What Is Radiation Therapy for Malignant Mesothelioma?

Radiation for mesothelioma is a treatment using ionizing radiation. It consists of high-energy X-rays or particles. The goal is to damage the DNA of cancerous cells and kill them. This treatment can extend survival and relieve pain for people with mesothelioma. The therapy results in tumor shrinkage and helps prevent cancer recurrence and spread.

Radiation therapy for mesothelioma uses energy beams. They enter the body at the cancer site. This disrupts the cancer’s cell growth, preventing it from spreading.

Radiation therapy for mesothelioma uses energy beams that go into the patient’s body at the site of the cancer, helping to disrupt the cellular regeneration of the cancer, preventing it from growing and spreading.

At high doses, radiation therapy damages cancer cells’ DNA. It kills them or slows their growth. This gradually affects their ability to multiply and survive. Cancer cells with DNA damaged beyond repair stop dividing or die. When the damaged cells die, the body breaks them down and removes them.

Types of Radiation for Mesothelioma

Radiation treatments for mesothelioma include external and internal therapies. Each has a variety of specific types. External beam radiation is the most common type of radiation therapy for mesothelioma. It involves aiming high-energy rays directly at malignant tumors. This noninvasive procedure effectively targets and shrinks tumors. It is often used for pleural mesothelioma.

Another type of radiation for mesothelioma is internal radiation. It involves placing radioactive material into or near the tumor. Patients receive this treatment less often than external beam radiation.

Example of external beam radiation

External Beam Radiation

External beam radiation is the most common type of radiation therapy for mesothelioma.

Image guided radiation therapy

Types of External Beam Radiation Therapy

Types of external beam radiation therapy for mesothelioma include 3-D conformal radiation therapy, image-guided radiation therapy and proton therapy.

Internal radiation therapy

Internal Radiation Therapy

Systemic radiation therapy is a type of internal radiation therapy. It can involve delivering treatment via an IV.

Brachytherapy example

Brachytherapy

Brachytherapy is a type of internal radiation therapy. It delivers radiation directly to mesothelioma tumors.

IV treatments and brachytherapy are two forms of internal radiation therapy. Knowing the types and uses of radiation therapy can help. It can improve discussions with your health care team. You can make informed decisions about the best mesothelioma treatment.

External Beam Radiation Therapy

External beam radiation therapy (EBRT) is a noninvasive procedure. It treats mesothelioma by directing high-energy rays at malignant tumors. This method is particularly effective for pleural mesothelioma. It can target large areas, shrink tumors and improve symptoms. This helps the patient.

Types of External Beam Radiation Therapy
  • 3-D Conformal Radiation Therapy: 3D-CRT imaging creates a 3D map of the tumor. It allows precise targeting of radiation beams.
  • Image-Guided Radiation Therapy: IGRT takes imaging before and after treatment. This is to adjust as the tumor position or the patient’s body changes.
  • Stereotactic Body Radiotherapy: SBRT uses one machine for imaging and radiation. It allows continuous imaging to improve accuracy and focus during treatment.
  • Intensity-Modulated Radiation Therapy: IMRT is an advanced form of 3D-CRT. It varies the intensity of the radiation beams. This allows for higher doses to the tumor. It also minimizes exposure to nearby healthy tissues.
  • Proton Therapy: This treatment uses protons, not photons. It targets mesothelioma tumors more precisely, with fewer side effects. It is available at select cancer centers.

These types of EBRT are used for mesothelioma. They can target the tumor and spare healthy tissue. IMRT is a common, precise and effective treatment. Proton therapy is less common but very effective in some cases.

Internal Radiation Therapy

Internal radiation therapy involves placing radioactive material into the body. This can be done systemically or by putting it directly into or near the tumor. It’s rarely used for mesothelioma. However, internal therapies can be an effective treatment option in specific cases.

Types of Internal Radiation Therapy
  • Brachytherapy:It implants radioactive material directly into the tumor. This delivers high doses of radiation and spares surrounding tissue.
  • Systemic Radiation Therapy: This uses an IV to deliver radioactive substances into the body. It targets cancer cells anywhere in the body.

Internal radiation therapy targets specific tumor sites. Brachytherapy may be a recommended treatment for mesothelioma. It can deliver high doses of radiation directly to tumors. This can shrink the tumors and may stop cancer from spreading. These treatments can be especially beneficial when used in conjunction with other therapies.

