Mesothelioma radiation therapy is a common treatment to kill cancer cells and prevent the spread of cancer. In the treatment of mesothelioma, radiation is typically part of a multimodal plan used after surgery to kill residual cancer cells. Studies suggest that it can be successful if used before surgery. Radiation can also be used palliatively to reduce the symptoms.
Mesothelioma patients may receive radiation therapy before, during, or after the surgery to reduce tumor size or prevent the onset of cancer. Radiation alone can relieve pain and generally has fewer side effects than chemotherapy. This treatment can be used at any stage of cancer.
Radiation therapy is a common cancer treatment, including mesothelioma. Patients may undergo radiation therapy with chemotherapy and surgical intervention as part of a multimodal plan that has demonstrated improved life expectancy for patients with early-stage mesothelioma. Radiation therapy can also be used as a palliative treatment option to reduce symptoms and improve the quality of life of patients with advanced disease.
How Does Radiotherapy Treat Mesothelioma?
The main goal of radiotherapy is to improve life expectancy by preventing the spread of cancer cells. Doctors use it either in combination with other treatments or alone as palliative therapy to treat symptoms.
Oncologists have been using radiation as a cancer treatment for decades, and technological advances have made it a highly sophisticated treatment. Targeted mesothelioma radiation can kill cancer cells without causing the serious side effects that often accompany chemotherapy.
A 2016 study by researchers from the New York Icahn School of Medicine has investigated the results for thousands of patients with pleural mesothelioma. Overall survival at two and five years was nearly twice that in patients who received radiotherapy, regardless of which other treatments were used. Physicians can perform radiation therapy for patients in various stages of mesothelioma for a variety of reasons.
Benefits Of Radiotherapy For Mesothelioma
Improved survival: In combination with surgery and chemotherapy, radiation may lead to a longer life as it reduces the risk of local recurrence. Some patients live on this approach for three to five years longer.
Pain Relief: Radiotherapy relieves pain by reducing the size of mesothelioma tumors. This relieves the lungs and the chest. About 60 percent of mesothelioma patients report relief of symptoms after radiotherapy.
Seed prevention: During surgery, microscopic cancer cells can penetrate new areas. This is known as seeding. Radiation therapy along incisions is common. Even modest radiation in the places of surgery or drainage tubes can help.
Adjuvant Mesothelioma Radiation Therapy
Adjuvant treatment refers to secondary treatment. The adjuvant radiation therapy is performed after surgery to kill remaining cancer cells and prevent recurrence. Surgical resection risks recurring mesothelioma tumors, which may be prevented by the use of radiation.
Radiation can also be used in combination with surgical procedures for the prevention of seed. During surgery, microscopic cancer cells can be distributed to other areas where they can develop into tumors. Radiation can be applied to incisions and surgical sites to prevent the occurrence of vaccinations.
Surgery For Mesothelioma After Radiotherapy (SMART)
The surgery for mesothelioma after radiation therapy (SMART) is a new type of radiation that is used before surgery. A high dose of radiotherapy is given, typically at a much higher dose than normal. About six days later, surgery is performed to remove the affected tissue.
Studies suggest that this may help to limit cancer to a surgical resection area, which has been shown to succeed in extending life expectancy, especially in malignant pleural mesothelioma patients. In one study, the SMART method, combined with extrapleural pneumonectomy (EPP), extended life expectancy for stage 3 and 4 epithelioid mesothelioma patients to more than four years.
Palliative Radiotherapy
Mesothelioma patients can be palliatively treated at any time and at any time of their treatment journey to reduce symptoms and improve quality of life. Radiation for palliative use is typically used in patients with mesothelioma stage 3 or 4, when cancer has spread to reduce tumors and symptoms such as pain, shortness of breath and shortness of breath, which are caused by pressure on the lungs and abdominal organs, to reduce.
Types Of Mesothelioma Radiation Therapy
There are two main types of radiation therapy for mesothelioma, including external beam radiation therapy (EBRT) and brachytherapy, also referred to as internal radiotherapy (IBRT). Benefits and risks vary for each type, and patients should discuss the options with their medical team.
Irradiation of malignant mesothelioma can be external and internal. The inner form is called brachytherapy. The external shape is called External Radiation Therapy (EBRT). EBRT is more commonly used for pleural mesothelioma because it has proven to be more effective.
External Radiotherapy (EBRT)
External mesothelioma radiotherapy is a noninvasive procedure that uses intense radiation to fight malignant tumors. A computer is used to direct the rays to avoid healthy organs and tissues while targeting malignant tumors to damage and kill cancer cells.
