The treatment of radiation may be a part of a pleural mesothelioma patients treatment plan. It could reduce the possibility that cancer will return after surgery.
Radiation therapy utilizes radio waves that ionize and destroy DNA in cells, killing them. It can be given before or after surgery.
Doctors often combine it with chemotherapy to boost the chances of success. It can also ease symptoms by shrinking tumors that cause discomfort, such as shortness of breath.
External beam radiation therapy (EBRT)
This treatment makes use of x-rays or particles that come from a machine outside the body to kill cancerous cells. It is offered prior to or after surgery or chemotherapy to eliminate cancerous cells in the area, or as a treatment to reduce symptoms such as breathlessness. Mesotheliomas aren’t able to grow as one distinct tumors, and therefore it can be difficult to target radiation at them while sparing healthy tissue. Newer techniques are helping to overcome this issue.
Experts in radiation use computers to create detailed images of the tumor as well as nearby healthy tissues. These images assist them in deciding how much radiation to use and where it should be directed. This information is used to direct a large machine that positions the radiation beam precisely over the tumor. Most EBRT types require treatment every day for weeks, although some patients require fewer treatments. Each session is between 15 to 30 minutes, but the majority of time is spent getting the patient into the proper position for treatment.
The kind of EBRT used for mesothelioma depends on the location of the tumor and the health of the patient. It can be a standard EBRT known as three-dimensional conformal radiotherapy (3D-CRT) or a more advanced technique such as intensity modulated radiation treatment for mesothelioma therapy (IMRT). In certain instances, it may be combined with a more specific method such as stereotactic body radiation therapy to treat larger tumors or with other treatment options such as intraoperative radiation therapy to treat smaller tumors that can’t be removed surgically.
Proton beam radiation therapy is yet another alternative for radiation therapy. It involves aiming beams of particles like protons or heliumions, towards a tumor from different angles. This allows for targeted treatment that is more precise and reduces damage to nearby healthy organs and tissues. However, proton beam radiation therapy is not commonly utilized in Australia for mesothelioma.
Another type of radiation is intraoperative radiation therapy (IORT), which is given alongside surgery to try and eliminate any mesothelioma that can’t be removed surgically. This is a quick procedure that takes just few minutes to complete.
Intensity-modulated Radiation Therapy (IMRT)
IMRT is a procedure that allows doctors to treat tumors without damaging healthy tissue. It is a treatment that makes use of a medical linear accelerator (LINAC) machine that generates photons, or X-rays, to target the tumor and its surrounding tissue. The machine rotates to allow the beam to be directed at different angles, so that all areas are treated. This allows the doctor to administer an increased dose to the tumor and protect the healthy tissues around it from being damaged.
IMRT is utilized in conjunction with Image-Guided Radiation Therapy (IGRT) which allows the doctor to pinpoint the exact location of the cancer. IGRT uses computerized images, like CT scans, X-rays and MRI scans, if they are available, to help the radiation oncologist identify the mesothelioma accurately. Once the area of interest has been identified, the IMRT can be used to create a treatment strategy that targets the mesothelioma precisely.
The IMRT system also enables the doctor to tailor the treatment according to each patient’s unique anatomy and reduce the risk of adverse effects. Radiation oncologists typically provide patients with five daily IMRT treatments per week, for five to eight consecutive weeks. Each session lasts between 15 and 30 minutes. The daily dose of radiation is designed to protect the body’s normal tissues. It is important to remember also that a weekend break is often required to ensure that the healthy tissues of the body can recover.
The IMRT technique has shown good results for patients with mesothelioma of the head and neck. It is especially useful for [Redirect-Java] tumors that are located near radiosensitive structures such as the parotid glands, as an earlier study demonstrated that IMRT can allow a high dose to be delivered to the tumor without affecting the neighboring parotid gland. The parotid glands that were spared recovered to 63 percent of their pretreatment levels, compared to just 3% recovery in patients who received conventional radiation. This is an extremely promising outcome, but more research needs to be conducted. Large-scale trials using IMRT will be required to confirm the early findings.
