Mesothelioma Radiation Treatment
Mesothelioma radiation treatment uses X-rays and other energy beams to shrink tumors and keep them from growing or spreading. It can be given at any stage of mesothelioma as an option to treat the disease and prolong its time or as a palliative treatment to relieve symptoms.
It can also be utilized by doctors prior to surgery to reduce the size of the tumor, making it easier for surgeons. They may also use it following surgery to kill any remaining cancer cells and prevent recurrence.
External beam radiation therapy
Radiation therapy utilizes high-energy beams of X-rays or particles that kill cancerous cells. It is difficult to focus radiation mesothelioma cancers because they tend to be small, multiple areas of tissue. New methods enable doctors to pinpoint the tumor and minimize damage to other parts of the body. Radiation therapy can be used to kill cancerous cells that persist after surgery or chemotherapy. It can be used alone or together with palliative treatments to alleviate symptoms of mesothelioma, such as pain and trouble breathing.
For external beam radiation therapy, doctors employ a machine to direct radiation towards the mesothelioma tumor from outside the body of the patient. The doctors use the techniques of a CT, MRI, or PET scan to determine the exact location of mesothelioma. They then devise a strategy for delivering radiation to the area while limit damage to the surrounding tissue. The radiation oncologist might mark your skin with tiny dots to help them locate the site. They also mark the treatment field, which is the area that requires treatment.
You’ll lie down on a treatment bed, and a machine will be placed over the part of your body that is affected by mesothelioma. You may be asked to move around a few times throughout your session, but you won’t be able to feel or see the machine moving around your. During the procedure, you might hear clicking or whirring sounds from the equipment. The radiation oncologist will be monitoring you from a room of observation.
EBRT is usually performed once a day for 5 days per week for between 2 and 8 weeks. Based on the type of radiation and the purpose of treatment, you will receive different treatments. Certain kinds of EBRT like intensity-modulated radiation therapy or IMRT makes use of computers to more accurately target the tumor and reduce radiation exposure to nearby tissues.
Other types of radiation, such as proton beam radiation or SBRT, utilize a particle beam instead of an X-ray. Proton beam radiation damages the DNA of cancer cells, causing them to die more quickly than normal cells. This type of treatment could be more precise than EBRT, but it isn’t yet widely used for mesothelioma.
Intensity-modulated radiation therapy (IMRT)
Intensity-modulated radiation therapy aligns the radiation beams with the 3-dimensional shape and size of the tumor with 3-D computed-tomography (CT). This allows higher radiation doses to be given to the tumor while keeping the organs and tissues around it. IMRT can also be used to treat other cancers like lung cancer, prostate cancer as well as head and neck tumors and Sarcomas.
In studies on patients with complicated tumors, IMRT produces superior dose distributions and lower toxicity when as compared to conventional radiation methods. Radiation oncologists utilize IMRT to plan the course of treatment for their mesothelioma patients and ensure that the radiation is directed to the correct part of the body. The radiation oncologist consults the patient and seeks informed consent before deciding whether IMRT is appropriate for the mesothelioma treatment.
The radiation oncologist and medical physicist collaborate to develop an individual IMRT treatment plan for mesothelioma. The radiation therapists administer the IMRT treatment. During the sessions the patient is lying on a table. mesothelioma treatment options might hear noises or smell odors from the machine, but they shouldn’t feel pain. The medical physicist and radiation oncologist remain outside of the room to observe from a secure distance.
During the IMRT session, the radiation oncologist can alter the intensity of radiation according to the need to focus on the tumor. The radiation oncologist can also alter the intensity of each beam, which can help protect vital structures such as the heart and blood vessels.
For the past 10 years the team at MSKCC of radiation oncologists has used IMRT for the treatment of mesothelioma. Their findings indicate that IMRT improves lung function, survival, and reduces the risk of side effects such as radiation pneumonitis or radiation esophagitis. The mesothelioma patients studied had mesothelioma pleural biopsy-proven in the hemithorax. However, they were not suitable for P/D or resection due to impaired lung function. They were treated with IMRT to the hemithorax with or without pleurectomy. In the patients who received IMRT the overall survival was 71 percent at one year and 53 percent after two years.
Brachytherapy
The use of radiation therapy is to kill cancerous cells within mesothelioma which is a deadly cancer. It can also shrink tumors to make them easier to remove via surgery. It is a kind of targeted treatment that utilizes narrow beams to protect healthy tissues in the vicinity.
Radiation can be used alone or in conjunction with other treatment for cancer, such as chemotherapy. Many mesothelioma patients also receive additional chemotherapy to decrease the risk of cancer recurring after surgery and to enhance the effectiveness of their treatment.
Brachytherapy is the process of placing the radioactive source near or inside a mesothelioma tumor which allows doctors to deliver a higher dose of radiation to the tumor. Doctors can utilize a 137Caesium or Iridium source for this treatment that requires hospitalization. The patient stays in a room that is shielded with the source for 12-24 hours. Patients may experience short-term side effects from the procedure, such as a rash at the site of the implant and a small amount of bleeding from the area at which the applicator was put.
Another option is High-dose Rate (HDR) Brachytherapy which involves placing a variety of radioactive sources around the tumor area and delivering higher doses of radiation over a longer duration of time. The treatment typically takes three to five days, and requires an overnight stay in the hospital. This type of brachytherapy can cause short-term adverse effects. This includes soreness and bleeding at the area where the applicators have been placed.
Because mesothelioma typically develops as an layered mass which makes it difficult to target with radiation. Newer technology enables radiation specialists to focus on the tumor with greater precision and to avoid surrounding tissue.
In certain cases mesothelioma sufferers may be given brachytherapy as part of a preoperative treatment called Neoadjuvant Therapy or as an adjuvant post-surgical treatment to eliminate any remaining mesothelioma cancerous cells that the surgeon was unable to fully remove. In addition, some mesothelioma patients are treated with brachytherapy alongside pleurectomy/decortication and conventional radiation therapy as a palliative treatment for their symptoms.
Proton beam radiation
Radiation oncologists focus on mesothelioma cancers in specific areas of the body. This type of treatment offers an improved method of treatment and lowers the risk of exposing healthy tissues to high levels of radiation. Patients with mesothelioma should discuss proton radiation therapy with their physician to determine if it is the best option for them.
The process of proton beam radiation begins with the radiation oncologist creating a plan to treat the cancerous tissue. Using a computer program, dosimetrists determine the precise amount of radiation that needs to be injected into the area. They also decide which part of the body to deliver the radiation and how deep into the body it should travel. The dosimetrists send the information on to a physicist, who makes use of a device called synchrotron to accelerate protons into the energy required for treatment.
When the protons arrive in the treatment room they are directed at the tumor using a method that is similar to a CT scanner. The patient is placed on a table that moves to the exact shape of the tumor. The physicist uses a system to rotate the proton beam’s nozzle around the patient to ensure that radiation is directed towards the tumor at the most optimal angle that is possible.
A device called a gantry is used to shape and direct the proton beam. This device is surrounded with an immobilization frame which keeps the patient still while being treated. A computer regulates the gantry. It is monitored from a nearby room by a team of radiation technicians. The radiation oncologist may alter the treatment plan if necessary during weekly appointments.
Proton beam radiation penetrates lung tissues less than traditional photon radiation. This means that there is a less chance of developing radiation-related complications including toxicity and the development of mesothelioma cells that are resistant to treatment.
The proton beam is used to target mesothelioma-related tumors in the pleural linings of the abdomen and the lungs. However, it is important for patients to work with mesothelioma specialists that have experience working with proton beam radiation.