High-energy X-rays or particles are used in mesothelioma radiation therapy to kill cancer cells and prevent them from spreading. Radiation provides mesothelioma sufferers with pain relief by shrinking tumors. Radiation therapy can help patients with mesothelioma live longer lives.
What Is Radiation Therapy for Malignant Mesothelioma?
Radiation therapy is used to help people with mesothelioma live longer and have less discomfort.
It kills malignant cells by damaging their DNA with ionizing radiation, which is high-energy X-rays or particles. This causes tumor shrinking as well as cancer recurrence and spread prevention.
Radiation is a targeted treatment, meaning it only affects the parts of the body to which it is applied. During administration, there is no discomfort. When a radiation oncologist administers this mesothelioma treatment, there is no need to be concerned about pain. Some persons may have skin irritation around the area where radiation was given after treatment.
Radiation oncologists recommend this treatment to individuals with various stages of mesothelioma for a number of reasons.
Benefits of Radiation Therapy for Mesothelioma
- Improved Survival: When combined with surgery and chemotherapy, radiation helps some patients live longer by reducing the risk of local recurrence. Some patients may live three to five years longer with this multimodal approach.
- Pain Relief: Radiation therapy alleviates pain by reducing the size of mesothelioma tumors. This relieves pressure on the lungs, chest or spine. Approximately 60% of mesothelioma patients report symptom relief after radiation therapy.
- Seeding Prevention: During surgery, microscopic cancer cells can move to new areas. This is known as seeding. Radiation therapy along incision sites is relatively common, although recent studies have questioned its effectiveness.
Radiation for Pleural Mesothelioma
Researchers at the Icahn School of Medicine in New York examined the results of thousands of pleural mesothelioma patients in a 2016 study. Patients who got mesothelioma radiation therapy had approximately doubled overall survival at two and five years, regardless of previous therapies.
Patients with early-stage pleural mesothelioma who had radiation therapy in addition to surgery and chemotherapy had a better overall survival rate, according to a study published in Lung Cancer in 2020. Patients in later stages did not show a substantial survival benefit.
Prophylactic irradiation of tracts, areas affected by diagnostic or therapeutic operations, dramatically reduced the occurrence of metastases for pleural mesothelioma patients who underwent chest wall treatments, according to researchers in 2021.
Types of Radiation for Mesothelioma
External and internal radiation therapy can be used to treat malignant mesothelioma. Brachytherapy is a type of internal radiation therapy for mesothelioma. External beam radiation therapy is a type of radiation therapy that is administered externally (EBRT).
Because it has been shown to be more successful, EBRT is more routinely employed for pleural mesothelioma.
External Beam Radiation Therapy
External beam radiation is a noninvasive radiation therapy procedure that uses high-energy photons to target cancerous tumors directly.
Intensity-modulated radiation therapy is the most popular and successful method of EBRT for mesothelioma. IMRT is a type of three-dimensional conformal radiation therapy that is more advanced. It adjusts the power of beams in certain regions, allowing it to pinpoint malignancies with pinpoint accuracy.
The radiation beam is emitted in multiple dosages and conforms to the 3D geometry of the tumor. This allows for higher radiation doses within the tumor while reducing the dosage to nearby organs and tissues.
Image-guided radiation treatment, a 4D version, combines a CT scanner and radiation therapy into one system, allowing patients to stay in one room for imaging and radiation delivery.
Proton treatment is a new type of ERBT that uses a beam of protons rather than photons to more precisely target mesothelioma tumors. Only a few cancer hospitals in the United States offer this sort of radiation.
External beam radiation is quick and painless, with each session lasting only a few minutes. The time it takes to get you in the appropriate posture for treatment, known as setup time, can be lengthy. Treatments are normally given five days a week for several weeks by radiation oncologists.
Brachytherapy is a sort of radiation therapy that uses a radioactive substance inserted in the tumor to kill cancer cells.
The radioactive substance can be implanted during surgery or through a hollow tube with the help of an imaging scan. To prevent cancer from spreading, brachytherapy can be used on biopsy and surgical scars for a limited time.
When administered into a tumor site, it has been shown to be useful in treating lung cancer, however it is rarely used to treat mesothelioma.
Side Effects of Radiation Therapy
- Skin problems
- Hair loss near the radiated area
- Difficulty swallowing
- Shortness of breath
- Cough, fever and fullness of the chest (radiation pneumonitis)
- Scarring of the lungs (radiation fibrosis)
Side effects of mesothelioma radiation are most often temporary and are typically more constrained than those of chemotherapy, which can affect the entire body. However, some side effects of radiation may be chronic and appear months or years after the patient finishes treatment, including a low risk of secondary cancer.
Radiation-related skin irritation, known as radiodermatitis, is most common at the point where the radiation beam was focused. It can cause rashes, redness and a tight feeling or swelling. Peeling or darkening of the skin may occur.
Loss of energy is typically most severe two to four hours after a radiation session. It may also peak between the third and fifth week of treatment as the healing process uses more of the patient’s energy.
Radiation Side Effects by Mesothelioma Type
The symptoms of pleural mesothelioma, such as shortness of breath, trouble swallowing, and coughing, may be temporarily exacerbated by chest radiation.
Fibrosis, or scarring of the lungs, can occur in rare circumstances.
Radiation to the chest can potentially induce inflammation of the heart and lungs’ linings (radiation pneumonitis). There’s also the possibility of heart muscle injury, which could lead to cardiac toxicity.
Fluid buildup (pleural effusions), compressed lungs, and lymph node calcification are all rare consequences of radiation therapy for mesothelioma. Pleural effusions, if they arise at all, are usually documented within six months of the initial mesothelioma radiation treatment, according to research.
Radiation therapy is ineffective in the treatment of peritoneal mesothelioma. The reason for this is because of the location.
The lining of the abdominal cavity is affected by peritoneal carcinoma. The small intestines, liver, kidneys, and other organs in this area can be particularly hazardous to radiation. The most common side effects in individuals who get radiation to the abdomen are nausea, vomiting, and bladder irritation.
Radiation is exclusively used on peritoneal cancer patients to prevent cancer from spreading to biopsy and surgical scars.