Radiation therapy utilizes high-energy particle beams to eradicate cancer cells within a targeted area and prevent them from spreading throughout the body. Radiation has been shown to shrink mesothelioma tumors, relieving associated pressure and pain. Oncologists utilize “targeted” therapy — only exposing specific areas of the body to minimize damage to healthy cells. As a result, patients report fewer side effects than other forms of treatment, like chemotherapy.
There are several advantages to using this type of therapy for malignant mesothelioma. Radiation may be administered during any stage of the disease, as both a curative treatment to extend life or as a palliative treatment to make the patient more comfortable. Similar to other treatment options, radiation can be used alone or combined with surgery or chemotherapy. When following surgery, adjuvant radiation therapy has shown increased survival times, as it kills any remaining cancer cells not removed during the surgery. According to a 2009 study, patients who received a combination of surgery and radiation lived six months to a year longer than those who only underwent surgery.
3 Ways Radiation Therapy Can Benefit Mesothelioma Patients
- Improving overall survival: A 2018 meta-analysis published in the International Journal of Radiation Oncology compiled nine years of studies from the National Cancer Data Base on patients with malignant pleural mesothelioma. The results: patients who underwent adjuvant radiation therapy — or radiation after surgery — survived longer than those who had surgery alone.
- Seeding prevention: Some studies indicate that it is possible for microscopic cancer cells to metastasize (or spread) to other areas of the body during surgery. This is called “seeding.” To combat this, oncologists may deliver radiation therapy to prevent new tumor growth.
- Easing discomfort: As the cancer progresses, tumors grow larger and press against internal organs, leading to pain and discomfort such as breathing difficulties. Radiation therapy is often used to shrink those tumors, especially for patients who can’t undergo surgery to remove them.
Administering Radiation Therapy to Mesothelioma Patients
Radiation treatments are delivered in two ways: externally and internally. External beam radiation therapy (EBRT) is the most common and involves using an external machine to direct high-energy radiation beams into specific areas of the body. Brachytherapy, or internal radiation, involves placing radioactive material inside the body on or near the tumor.
EBRT is the most common form of radiation therapy used to treat mesothelioma. The procedure is noninvasive and generally done on an outpatient basis. Typically, patients will receive radiation five times a week. Appointments last between 10 to 30 minutes. Patients may notice relief from specific symptoms after just one or two visits.
How to Prepare for Radiation Treatments
- Rest: Radiation therapy is usually administered in brief, concentrated doses over a period of three to four weeks. This treatment can tax the immune system, causing patients to feel more tired than usual. This exhaustion can last for several weeks after treatment, so it’s important to schedule extra time off to allow the body to rest and rejuvenate.
- Plan meals: Treating areas near the abdomen or throat can cause digestive issues or lead to a temporary loss of your ability to taste food. Spicy and chewy foods can be tough to swallow. Oncologists suggest eating a bland diet of soft foods for a few weeks.
- Ask for help: Side effects from radiation therapy can last for several weeks after the treatment ends. Simple tasks like cleaning, running errands, doing laundry, or cooking can feel exhausting and overwhelming. It may help to gather a small group of family members and close friends who can help with daily or weekly errands and chores.
What to Expect During Treatment
Shortly before your first appointment, you’ll meet with your oncologist and a radiation therapist. Together, they’ll design a treatment plan that works specifically for you. This process may be referred to as “radiation simulation” and involves taking images and making small marks around the treatment area to ensure your body is in the ideal position.
Radiation therapy is not invasive, and the process is similar to having an X-ray. Patients lie down on a table in the exact same position each time to ensure the radiation reaches the correct area of the body. In some cases, a radiation therapist will use an immobilization device — like a head or neck cradle — to prevent excess movement.
Once your body is correctly placed, the therapist will move into a control room where he or she can administer the radiation and watch the treatment from a television monitor. You may hear the machine click or make soft whirring sounds as it moves around the table. There is a microphone in the treatment room, so you may ask questions or talk at any time.
The radiation therapist will work with your oncologist to monitor your treatments. This monitoring will help the medical team see how your body is responding to the treatment and determine if any changes need to be made during therapy. For example, if any tumors shrink significantly, your therapist may decide to adjust the treatment area, making it smaller to avoid damaging nearby healthy cells.
Radiation Side Effects
As with any treatment, patients may experience both short-term and long-term side effects from radiation therapy. These vary depending on the type of mesothelioma the patient is fighting, the size of the area that is exposed, and the length of treatment. Receiving radiation isn’t painful, but the side effects can be uncomfortable. It’s important to keep track of any symptoms you are experiencing and talk to your doctor if you’re feeling uncomfortable. There are medications that can provide relief both during and after treatment.
Common radiation side effects include:
- Hair loss: Hair follicles are sensitive and don’t respond well to radiation therapy. Two to three weeks after treatment, patients may experience temporary or even permanent hair loss in and around the targeted treatment areas.
- Skin irritation: Red, irritated skin is a common symptom for more than 80 percent of patients receiving radiation. This type treatment often causes the skin to peel away faster than it grows back, leading to blisters and even ulcers. Radiation-induced dermatitis usually heals within two to four weeks after therapy. Talk to your doctor if your reaction is severe.
- Fatigue: Radiation therapy destroys both healthy and cancerous cells, which can stress your immune system and cause mild to extreme exhaustion. This tiredness often increases, so it’s important to get plenty of rest during therapy.
Radiation affects each patient differently. Your oncologist can determine if this type of therapy will work for you.