One particular type of EBRT that is common in mesothelioma treatment is Intensity Modulated Radiation Therapy (IMRT), which allows the radiologist to adjust the intensity of the rays according to tumor size, location, and other factors. IMRT is also a three-dimensional radiation therapy that uses a computer-controlled machine that moves around the patient and generates radiation beams that conform to the tumor shape, allowing intense radiation to be directed to malignant tissue with minimal damage to healthy cells.
A recent study has shown that IMRT followed by extrapleural pneumonectomy can extend the patient's life expectancy to up to 39 months. By comparison, typically only about 35% of patients with pleural mesothelioma have a survival of more than one year. The beam corresponds to the 3D shape of the tumor and is delivered in several doses. This allows higher doses of radiation within the tumor while minimizing the dose to the surrounding organs and tissues.
The radiation from the outside is non-invasive and contains high-energy rays, which are directed to malignant tumors. It is performed by experienced radiologists who take into account the tumor size, location, stage of cancer and general health of the patient. The patient is irradiated from the outside.
To reduce the risk of side effects, a computer directs the radiation machine to accurately dose certain areas and not damage healthy cells.
External Radiotherapy Procedure
- Patients lie flat on a table and body parts are covered to protect against radiation.
- A technician is in another room to control the irradiation machine and to communicate with the patient via an intercom.
- The radiation machine begins administration, which is normally painless and fast for the patient.
- Irradiation usually takes place several times a week but depends on patient characteristics and other ongoing treatments.
Brachytherapy
Brachytherapy is a type of radiotherapy in which cancer cells are implanted with radioactive material in the tumor.
Doctors can place the radioactive material during a surgical procedure or using a hollow tube with the help of an imaging scan. Brachytherapy may also be used temporarily in biopsies and surgical scars to prevent the spread of cancer.
It is effective in the treatment of lung cancer when placed at a tumor site but is rarely used to treat mesothelioma. Brachytherapy is less common in the treatment of mesothelioma, but clinical studies continue to explore the potential of IBRT to improve patient prognosis. This treatment differs from EBRT in that high doses of radiation are applied directly to the tumor. As treatment in the body is more targeted, it has minimal impact on nearby healthy tissue.
There Are Two Types Of Brachytherapy, Including
Permanent Brachytherapy: Radioactive seeds are never removed, although they usually do not emit radiation after 3 to 12 months, depending on the dosage and type of radioactive material used in the treatment.
Transient Brachytherapy: Radioactive seeds are implanted for a pre-determined period of time, such as several weeks or months, prior to collection. The length of time depends on the objectives of the irradiation and the dosage.
Brachytherapy Procedure
- Radioactive seeds or rods are introduced with a metal tube or catheter near the tumor.
- Highly concentrated radiation doses are administered directly to the tumor.
- For temporary therapies, the seed removal applicator can be left in place.
- The procedure can usually be performed on an outpatient basis without hospital requirements.
- Despite low post-operative radiation exposure, patients should avoid interacting with pregnant women and young children as they are susceptible to radiation.
Impact On The Timing
Doctors use external radiation therapy at different times to achieve different effects. EBRT as a single treatment can be used at any time for pain relief. In combination with pleural mesothelioma surgery, EBRT can be used after, before, or during surgery.
Radiotherapy After Surgery
Traditionally, multimodal therapy of pleural mesothelioma begins with chemotherapy followed by surgery and then radiotherapy as the patient recovers from the surgery. In this environment, radiation is used to kill cancer cells left behind in the surgery. About half of the early stage patients with epithelioid mesothelioma can live with this treatment for more than five years.
Surgery For Mesothelioma After Radiotherapy (SMART)
This treatment approach is a reversal of the traditional protocol. It has produced impressive results for some mesothelioma patients. In a 2015 study, specialists from two leading cancer centers in Toronto estimated the 51-month median survival for patients with pleural mesothelioma using the SMART approach. About 66 percent of patients with early-stage epithelioid tumors lived longer than three years.
An experienced multidisciplinary team requires the secure implementation of the SMART approach. The lungs are heavily irradiated, which can lead to death if the lungs are not subsequently removed. This means that a patient when being irradiated performs an operation.
Intraoperative Radiotherapy
Intraoperative radiotherapy (IORT) is used as part of a surgical procedure. A radiologist applies the radiation to the affected areas to prevent germination or spreading of the cancerous cells during surgery. Immediately after removal of the tumor, a concentrated dose of radiation is delivered to the tumor site.
This option may help some patients stop treatment earlier, so there is no need for additional radiotherapy after surgery. Patients requiring additional radiation sessions may be boosted by IORT and usually have fewer complications.