Radiation in Multimodal Therapy

Multimodal therapy for mesothelioma involves combining multiple treatment methods to improve patient outcomes. Radiation therapy is a key part of this approach. It’s often used with surgery and chemotherapy to boost treatment effectiveness.

Combining radiation with other therapies lets doctors target cancer cells better. This reduces the risk of recurrence and improves survival rates.

Recent studies show that radiation with surgery and chemo can help mesothelioma patients. It can extend their lives and improve their quality of life. A 2023 study may inform mesothelioma treatment. It looked at surgery for recurring tumors after radiation for non-small cell lung cancer.

Intraoperative Radiation Therapy 

Intraoperative radiation therapy gives a high dose of radiation to a tumor during surgery. This method targets cancer cells. It minimizes exposure to nearby healthy tissues. IORT is less common for treating mesothelioma compared to other radiation therapies. But it offers significant benefits in some cases.

One of the key advantages of IORT is its ability to deliver high doses of radiation in a single session. This helps mesothelioma patients. It can target leftover cancer cells after tumor removal. Using radiation during surgery cuts the risk of cancer returning. It can also make the treatment more effective.

IORT is a promising option for some mesothelioma patients. But its use depends on the tumor’s traits and the treatment plan. Doctors will consider the tumor’s location, disease stage, and your health. These factors will help them decide if IORT is a good part of your therapy plan.

Radiation Therapy After Surgery

Adjuvant radiation therapy is radiation after surgery. It targets any remaining cancer cells that surgery missed. This therapy is vital for treating mesothelioma. It can lower the risk of recurrence and improve survival rates. 

In the first meeting, you’ll talk with a radiation oncologist. They will discuss the best approach for your case. Imaging scans will find any remaining tumors’ size, shape, and location. Your oncologist will use these images to create a safe and targeted treatment plan. The goal is to kill residual cancer cells and limit harm to healthy tissue.

Radiation therapy is usually done on an outpatient basis. Sessions are scheduled 1 or more times a week for several weeks. A medical professional will guide you through each step. This includes positioning, protective coverings, and applying the radiation. Follow-up appointments are vital. They check for side effects and the treatment’s effectiveness through imaging scans.

Surgery for Mesothelioma After Radiation Therapy

The surgery for mesothelioma after radiation therapy involves a two-step plan. First, treat pleural mesothelioma patients with a high dose of intensity-modulated radiation. Then, remove the entire affected lung and lung lining in an extrapleural pneumonectomy. Reversing the usual order of surgery and radiation can extend survival rates. But this protocol has notable risks.

Research shows a median survival of 51 months for patients who had the SMART treatment. A study published in 2020 followed up with 5 SMART patients. Researchers report that 4 patients were alive after a year. One had no cancer recurrence after 2.7 years. 

The high fatality rate for EPP may make it risky for most patients. Also, the lung’s high radiation levels can be fatal. So surgery is necessary for patients after radiation treatment.

I believe that radiation therapy for mesothelioma and other asbestos-related diseases is getting better. Its benefits are improving. This treatment option holds great promise and is advancing each day.

Sean Marchese

Benefits of Radiation Therapy for Mesothelioma

Radiation therapy helps mesothelioma patients. It can extend survival, relieve pain, and prevent cancer spread. Patients can receive this treatment at various disease stages. They can use it alone or with other therapies, such as surgery and chemotherapy.

Key Benefits of Radiation Therapy
  • Improved Survival: A multimodal therapy approach that includes radiation may help some patients live 3 to 5 years longer.
  • Pain Relief: Approximately 60% of mesothelioma patients report symptom relief after radiation therapy.
  • Tumor Reduction: Radiation therapy shrinks mesothelioma tumors. It eases pain and pressure on the lungs, chest or spine.
  • Seeding Prevention: Preventive radiation along surgical cuts may limit cancer spread. Seeding is the term used for this.

Incorporating radiation therapy into the treatment plan for mesothelioma provides many advantages. Radiation therapy shrinks tumors and relieves pain. It improves patients’ quality of life. It can boost survival rates and stop cancer’s spread when used with other treatments.

Benefits of Radiation for Pleural Mesothelioma

A 2023 study reviewed outcomes for thousands of pleural mesothelioma cases. It found that radiation therapy nearly doubled 2- and 5-year survival rates. These findings show that radiation therapy may help treat pleural mesothelioma. This study also noted a reduction in complications such as fluid buildup.

Radiation is not fun, but it is bearable. The combination of targeted radiation and immunotherapy had an effect. My tumors didn’t go away, but growth slowed to a comparatively glacial pace.

