation therapy have side effects?

Unfortunately, some mesothelioma treatment options will have side effects.

Radiation therapy has some side effects including:

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

If side effects appear, talk with your doctor as soon as possible so they can provide options to alleviate symptoms and side effects.

Reviewed by:Dr. Mark Levin

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 also 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
Written by:

Lead Editor

Laura Wright is a journalist and content strategist with more than 15 years of professional experience. She attended college at the University of Florida, graduating magna cum laude with a bachelor’s degree in journalism in 2008. Her writing has been featured in The Gainesville Sun and other regional publications throughout Florida.

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  1. American Cancer Society, “Radiation Therapy for Malignant Mesothelioma.” Retrieved from: Accessed on December 22, 2022.

  2. Cancer Research UK, “Mesothelioma: Radiotherapy treatment.” Retrieved from: Accessed on December 16, 2022.

  3. Journal of Thoracic Oncology, “A Feasibility Study Evaluating Surgery for Mesothelioma After Radiation Therapy: The “SMART” Approach for Resectable Malignant Pleural Mesothelioma.” Retrieved from: Accessed on December 22, 2022.

  4. NCI Office of Communications and Public Liaison. (2016). Radiation Therapy and You: Support for People with Cancer [pdf file]. Retrieved from Accessed on December 22, 2022.

  5. Mayo Clinic Staff. (2018). Brachytherapy. Retrieved from Accessed on December 22, 2022.

  6. 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.

  7. 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.

  8. 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.

  9. Allan Price, What Is the Role of Radiotherapy in Malignant Pleural Mesothelioma?, The Oncologist, Volume 16, Issue 3, March 2011, Pages 359–365,

  10. 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.

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