Radiation Treatment in Mesothelioma
Radiation therapy could be a component of the pleural mesothelioma patient’s treatment plan. It can reduce the likelihood that cancer will return after surgery.
Radiation therapy uses ionizing radiation that damages DNA in cells and kills them. It is available prior to or after surgery.
Doctors often mix it with chemotherapy to increase surgical outcomes. It can also help reduce symptoms such as breath shortness by shrinking tumors.
External beam radiation therapy
This treatment makes use of x-rays or particles that come from an outside device to eliminate cancerous cells. It can be used prior to or after surgery and chemotherapy to eliminate cancerous cells in the affected region. It can also be employed as a palliative therapy to ease symptoms such as breathing problems. It is difficult to treat mesotheliomas with radiation without causing damage to healthy tissue because they don’t create one distinct tumor. However, newer techniques are helping to overcome this problem.
Radiation specialists use computers to create precise images of the tumor as well as nearby healthy tissues. These images assist them in deciding how much radiation to apply 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 types of EBRT involve having treatments five days a week for a period of weeks, but some patients require less treatments. Each session lasts between 15 and 30 minutes. However most of the time is spent preparing the patient for treatment.
The type of EBRT that is used to treat mesothelioma will rely on the location of the tumors and the health of the patient. It could be a standard EBRT, known as three-dimensional conformal radiotherapy (3D-CRT) or a more advanced technique such as intensity modulated radiation therapy (IMRT). In some instances it could be paired with a more specific method such as stereotactic body radiation therapy to treat larger tumors, or with other treatment options like intraoperative radiation therapy to treat smaller tumors that can’t be surgically removed.
Another option for treating radiation is proton beam radiation therapy, which involves aiming particle beams (like protons or the helium particles) at the tumour from various angles. This allows more precise targeting of the tumor’s site and limits the damage to healthy tissues and organs in the vicinity. In Australia proton radiation treatment for mesothelioma has not become common.
A different kind of radiation, intraoperative radiation therapy (IORT) is used in conjunction with surgery to try and kill any mesothelioma which could not be removed surgically. This is a fast procedure that takes only a few moments to perform.
Intensity-modulated Radiation Therapy (IMRT)
IMRT is a procedure that allows doctors to treat tumors without harming healthy tissue. The treatment uses a medical linear acceleration (LINAC) device that emits X-rays or photons to target the tumor. The machine rotates around the patient, allowing the beam to be placed on several different angles to ensure that every area is being treated. This allows the doctor to administer a higher dose to the tumor while protecting the surrounding healthy tissues from damage.
IMRT is used in combination with Image-Guided Radiation Therapy (IGRT) which aids the physician to target the exact area of cancer. IGRT utilizes computerized imaging such as CT scans or X-rays, together with MRI scans, if available to assist the radiation oncologist locate mesothelioma and its surrounding areas accurately. Once the target area is located, the IMRT system can be used to produce an individual treatment plan that targets mesothelioma.
The IMRT system allows the doctor to tailor treatment according to the specific anatomy of each patient, thereby reducing the adverse effects. Radiation oncologists typically give patients five daily IMRT treatments every week, lasting between five and eight consecutive weeks. Each session lasts between 15 and 30 minutes. The small amount of radiation given on a daily basis helps to reduce the damage to the body’s normal tissues. It is important to remember that a break on weekends is usually required so that the body’s healthy tissues are able to recover.
The IMRT technique showed good results for patients with mesothelioma in the neck and head. It is particularly useful for tumours that are close to radiosensitive structures like the parotids. A recent study has found that IMRT could deliver a high dose of radiation to the tumor without causing damage to the parotid. The parotids that were protected were able to recover to 63% of their pre-treatment levels, compared to only 3% for patients who received conventional radiation. This is a promising result, but more research is needed. Large-scale studies using IMRT will be required to confirm the early findings.
