Mesothelioma Radiation Therapy

Radiation therapy is a standard treatment for mesothelioma that many patients undergo. A non-invasive treatment, radiation therapy has minimal side effects and can significantly contribute to increased life expectancies when used as part of a multimodal treatment plan.

Radiation for Mesothelioma

Considered one of the standard 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 uses high-energy rays to target tumors and kill cancer cells. 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.

How Does Radiation Therapy Work?

Radiation therapy involves the use of high-energy rays—typically gamma or x-rays—to shrink and destroy mesothelioma tumors. These rays are aimed directly at the site of the tumor. Depending on the stage of mesothelioma and location of the tumor, radiation may be applied externally or internally.

Radiation Precision Saves Healthy Cells

Radiologists deliver radiation to the tumor site in measured doses to accurately target the cancer cells without damaging the surrounding healthy tissue.

Radiation interferes with the DNA of mesothelioma cells to change how these cells behave. Located in the nucleus of each cell, this DNA tells mesothelioma cells to grow and divide. Radiation effectively scrambles the DNA to prevent cells from dividing. As a result, mesothelioma cells die off instead of growing and multiplying.

Who Administers Radiation Therapy

Radiologists administer radiation therapy at specialized cancer centers. Radiologists are medical doctors who specialize in the use of imaging to diagnose and treat diseases in the human body. After undergoing at least 13 years of intensive training, these specialists understand how to use radiation to treat diseases safely while minimizing damage to other parts of the body.

Radiation oncologists are specialized radiologists who use radiation therapy to treat cancer. These doctors oversee patient treatments plans, monitor progress and adjust treatments as needed.

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Why Is Radiation Used?

Radiation often plays a role in mesothelioma treatment success. Depending on the cancer location, cell type and stage, radiation therapy may be used in different ways. Although radiation is sometimes used as a treatment solution alone, it’s often combined with surgery.

Radiation therapy for mesothelioma has several goals, including:

  • 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.

External Beam Radiation Therapy

External beam radiation therapy (EBRT) 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 alters 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.

New Radiation Techniques Improve Patient Outcomes

Intensity-Modulated Radiation Therapy is more accurate and effective than older radiation techniques, and it’s minimally damaging to healthy tissues.

Intraoperative Radiation Therapy

Intraoperative radiation therapy (IORT) is a radiation therapy approach used to support surgery—an approach called adjuvant therapy. 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 your exact diagnosis, doctors may recommend the IORT approach with pleural or peritoneal mesothelioma surgeries.

Surgery for Mesothelioma After Radiation Therapy

Surgery for mesothelioma after radiation therapy (SMART) is only used on patients with pleural mesothelioma who will undergo surgery. Administering radiation therapy before an extrapleural pneumonectomy (EEP) surgery has significant benefits. With the SMART approach, doctors deliver large doses of radiation to the tumor site to kill tumor cells aggressively.

Preventing Recurrence With Radiation Therapy

Doctors have found that SMART (surgery for mesothelioma after radiation therapy) helps shrink tumors and kills outlying mesothelioma cells, which prevents them from forming new tumors.

Targeting a large area of mesothelioma cells with radiation can prevent mesothelioma from spreading to distant sites during surgery. By using the SMART approach, doctors can limit mesothelioma recurrence and increase survival. Damaging healthy tissue is less of a concern during this procedure because the entire lung will be removed in the following surgery.

Side Effects of Radiation Therapy

Although radiologists 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 the location and size of the area under treatment, as well as the radiation dosage level and treatment frequency. Side effects can happen during therapy, immediately after or they may take weeks to develop following treatment.

Some common radiation side effects that mesothelioma patients may experience include:

  • Fatigue
  • Loss of appetite
  • Hair loss
  • Nausea and vomiting
  • Skin problems
  • Radiation pneumonitis
  • Radiation enteritis

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

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Seeing Mesothelioma Radiation Therapy

If your doctor has suggested radiation therapy as part of your mesothelioma treatment plan, seek a second opinion from a mesothelioma specialist. Oncological radiologists know the best ways to administer radiation therapy for mesothelioma to increase survival and minimize damage to healthy tissue.

Specialists develop personalized radiation treatment plans to best support the overall treatment goals of each patient.

For more information about receiving radiation therapy from a mesothelioma specialist, contact the Mesothelioma Justice Network today. Our Claim Advocates will answer any questions you have about radiation therapy and how you can get a second opinion.

Author:Stephanie Kidd

Editor-in-Chief of the Mesothelioma Justice Network

Stephanie Kidd

Stephanie Kidd works tirelessly as a dedicated advocate for the vulnerable and underrepresented. Stephanie worked as a copywriter for an agency whose focus was communicating safety procedures on construction work sites. With her extensive background in victim advocacy and a dedication to seeing justice done, Stephanie works hard to ensure that all online content is reliable, truthful and helpful.

Last modified: June 25, 2019

View 3 Sources
  1. American Cancer Society, “Radiation Therapy for Malignant Mesothelioma.” Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/treating/radiation.html. Accessed on January 3, 2018.
  2. Cancer Research UK, “Mesothelioma: Radiotherapy treatment.” Retrieved from: http://www.cancerresearchuk.org/about-cancer/mesothelioma/treatment/radiotherapy/treatment. Accessed on January 3, 2018.
  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: http://www.jto.org/article/S1556-0864(15)30223-9/fulltext. Accessed on January 3, 2018.
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