A recent study found that radiation of incisions reduced spreading for pleural mesothelioma patients who had chest wall surgeries. Another study found that early-stage pleural patients lived longer if they got radiation, surgery and chemotherapy.

Can Radiation Therapy Benefit Other Mesothelioma Types?

Radiation therapy is commonly used for treating pleural mesothelioma. Its benefits for peritoneal, pericardial, and testicular mesothelioma are limited. This is due to factors related to tumor location and radiation sensitivity.

Radiation therapy is less common for peritoneal mesothelioma. The intestines, liver, and kidneys are too close. It is hard to deliver effective radiation without damaging them. Pericardial mesothelioma affects the heart’s lining. It isn’t usually treated with radiation for similar reasons. 

Testicular mesothelioma is extremely rare. It has a poor prognosis. This type of mesothelioma isn’t sensitive to radiotherapy or chemotherapy. Treatment mainly involves surgery to remove the tumor. Patients need regular check-ups to catch any recurrence.

Survivor Story
Survivor Story
Michael Cole Pleural Mesothelioma

SAbR/PULSAR Radiation Is a Success for Pleural Mesothelioma Survivor

I’ve had SAbR targeted radiation therapy and SAbR/PULSAR radiation treatment. It turned out that my SAbR/PULSAR radiation treatment at UT Southwestern in Dallas was a dramatically successful round of treatment for me, and I doubt that I would be here without it. I currently see doctors at UT Southwestern Dallas for follow ups with the radiation oncologist.

Read Michael’s Story

Side Effects of Mesothelioma Radiation Therapy

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. They include a low risk of secondary cancer.

Common Radiation Therapy Effects
  • Cough, fever and fullness of the chest (radiation pneumonitis)
  • Difficulty swallowing
  • Fatigue
  • Hair loss near the radiated area
  • Scarring of the lungs (radiation fibrosis)
  • Shortness of breath
  • Skin problems

Its high risk of radiation toxicity has sparked debate. It concerns its role in improving mesothelioma patients’ quality of life. Its damage to cell DNA kills cancer cells. It affects cancer cells more than normal ones. But, side effects from the death of healthy cells are common. Early recognition and management care can help prevent long-term issues.

Radiation therapy in the chest may cause pleural effusions. This buildup of fluid between the lungs and the chest wall can cause chest pain and shortness of breath. Research shows that radiation causes pleural effusions in 67% of cancer patients. The effusions occur on the same side of the chest. This likely results from inflammation and scarring that block drainage.

Patient holding side speaking with doctor
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What to Expect from Mesothelioma Radiation

In general, mesothelioma radiation patients first have a consult. Then, they get imaging scans. Finally, they receive outpatient treatment. Understanding the radiation therapy process can help you prepare for treatment.

Radiation Therapy Process
  1. First Appointment: You’ll meet with a radiation oncologist during the visit. They’ll discuss the best approach for your case. You might have to sign a consent form once you’re fully informed of the process and want to proceed.
  2. Imaging Scans: Doctors use imaging scans to safely and accurately apply treatments. The scans show the exact size, shape and location of tumors.
  3. Treatment: A medical professional will explain what to do before, during and after treatment. They’ll help position you and cover you to prevent radiation exposure to healthy tissue. Radiation is typically applied 1 or more times a week for several weeks.
  4. Follow-Up Appointment: Your doctor will check for side effects at follow-ups. More imaging scans help doctors check how radiation affects tumor size.

Radiation oncologists work closely with other members of a multidisciplinary cancer care team. This includes other oncologists, oncology nurses, pathologists and diagnostic radiologists. Your radiation oncologist will consult your medical team. Then, they will discuss the best approach for your case with you.

Your radiation oncologist may discuss a clinical trial with you. They may also share how recent trials can benefit you.

Is Radiation Therapy Right for You? 

There is no one-size-fits-all treatment for mesothelioma. Experts analyze many clinical studies and determine what works best in specific situations. Mesothelioma treatment guidelines help doctors choose the best treatments. They base this on the cancer type and the patient’s health.

I have a scan around once a year. One year, I was scanned twice as I was suffering a lot more pain than normal. Some [patients] at different hospitals get scanned a lot more often. I get X-rays in between also.

Doctors choose mesothelioma treatments after checking the tumor type, cell type and stage. Age, coexisting conditions, and performance status are also important. They help find the best treatment with the most benefit and least risk.

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