Mesothelioma Radiation Treatment
Mesothelioma radiation treatment uses X-rays and other energy beams to shrink tumors and keep the growth or spread. It can be administered at any stage of mesothelioma to serve as an option to treat the disease and prolong its the life of the patient or as an alternative treatment to ease symptoms.
Doctors may also use radiation prior to surgery in order to shrink the tumor and make it easier for surgeons to remove it. They can also use it after surgery to kill any remaining cancer cells and to avoid any recurrence.
External beam radiation therapy
Radiation therapy is the application of high-energy beams or X-ray particles to kill cancerous cells. abdominal mesothelioma treatment is difficult to target radiation at mesothelioma tumours because they tend to be small, with a few areas of tissue. New techniques enable doctors to better pinpoint the cancer and minimize the damage to other parts of the human body. Radiation therapy can also be utilized after chemotherapy or surgery to eliminate any remaining cancer cells. It can be administered by itself or as a part of a palliative treatment to treat mesothelioma symptoms like difficulty breathing and pain.
External beam radiation therapy is a form of radiotherapy external beam in which doctors use an instrument that directs radiation from outside the body to the tumor. The doctors utilize a CT, MRI, or PET scan to determine the exact location of mesothelioma. They then devise a strategy to provide radiation to the site while limiting damage to surrounding tissue. Radiation oncologists can mark your skin in tiny dots to locate the affected area. They may also mark the area to be treated, referred to as the treatment field.
You will lie down on a bed for treatment and the machine will be placed on the area of your body that is affected by mesothelioma. During the procedure you may be asked to move around. However, you will not notice or feel any movement. During the procedure, you may hear clicks or whirring noises from the machine. The radiation oncologist monitors you in a room for observation.
EBRT is usually performed every day for 5 days per week for 2 to 8 weeks. You will receive a number of treatments, based on the purpose of your treatment and the type of radiation being used. Certain EBRT treatments, like intensity modulated radiation therapy (IMRT) utilize a computer in order to precisely target the tumor and limit radiation exposure on nearby tissues.
Other forms of radiation such as proton-beam radiation, or SBRT utilize a particle instead of an X radiation. Proton beam radiation damages the DNA of cancer cells, causing them to die faster than normal cells. This kind of treatment may be more precise than EBRT, but it isn’t yet widely used to treat mesothelioma.
Intensity-modulated Radiation Therapy (IMRT)
Intensity-modulated radiation therapy employs 3-D computed tomography (CT) images of the patient as well as computerized dose calculations to align radiation beams to the three-dimensional shape of the tumor. This allows higher radiation doses to be delivered to the tumor while minimizing exposure to surrounding tissues and organs. It can also be used to treat other cancers like prostate cancer, lung cancer as well as head and neck tumors and Sarcomas.
In studies of patients with complex tumours, IMRT produced superior dose distributions and lower toxicity in comparison with conventional radiation techniques. Radiation oncologists use IMRT to determine the treatment plan for their mesothelioma patients and ensure that radiation is directed at the appropriate part of the body. Radiation oncologists meet with patients and seek informed consent before deciding if IMRT would be appropriate for mesothelioma treatments.
Together, the radiation oncologist and medical physicist design an individual IMRT treatment plan for mesothelioma. The radiation therapists then carry out the actual treatments using IMRT. During the sessions the patient lies down on a table. They may hear noises or smell odors from the equipment, but they should not feel any pain. The radiation oncologist and medical physicist remain out of the room to observe from a safe distance.
During the IMRT session, the radiation oncologist can adjust the radiation levels depending on the need to focus on the tumor. The radiation oncologist could also adjust the intensity of beams to safeguard vital structures like the heart and large vessels.
At MSKCC the MSKCC team of radiation oncologists have used IMRT to treat mesothelioma for more than a decade. Their results indicate that IMRT improves lung function, survival and reduces long-term side consequences such as radiation esophagitis and radiation pneumonitis. The mesothelioma cases studied had biopsy-proven mesothelioma pleural in the hemithorax. However, they were not candidates for P/D or resection because of impairment in lung function. They were treated using IMRT in the hemithorax with or without pleurectomy. In the group that received IMRT, overall survival was 71 percent at one year. It was 53 % at two years.
Brachytherapy
Mesothelioma is a cancer that is aggressive radiation therapy eliminates cancerous cells. It can also help shrink tumors, making them easier to remove surgically. It is a targeted procedure which uses narrow beams to prevent damaging healthy tissue nearby.
Radiation therapy can be utilized by itself or in conjunction with other treatment for cancer, such as chemotherapy. Many mesothelioma sufferers are also treated with chemotherapy in addition to lower the chance that cancer will return after surgery and make their treatment more efficient.
Brachytherapy involves inserting a radioactive material near or inside a mesothelioma tumor. This enables doctors to deliver higher doses radiation to tumor. This treatment requires hospitalization and doctors may choose to use the 137Caesium source or an Iridium source. The patient remains in a shielded room with the source for 12-24 hours. The treatment could cause short-term adverse effects, like discomfort around the site of the implant and a slight amount of bleeding around the area in which the applicator is located.
Another option is high-dose rate (HDR) brachytherapy, which involves placing multiple radioactive sources around the tumor, and then delivering a higher dose of radiation over longer periods of time. The procedure typically takes between three and five days and requires an overnight stay in a hospital. This kind of brachytherapy may cause short-term side effects. These include bleeding and soreness at the location where the applicators are placed.
Because mesothelioma often grows as multi-layered masses and is difficult to target with radiation. However, the latest technology has allowed radiation therapists to focus the beam towards mesothelioma and away from surrounding tissue.
In some cases it is possible to use brachytherapy to treat mesothelioma as part of a preoperative treatment known as Neoadjuvant or as an adjuvant following surgery to kill any mesothelioma cancerous cells that surgeons were not able to remove completely. 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 employ proton beam radiation to target the particular areas of a person’s body where mesothelioma tumors can be found. This type of treatment allows for a more precise approach and reduces the risk of exposing healthy tissues to high levels of radiation. Mesothelioma patients must discuss proton beam radiation therapy with their physicians to determine if it’s an appropriate treatment for them.
Radiation oncologists create a plan for treating cancerous tissue prior to starting the proton beam therapy. Dosimetrists utilize a computer program to calculate the exact amount of radiation required for the specific area. The doctors also determine the location in the body where to place radiation and how far into the body it needs to travel. The dosimetrists send the information on to a physicist, who makes use of a device called a synchrotron in order to accelerate protons into the energy required for treatment.
The protons are directed to the tumor through a mechanism similar to that of the CT scanner once they have reached the treatment room. The patient will be placed on a table that shifts to a position that matches the shape of the tumor. The physicist will then employ a system that rotates proton beam’s nozzle around the patient in order to ensure that the radiation reaches every area of the tumor at the most optimal angles.
A gantry device is used to shape and direct the proton beam. This device is enclosed by an immobilization frame which ensures that the patient remains still while they are being treated. A computer controls the gantry, which is monitored by a team of radiation technicians who are located in an adjacent room. The radiation oncologist may alter the treatment plan as needed during the course of weekly appointments.
Proton beam radiation penetrates the lung tissues less deeply than traditional photon radiation. This means that there is less chance of radiation-related complications such as toxicity and the growth of mesothelioma cancer cells that are resistant.
The proton beam can be used to target mesothelioma cancers in the pleural lining of the lungs and abdomen. It is vital for patients to consult with mesothelioma specialists that are familiar with proton beam radiation.
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