Mesothelioma Radiation Therapy
Radiation therapy, also called radiotherapy
or just radiation, is a common cancer treatment strategy. Mesothelioma
radiation therapy is one of three main treatment techniques used to battle this
aggressive type of cancer. The other two are surgery and chemotherapy. Radiation
therapy may be used alone, but is more often used as part of a multimodal
treatment approach along with chemotherapy, surgery, and other treatments.
For managing mesothelioma, radiation therapy
is typically used to destroy cancer cells left in the body after surgery to
remove tumors. It is also used to shrink tumors as a palliative treatment. The
use of radiation involves harmful, high energy rays to kill cells, but it is
targeted at cancer cells. There may be some side effects, but they are
typically less severe than those associated with chemotherapy.
What is Radiation Therapy?
This type of treatment, which is used for various types
of cancer, not just mesothelioma, uses high energy beams of radiation to kill
cancer cells. The radiation may be X-rays or gamma rays, as well as
high-energy, charged particles. These high energy particles and rays kill
living cells by damaging the DNA, or the genetic material.
When DNA is damaged madly enough a cell will stop growing
and dividing. The dead cell is then broken down and recycled or eliminated from
the body through natural processes. Radiation kills all cells, not just cancer
cells. Technicians and oncologists administer radiation in a way that is
targeted to minimize the death of healthy cells and minimize side effects.
Types of Radiation Therapy
Radiation therapy can be used in one of two
main ways: externally and internally, depending on how it is applied to the
patient. There are more specific variations within these two categories.
External Radiation Therapy
External radiation involves using a machine
that creates a beam of radiation and aiming that beam at the part of the body
in which the cancer has been found. The actual procedure is painless and is a
lot like getting an X-ray. There are several different variations on external
radiation therapy.
One of these variations is image-guided
radiation therapy, which uses CT scans or MRI images to target the tumor in the
body and aim the radiation beam more accurately. Three-dimensional radiation
uses these images, but pieces them together to give an even clearer picture of
where the tumor is. Using images helps to minimize the exposure of healthy
tissue to radiation.
Another type of externally-applied radiation
is known as intensity-modulated radiation. It is administered in varying bursts
of intensity. This allows the treatment to better target the exact size and
shape of the tumor, again minimizing harm to healthy cells and resulting side
effects.
Systemic Radiation Therapy
Systemic radiation therapy is a different way of targeting tumor cells with radiation. Instead of using an external beam, radioactive drugs are used to deliver radiation systemically, throughout the whole body. This is an internally-administered type of radiation.
The drugs can be given intravenously or orally. The radioactive drug is typically attached to an antibody that targets cancer cells so that the radiation is not delivered to all cells in the body. The radioactive material accumulates in the tumor where it can kill cancer cells.
Brachytherapy
Brachytherapy is another type of
internally-delivered radiation therapy used to treat mesothelioma and other
types of cancer. A radioactive substance is placed within an implant, which is
then surgically placed inside the body, next to the tumor. Here the material
will emit radiation to kill cancer cells. The benefit of this type of radiation
therapy is that, although it is invasive, it allows for a higher dose of
radiation to be targeted at a smaller area of the body.
Brachytherapy implants may be placed
permanently, which is called seeding or seed implantation, or temporarily. The
radioactivity, or the radiation emitted by the material in the implant,
diminishes over time, so permanent placement does not mean that a patient will
have a device emitting radiation inside of them forever.
Curative Mesothelioma
Radiation Therapy
There are two possible goals in using radiation therapy
in patients with mesothelioma. One is as part of an overall treatment plan that
it is hoped will be curative. In people diagnosed in an early stage of
mesothelioma, before the cancer has spread very far from the pleura or
peritoneum, a cure is considered unlikely, but not impossible. Aggressive
treatment that includes radiation gives these patients a chance at eliminating
the cancer or going into remission.
The most common way that radiation is used in
mesothelioma is after surgery. Surgery is the best way to attempt to cure early
stage mesothelioma. It is used to remove as much of the cancer as possible.
After surgery, radiation is used to destroy any remaining cancer cells and to
reduce the risk that the cancer will return.
Mesothelioma cancer cells are particularly sensitive to
radiation, but using this as the lone treatment is not usually possible because
the nearby organs—the lungs, heart, and spinal cord—are also sensitive to
radiation. Doses of radiation high enough to cure mesothelioma without the aid
of surgery would cause too much damage to these other tissues.
Even when a multimodal treatment approach that includes
radiation cannot cure mesothelioma, it is often successful at extending the
life expectancy of early stage patients. One study showed that life could be
extended by nearly three years in patients who underwent radical surgery
followed by high doses of radiotherapy.
Radiation Therapy for
Palliative Care
The other reason to use radiation therapy for
mesothelioma patients is to relieve pain or reduce other symptoms of cancer by
shrinking the size of tumors. Radiation therapy has been shown in research to
reduce the pain of patients with pleural mesothelioma. By reducing the size of
the tumor, pressure on the lungs and pleura is reduced. In other types of
mesothelioma, radiation can have a similar palliative effect. Even when there
is no hope for a cure, radiation can still be a useful treatment.
Side Effects of Radiation Therapy
Because radiation therapy is usually
targeted, side effects are typically not as severe as with other treatments
like chemotherapy. The targeting is not perfect, though. For instance, an
external radiation beam has to go through the skin, which means that skin-related
side effects are common. These include:
- ·
Redness
- ·
Irritation
- ·
Burning
- ·
Blistering
- ·
Hair Loss and Extended Dryness
- ·
Peeling
- ·
Itchiness
Another common side effect of radiation
therapy is fatigue, which mostly sets in after a couple of weeks of radiation
treatments. Other potential side effects include low white blood cell and
platelet counts, which can cause infections and bleeding. Eating difficulties
are also common, especially with radiation therapy for peritoneal mesothelioma.
With radiation therapy there is also a risk
that the radiation will cause long-term damage to organs near the site of the
tumor. With mesothelioma, this especially puts the lungs and heart at risk.
There is also a possibility that radiation treatment will increase the risk of
developing another type of cancer. With mesothelioma, though, a patient’s life
expectancy is already limited, so this is not often a concern.
Weighing Benefits and
Risks
The idea of getting radiation therapy can be frightening,
considering the potential risks and side effects. As with any medical
treatment, it is important to weigh the benefits against the risks. Benefits
include potentially curing the cancer or extending life expectancy and reducing
pain. Risks include feeling fatigued and getting infections or even developing
another type of cancer.
If you have been diagnosed with mesothelioma, consider
benefits and the risks of radiation and take into account the advice and
expertise of your medical team as you make final decisions about treatment.
Rely on the support of your loved ones as well to help you make difficult
choices. Considering how aggressive mesothelioma is, radiation as an aggressive
treatment makes sense for most patients, in spite of side effects.
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