Brachytherapy
Radiation can shrink a tumor, and also reduce symptoms if doctors are not able to eliminate the mesothelioma. This is known as palliative treatment. Doctors use it in conjunction with other treatments such as chemotherapy and neoadjuvant therapies to maximize a patient’s lifespan.
Radiation therapy utilizes x-rays generated by an equipment outside of the body to kill cancerous cells. With the development of new techniques such as IMRT doctors can better target the region around the tumor and limit radiation damage to the surrounding tissues.
Certain forms of radiation may also be used within the body to kill cancer cells. In treating pleural mesothelioma place a radioactive source that is sealed in or near the mesothelioma. This can be done with a catheter or applicator. Doctors are able to deliver doses of radiation from a machine outside the body to target the source of. This is known as external beam radiation therapy (EBRT).
Doctors can choose to use high-dose or pulsed-dose radiation in brachytherapy. In the first, patients stay in the hospital and may receive 10-minute sessions every day for two weeks. High-dose brachytherapy is a procedure that requires a larger machine with longer exposure times is less common.
Protons are used in a different type of brachytherapy instead of x rays. Because they are physical particles protons are not absorbed by tissues as easily and may cause less damage to the surrounding areas. However, this type of radiation is more expensive and is not as widely accessible as x-rays.
Radiation therapy may be required for several weeks or more for patients suffering from mesothelioma. It can be a challenge to tolerate. Patients should talk to their doctors about any adverse effects they may experience during treatment. Patients should also consult their doctors for tips to minimize adverse effects.
As part of a multimodal treatment plan mesothelioma patients can also benefit from genetic therapy and immunotherapy. Immunotherapy can boost the immune system and mesothelioma sufferers who have undergone chemo can benefit from immunotherapies to improve their chemotherapy regimen.
Mesothelioma researchers are also looking at ways to improve mesothelioma results using radiation treatment. One approach is to combine brachytherapy with immunotherapy by injecting cells that are infused with the drug Yervoy into the chest cavity. Clinical trials have demonstrated that this treatment works. Gene therapy is an alternative treatment that involves replacing mesothelioma tumor cells with genes or repairing them in order to limit their growth and make them more susceptible to chemotherapy.
The treatment of radiation after surgery
The use of radiation therapy cannot cure mesothelioma but it can improve the outlook of the patient. If used as part a multimodal treatment plan that includes radiation therapy, it can shrink mesothelioma tumors and reduce pain and discomfort caused by cancer. It also reduces the risk of mesothelioma cells spreading after surgery or following the removal of a lung tumor (known as “seeding”).
Each session lasts for about 30 minutes. The treatment may be uncomfortable as the radiation oncologist and technicians will require positioning the patient and keep them in the correct position.
Before the session begins patients should dress comfortably. Patients should avoid wearing any metal that could affect the precision of the equipment. Patients should also consume six small meals throughout the day to avoid nausea from the treatments.
Depending on the patient’s health condition, patients may be treated with a conventional or brachytherapy version of radiation. In conventional treatment, doctors use a machine known as a linear accelerator to deliver the radiation. This is the most popular mesothelioma type of radiation therapy. It is generally used to treat mesothelioma pleural that grows on the lining of the lung.
Brachytherapy is an improved treatment that uses an implanted radiation source inside the body. The implant may be inserted temporarily or permanently. When implanting the implant, the surgeon must ensure that only cancerous tissue is targeted and not the surrounding organs.
Researchers are examining the possibility of combining radiation therapy with surgical procedures in specific mesothelioma trials that are aimed at patients suffering from mesothelioma that has been resectable. One example is the SMART trial. This treatment method is experimental and involves giving patients extrapleural pneumonectomy before the procedure of hemithoracic radiotherapy. This combination of treatments allows doctors to provide patients with higher doses and reduce the chance of post-surgical seeding of mesothelioma.
Patients with mesothelioma can experience a partial or full remission. This means that the size of the tumor has decreased or even disappeared completely. Some patients have been in remission for a number of years and have survived past their original prognosis.
PHOENIX GAMING PC