Radiation Therapy Process
Most people do not know what to expect when they receive radiotherapy. In general, patients undergo initial consultation, receive imaging scans, and are then treated on an outpatient basis.
First appointment: During the consultation visit, you will meet with a radiation oncologist to discuss the best course of action for your case. You may be asked to sign a consent form if you are fully aware of the process and wish to continue treatment.
Imaging scans: To ensure accurate and safe use, imaging scans are performed to determine the exact size, shape, and location of tumors. The use of radiation is based on these images to ensure safety.
Treatment: A doctor will tell you what to do before, during and after treatment. They help with positioning and apply protective layers to prevent the radiation exposure of healthy tissue. The radiation is usually applied once or several times a week for several weeks.
Follow-up: At follow-up appointments, your doctor will check for signs of side effects. Imaging scans are performed to closely monitor how the radiation affected the size of your tumors.
Common Side Effects Of Mesothelioma Radiation Therapy
Radiation therapy is not painful during administration. During treatment, you do not have to worry about pain.
After treatment, some people may experience skin irritation in the area where radiation has been given off. All cancer treatments have side effects, It including mesothelioma radiation therapy. Patients should discuss any potential side effects with their doctor and report any adverse reactions that may occur during the treatment process. There are radioprotective drugs or other palliative treatments that can be used concomitantly to reduce the severity of the side effects of the treatment.
Side effects of radiation are mostly temporary and usually more limited than chemotherapy, which can affect the entire body. However, some side effects of radiation can be chronic and occur months or years after treatment is stopped.
Most side effects occur when tissue damage accumulates over multiple radiotherapy sessions. A single cycle can take up to eight weeks. As treatment progresses, the side effects often become more severe.
Common Side Effects Of Radiation
Skin problems: Radiation-induced irritations, also known as radiodermatitis, occur most often where the beam was focused. It can cause rashes, redness and a feeling of tightness or swelling. It may come to flaking or darkening of the skin.
Fatigue: The energy loss is usually strongest two to four hours after a radiation session. It can also peak between the third and fifth week of treatment, as the healing process requires more energy from the patient.
Other side effects may occur depending on where the radiotherapy is applied. In peritoneal mesothelioma patients nausea, vomiting, diarrhea, and loss of appetite are common even after administration to the abdomen. To combat side effects, patients should rest sufficiently, maintain a balanced and healthy diet, and discuss all supplements and medications taken with their mesothelioma specialist. It is also important for patients to take care of their skin, especially the soaps, lotions, cosmetics, and perfumes used.
Radiation Side Effects After Mesothelioma Type
Advanced radiotherapy methods can help reduce the amount of healthy tissue exposed to radiation. However, there may still be some side effects in the area where the radiation has entered the body.
The type of mesothelioma diagnosis affects how a person's body responds to radiotherapy.
Pleural Mesothelioma
Radiation treatments in the chest area may temporarily increase the symptoms of pleural mesothelioma such as shortness of breath, difficulty in swallowing and coughing. In rare cases, there may be scarring of the lung, called fibrosis. Irradiation of the breast may also cause inflammation of the lung or the lining of the heart. There is also a risk of damage to the heart muscle, which leads to heart toxicity.
Other rare complications include fluid retention (pleural effusion), collapsed lungs and calcification of the lymph nodes. Research has shown that pleural effusions if they develop at all, are usually reported within six months after the first radiation therapy.
Peritoneal Mesothelioma
Radiotherapy is of limited benefit to patients with peritoneal mesothelioma. The reason is the place. Peritoneal carcinoma includes the lining of the abdominal cavity. Radiation can be extremely toxic to the small intestine, liver, kidneys, and other organs in this area. The only type of treatment for peritoneal patients is to prevent cancer from spreading to biopsies and surgical scars.
Nausea and vomiting are the most common side effects in patients who have their abdominal irradiation. These side effects can be caused by radiation damage in the gastrointestinal tract. These side effects are also common in the patients receiving other mesothelioma treatments, especially chemotherapy. It can also lead to bladder infections, which are known as cystitis.
It can be difficult to empty the bladder completely, allow it to urinate at normal intervals, or control urine flows from the bladder when coughing or sneezing. In rare cases, the urine may appear bloody or the bladder may get cramps. These side effects can occur within three to five weeks of treatment.
Is Radiotherapy The Right Thing For You?
Despite recent advances, a number of experts question the benefits of mesothelioma radiotherapy. These concerns arise from the conflicting results that have been published in clinical trials and scientific studies.
The decision to include radiotherapy in your treatment plan is up to you and your oncologist. The potential benefits of the therapy may outweigh the risks and side effects. However, you must discuss the pros and cons with your oncologist to make an informed decision.
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