Radiation Therapy for Mesothelioma
Radiation therapy is one of several treatment options for patients with mesothelioma. Radiation helps to extend a patient’s life expectancy and improve their quality of life.
Registered Nurse Amy Fair discusses what to expect when getting mesothelioma chemotherapy and its side effects. View Transcript.
Duration: 1 min 11 sec
What do I need to know about radiation and chemotherapy?
If radiation chemotherapy is the treatment choice your oncologist will talk with you about the side effects of radiation and the side effects of chemotherapy. They will talk with you about the different blood tests that need to be done. They usually check your B9 and your B12. They will check your platelet counts, blood counts that tend to fall during treatment such as chemotherapy.
The role of chemotherapy is to prevent those cancer cells from replicating. It not only kills the bad cells but it kills the good cells too. You’ll see nausea and some hair loss. So with the toxicity of chemotherapy do come some side effects. There are many medications out there now that control nausea. There are many medications out there that can help stimulate your appetite during chemotherapy. It’s important to keep a good relationship with your oncologist and be knowledgeable going into the therapy about the possible side effects.
Radiation therapy uses high-energy rays — typically gamma or X-rays — aimed directly at the site of the 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 exact location and extent of mesothelioma. This helps doctors prevent damage to healthy surrounding tissues.
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 because the tumors do not usually grow as one large mass that mesothelioma doctors can aim a radiation beam at. 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 also 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 imaging the body.
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.
Intraoperative Radiation Therapy
Intraoperative radiation therapy (IORT) is a type of EBRT radiation therapy approach used to support surgery. IORT is administered inside the body while the tumor site is 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 exact diagnosis, doctors may recommend the IORT approach with pleural or peritoneal mesothelioma surgeries.
Brachytherapy or internal radiation is a type of radiation therapy that works by inserting a radioactive device inside of 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 with the use of 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 the process of radiation therapy may vary from patient to patient, it generally follows the same basic steps.
- 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 tests and diagnostic test results.
Once there, the radiation oncologist will perform a thorough examination of 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.
- 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.
- Treatment Preparation
At times, doctors may create a faint marking on a patient to make sure they perform the most accurate radiation treatment possible and avoid as much healthy tissue as they can. They may also create molds to protect a patient’s face or other areas of the body during radiation.
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.
- 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 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 take weeks to develop following treatment.
Some radiation side effects mesothelioma patients may experience:
- Loss of appetite
- Hair loss
- Skin problems
- Lung inflammation
- Inflammation of the intestines
Fortunately, your medical team can help manage any side effects. For example, skin problems are typically treated with topical creams, and inflammation is treated with oral medications.
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 you have about radiation therapy and help you find a radiation oncologist.