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Radiation Treatment in Mesothelioma

Radiation treatment may be part of a pleural mesothelioma patients treatment plan. It can reduce the chance that cancer will recur after surgery.

Radiation therapy utilizes ionizing radiation that damages DNA in cells and kills them. It can be administered before or after surgery.

Doctors often combine it with chemotherapy to improve the success of surgery. It can also help reduce symptoms such as breath shortness by shrinking tumors.

External beam radiation therapy (EBRT)

The treatment involves x-rays, or particles from a machine that are outside the body to kill cancer cells. It is offered prior to or after chemotherapy and surgery to kill cancer cells in the area, or as a treatment to alleviate symptoms like shortness of breath. It can be difficult to treat mesotheliomas with radiation without damaging healthy tissue because they don't form one distinct tumor. However, newer techniques are helping to overcome this issue.

Radiation specialists use computers to create precise images of the tumor and adjacent healthy tissues. These images aid in deciding how much radiation to apply and where it should be directed. This information is used by a large machine to position the radiation beam over the tumor precisely. Certain patients may require more treatments, but generally EBRT requires five treatments per week over the course of a few weeks. Each session is between 15 and 30 minutes, although the majority of the time is spent ensuring that the patient is in the proper position for treatment.

The type of EBRT used for mesothelioma depends on the location of the tumor 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 like intensity modulated radiation therapy (IMRT). In some instances, it can be combined with a specific treatment method, such as stereotactic radiation therapy for larger tumors or with other treatments methods like intraoperative radiation treatment for smaller tumors that can't be treated surgically.

Another option for treating radiation is proton beam radiation therapy, which involves aiming particle beams (like protons or Helium Ions) at a tumour from various angles. This allows for more precise targeting of the tumor's site and minimizes damage to healthy tissues and organs in the vicinity. In Australia proton radiation treatment for mesothelioma has not become widely used.

A second type of radiation, called intraoperative radiation therapy (IORT), is used in conjunction with surgery to try and kill any mesothelioma which could not be removed surgically. It's a quick procedure that takes just less than a few minutes to carry out.

Intensity-modulated Radiation Therapy (IMRT)

For patients with pleural mesothelioma, IMRT allows the doctor to treat the tumor while preserving healthy tissue. It is a procedure that uses an medical linear accelerator (LINAC) machine that creates photons, also known as X-rays, to target the tumor and its surrounding tissue. The machine rotates to allow the beam to be positioned at different angles, so that all areas are treated. This allows the doctor to deliver a higher dose to the tumor while also protecting healthy tissues from being damaged.

IMRT is utilized in combination with Image-Guided Radiation Therapy (IGRT), which helps the physician to pinpoint the exact location of the cancer. IGRT makes use of computerized imaging like CT scans or Xrays, along with MRI scans when they are available to help the radiation oncologist locate the mesothelioma as well as surrounding areas precisely. Once the area of interest is located, IMRT can be used to create an effective treatment plan that targets the mesothelioma treatment options precisely.

The IMRT system allows the doctor to tailor treatment to the unique anatomy of each patient, thereby reducing the side effects. Radiation oncologists typically give patients five daily IMRT treatments per week, for between five and eight consecutive weeks. Each session lasts between 15 and 30 minute. The small amount of radiation given on a daily basis helps reduce damage to the body's normal tissues. It is also important to note that a weekend break is usually required so that the body's healthy tissues are able to recover.

The IMRT technique produced positive results for patients with mesothelioma in the head and neck. It is especially beneficial when tumors are located close to radiosensitive structures, such as the parotids. A recent study found that IMRT could deliver a large dose of radiation to the tumor without damaging the adjacent 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 however more research is required. To confirm these preliminary results, large-scale IMRT trials will be required.

Brachytherapy

Radiation can shrink a tumor, and also reduce symptoms if doctors are unable to remove asbestos mesothelioma treatment. Palliative care is what this is called. Doctors use it in conjunction with other treatments such as chemotherapy and neoadjuvant therapy in order to prolong the life of a patient.

Radiation therapy involves the use of x-rays to kill cancerous cells that are a part of an outside machine. With the development of new techniques like IMRT, doctors can better concentrate on the area around the tumor and limit radiation damage to the surrounding tissues.

Certain types of radiation can be utilized inside the body to kill cancer cells. In brachytherapy, doctors place an enclosed source of radioactive radiation in or near the mesothelioma. This can be done with a catheter or applicator. Doctors can give radiation doses from a machine that is outside the body to target the source. This is called external radiation therapy (EBRT).

Doctors can use either high-dose or pulsed-dose radiation in the treatment of brachytherapy. With the former, patients stay in the hospital and receive 10-minute sessions every day for two weeks. High-dose brachytherapy is less common because it requires a bigger device and longer exposure times.

Protons are used in a different type of brachytherapy, instead of the x-rays. Because they are physical particles, protons are not absorbed by the tissue as easily and may cause less damage to the surrounding areas. This type of radiation however, is more expensive and not as easily accessible as the x-rays.

Mesothelioma patients may have to undergo radiation therapy for several weeks or more. This can be very difficult to tolerate. Patients should discuss with their doctor any adverse reactions they may experience during treatment. Patients should also ask 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 improves your immune system. Patients with mesothelioma who have previously received chemotherapy may benefit from immunotherapies.

Mesothelioma researchers are also looking into other ways to improve mesothelioma results using radiation treatment. One approach is to combine brachytherapy and immunotherapy by injecting cells which are infused with the drug Yervoy into the chest cavity. Clinical trials have proven that this treatment works. Gene therapy is a different method that involves reprogramming mesothelioma cancer cell genes or repairing them to stop their growth and make them more vulnerable to chemotherapy.

Radiation therapy after surgery

Radiation therapy is not an effective treatment for mesothelioma however it can greatly improve the patient's chances of survival. If used as part an approach to treatment that includes multiple options, radiation can shrink mesothelioma tumors and decrease the discomfort and pain caused by cancer. It also reduces the risk of mesothelioma cancer cells spreading during surgery or following the removal of a pulmonary tumor (known as "seeding").

Each session lasts about 30 minutes. The treatment may be uncomfortable due to the radiation oncologist and technicians will need to position the patient in a certain position and hold them in place.

Before beginning a session, patients should dress comfortably. Avoid wearing jewelry as it could interfere with the precision and accuracy of the equipment. In addition, patients should take small meals throughout the day to avoid nausea caused by the treatments.

Based on the condition of a patient and health, the patient may be treated with a traditional form of radiation or brachytherapy. During conventional treatment doctors utilize a machine called a linear accelerator deliver the radiation. This is the most common mesothelioma treatment. It is usually used to treat pleural mesothelioma, which develops in the lung's lining.

Brachytherapy is mesothelioma treatable an advanced treatment that uses an energy source that is placed inside the body. The implant can be permanently or temporarily put in. When inserting the implant, the surgeon must ensure that only cancerous tissue is targeted, and not the organs surrounding it.

In a few mesothelioma clinical trials researchers are exploring the possibility of the possibility of combining radiation therapy and surgical procedures for patients with mesothelioma that is resectable. One example is the SMART trial. This treatment method is experimental and involves providing patients with extrapleural pneumonectomy prior to hemithoracic radiotherapy. This combination of treatments allows doctors to provide patients with higher doses and reduce the chance of post-surgical seeding of mesothelioma.

A mesothelioma patient may suffer a complete or partial remission. This means that the tumor radiation treatment in mesothelioma size has decreased or even disappeared completely. Some patients have been in remission for many years and have lived to the end of their initial prognosis.