Mesothelioma Radiation Treatment
Radiation treatment for mesothelioma makes use of X radiations and other beams in order to shrink tumors, and halt their growth and spread. It is available at any stage of mesothelioma to serve as an option to treat the disease and prolong its time or as a palliative treatment to relieve symptoms.
Radiation is also used by surgeons prior to surgery to shrink the tumor, which makes it easier for surgeons. They can also use it to eliminate any cancerous cells that remain after surgery, and to stop any repeat.
External beam radiation therapy
Radiation therapy involves the use of high-energy beams or particles of X-rays to kill cancerous cell. Mesothelioma tumors often develop as small, multiple areas of tissue, which makes it hard to aim radiation at the tumor and spare nearby healthy tissues. New techniques enable doctors to more precisely target the tumour and minimize damage to the other organs of the human body. Radiation therapy can be used to eliminate cancer cells that remain after chemotherapy or surgery. It can be used on its own or together with palliative treatments to alleviate symptoms of mesothelioma, such as pain and difficulty breathing.
For external beam radiation therapy, doctors employ a device to direct radiation at the mesothelioma cancer from outside the body of the patient. The doctors make use of the techniques of a CT, MRI, or PET scan to determine the exact location of mesothelioma. They then develop a plan to deliver radiation to the area while limiting damage surrounding tissue. The radiation oncologist may mark your skin with tiny dots to aid in locating the site. They may also mark the area that needs to be treated, called the treatment field.
You will lie down on a bed for treatment and a machine will be placed over the part of your body that has mesothelioma. During your treatment you may be asked to move around a bit. But you won't notice or feel any movement. During the procedure, you could hear whirring or clicking sounds from the machine. The radiation oncologist monitors you in a monitoring room.
EBRT is typically performed once a day for 5 days each week for 2 to 8 weeks. You will receive a number of treatments depending on the aim of your treatment and the type of radiation employed. Certain treatments for EBRT, such as intensity modulated radiation therapy (IMRT) utilize computers to target the tumor more accurately and reduce radiation exposure to nearby tissues.
Other forms of radiation, such as proton-beam radiation or SBRT utilize particles instead of X radiation. Proton beam radiation causes DNA damage in cancer cells, causing them to die more quickly than normal cells. This type of treatment is more precise than EBRT but it's not commonly used to treat mesothelioma.
Intensity-modulated Radiation Therapy (IMRT)
Intensity modulated radiation therapy aligns the radiation beams to the three-dimensional shape and size of the tumor by using 3-D computed-tomography (CT). This allows for greater radiation doses to be delivered to the tumor while minimizing the exposure to surrounding organs and tissues. In addition to pleural mesothelioma treatment, IMRT can be used to treat prostate cancer, lung cancer, sarcomas and head and neck tumors.
In studies of patients with tumours that are complex, IMRT produced superior dose distributions and lower toxicity compared with conventional radiation techniques. Radiation oncologists employ IMRT to determine the treatment plan for their mesothelioma patients and ensure that the radiation is aimed at the appropriate part of the body. Radiation oncologists consult with patients and obtain informed consent before deciding if IMRT would be appropriate for mesothelioma treatments .
The radiation oncologist as well as the medical physicist collaborate to design the individual IMRT treatment plan for mesothelioma. Radiation therapists carry out the actual IMRT treatment. During the sessions, the patient lies on a table. The patient might hear noises or smell odors from the equipment, but they shouldn't feel discomfort. Medical scientist and radiation oncologist should remain in the room for a safe viewing distance.
During an IMRT session the radiation oncologist can alter the radiation levels to target the tumor better. The radiation oncologist may also alter the intensity of the beams to protect vital structures like the heart and large vessels.
At MSKCC the MSKCC team of radiation oncologists have utilized IMRT to treat mesothelioma over the past decade. Their findings show that IMRT improves lung function, survival, and reduces side effects like radiation esophagitis and radiation pneumonitis. The mesothelioma cases studied had biopsy-proven mesothelioma pleural in the hemithorax, but they were not suitable for resection or P/D due to impairment in lung function. They were treated with an IMRT procedure to the hemithorax or without pleurectomy. In the group that received IMRT the overall survival rate was 71 percent at one year, and 53 percent at two years.
Brachytherapy
The radiation therapy treatment is used to destroy cancerous cells in mesothelioma which is a deadly cancer. It can also help shrink tumors and make them easier to remove surgically. It is a kind of targeted treatment that uses narrow beams to prevent damaging healthy tissues around.
Radiation is used alone or in conjunction with other cancer treatments such as chemotherapy. A lot of patients with mesothelioma receive additional chemotherapy to decrease the risk of cancer recurring after surgery and to improve the effectiveness of their treatment.
Brachytherapy involves placing the radioactive source near or inside a mesothelioma tumor, which allows doctors to deliver a larger dose of radiation to the tumor. Doctors may utilize a 137Caesium or Iridium source for this treatment that requires hospitalization. The patient remains in a room that is shielded with the source for 12-24 hours. This treatment may cause some minor side effects, such as soreness around the site of the implant and a tiny amount of bleeding at the location in which the applicator is located.
Another alternative is High-dose (HDR) Brachytherapy which involves placing a variety of radioactive sources around the tumor area and delivering higher doses of radiation over a longer period of time. The procedure is usually carried out over a period of 3 to 5 days and requires an inpatient stay. Mesothelioma patients who undergo this kind of brachytherapy might also experience some short term side effects, including discomfort at the site of insertion as well as a small amount of bleeding at the site at which the applicators were inserted.
Because mesothelioma typically develops as a multi-layered mass, it can be difficult to treat with radiation. However, newer technology has allowed radiation doctors to more precisely aim an arc of radiation at the mesothelioma tumor and avoid surrounding tissues.
In some instances mesothelioma sufferers may be given brachytherapy as the preoperative treatment known as Neoadjuvant Therapy or as a post-surgical adjuvant treatment to kill any lingering mesothelioma tumors that the surgeon was not able to completely 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 treat mesothelioma tumors in specific areas of the body. This type of treatment allows for a more precise approach and reduces the chance of exposing healthy tissue to radiation levels that are too high. Patients with mesothelioma should discuss proton radiation therapy with their physician to determine if this is the best treatment for them.
The process of proton beam radiation begins by the radiation oncologist who develops an action plan to treat cancerous tissue. Dosimetrists make use of computers to calculate the precise dose of radiation required for the specific area. The doctors also determine where in the body to distribute the radiation and how deep into the body it must travel. The dosimetrists send the data to a physicist, who utilizes a device known as a synchrotron to accelerate protons into the amount of energy required for treatment.
The protons are directed towards the tumor via a process similar to that of the CT scanner after they reach the treatment room. The patient is placed on a table that moves to match the size and shape of the tumors. The physicist uses a system to rotate the nozzle of a proton beam around he patient in order to ensure that the radiation reaches the tumor at the best angle that is possible.
A device called a gantry is used to form and direct the proton beam. This device is surrounded by an immobilization frame which keeps the patient still during treatment. A computer controls the gantry, which is monitored by a team of radiation technicians from an adjacent room. The radiation oncologist is able to alter the treatment plan as needed during the course of weekly appointments.
Proton beam radiation penetrates the lung tissues less deeply than conventional photon radiation. This means that there is a less chance of developing radiation-related complications including toxicity and the development of mesothelioma tumors that are resistant to treatment.
The proton beam is used to target mesothelioma tumors in the pleural lining of the lungs and abdomen. It is crucial that patients consult mesothelioma experts who have expertise using proton radiation.