Radiation can shrink a tumor and decrease symptoms when doctors are unable to eliminate the mesothelioma. This is known as palliative care. Doctors combine it with other treatments like chemotherapy and neoadjuvant therapy to prolong the life of a patient.
Radiation therapy makes use of x-rays from a machine outside of the body to kill cancerous cells. With the development of new techniques, such as IMRT, doctors can better concentrate on the region around the tumor and limit the damage caused by radiation to the surrounding tissues.
Some forms of radiation may also be used inside the body to kill cancerous cells. In brachytherapy, doctors place a sealed radioactive source near or in the mesothelioma. This can be accomplished using a catheter or applicator. Doctors can then deliver doses of radiation from a machine outside the body to target the source. This is referred to as external radiation therapy (EBRT).
Doctors can choose to use high-dose or pulsed-dose radiation in brachytherapy. For the former, patients stay in the hospital and may receive 10-minute sessions every day for a period of two weeks. High-dose brachytherapy is a procedure that requires a larger machine with longer exposure times, is not as popular.
Protons are used in a different type of brachytherapy instead of the x-rays. Protons are physical particles and therefore less likely to be absorbed by tissue. This may lead to less damage to the surrounding area. However, this form of radiation is more expensive and is not as widely available as xrays.
stage 2 mesothelioma treatments patients might need to undergo radiation therapy for a few weeks or more. This can be very difficult to tolerate. Patients should speak with their physicians about any side effects they might suffer from treatment. Patients should also ask doctors for tips on how to reduce the effects of treatment.
In addition to radiation, mesothelioma patients may benefit from gene therapy and immunotherapy as part of their multimodal treatment plan. Immunotherapy can boost the immune system, and mesothelioma patients who have had chemotherapy can benefit from immunotherapies to boost their chemotherapy regimen.
Mesothelioma researchers are also looking at ways to improve mesothelioma outcomes with radiation therapy. Combining brachytherapy with immunotherapy is possible by injecting cells that are infused with Yervoy directly into the chest cavity. This treatment has proven to be effective in clinical trials. Gene therapy is a new method of fixing or replacing genes in the mesothelioma experimental treatment cells to suppress their growth or make them more vulnerable to chemotherapies.
Radiation therapy after surgery
Radiation therapy is not a cure for mesothelioma, however, it can significantly improve the patient’s chances of survival. Radiation therapy, when used in conjunction with other treatments can shrink mesothelioma-related tumors and reduce the pain and discomfort that cancer causes. It also reduces the chance of mesothelioma cancer cells spreading during surgery or following the removal of a lung tumor (known as “seeding”).
Each session lasts about 30 minutes. The treatment can be uncomfortable since the radiation oncologist needs to place and hold the patient in place.
Before a session begins patients should dress comfortably. They should also stay clear of wearing any metal, which could affect the precision of the equipment. Additionally, patients should consume six small meals throughout the day to avoid nausea caused by the treatments.
In the case of a patient’s health depending on the patient’s condition, they could receive either a conventional form of radiation or brachytherapy. When treating patients with conventional radiation doctors use an accelerator machine to deliver radiation. This is the most popular form of mesothelioma treatment. It is usually used for pleural msothelioma that develops on the lung’s lining.
Brachytherapy is a sophisticated treatment that uses an energy source that is placed within the body. The implant may be permanent or temporarily put in. When implanting the implant, the doctor must ensure that only cancerous tissue is targeted and not the surrounding organs.
In some mesothelioma clinical studies, researchers are exploring the possibility of combining radiation therapy with surgical procedures for patients suffering from mesothelioma resectable. One example is the SMART trial. This experimental treatment plan consists of giving patients hemithoracic radiation prior to when they undergo extrapleural pneumonectomy (EPP). This combination of treatments allows doctors to give patients higher doses of radiation and reduce the chance of mesothelioma post-surgery seeding.
A mesothelioma sufferer may experience a complete or partial remission, which means that the tumor has decreased in size or disappeared entirely. Some patients have been in remission for several years and have survived past their initial prognosis.