Radiation Treatment in Mesothelioma
Mesothelioma patients may undergo radiation treatment as part of their pleural mesothelioma therapy plan. It could reduce the possibility that cancer will come back after surgery.
Radiation therapy uses ionizing radiation that damages DNA within cells and kills them. It is available prior to or after surgery.
Doctors often combine chemotherapy with it to improve the success of surgery. It can also help alleviate symptoms by shrinking tumors that cause discomfort such as breathlessness.
External beam radiation therapy
This treatment uses x-rays or particles that come from a machine outside the body to kill cancer cells. It can be utilized prior to or after surgery, chemotherapy, or both to kill cancerous cells in the affected region. It can also be used as a palliative treatment to ease symptoms such as shortness of breathe. Mesotheliomas aren’t able to grow as one distinct tumors, therefore it can be difficult to target radiation towards them while sparing healthy tissues. Newer techniques are helping overcome this problem.
Radiation experts use a computer to produce detailed images of the tumor as well as adjacent healthy tissues. These images help them determine how much radiation they should use and where to apply it. This information is used by a large machine to position the radiation beam over the tumor in a precise manner. The majority of EBRT procedures require treatments every day for a period of weeks, but some patients need fewer treatments. Each session lasts between 15 and 30 minutes. However the majority of the time is spent preparing the patient for the treatment.
The type of EBRT that is used to treat mesothelioma will depend on the location of the tumors and the health of the patient. It can be a standard EBRT called three-dimensional conformal radiotherapy (3D-CRT) or a more advanced technique such as intensity modulated radiation therapy (IMRT). In some cases it can be combined with a more specific method such as stereotactic body radiation therapy to treat larger tumors, or in conjunction with other treatment methods such as intraoperative radiation therapy to treat smaller tumors that can’t be removed surgically.
Another option for treatment is proton beam radiation therapy, which involves aiming particle beams (like protons or Helium particles) at the tumor from various angles. This allows for more precise targeting of the tumor’s site and reduces the risk of the damage to healthy tissues and organs nearby. However proton beam radiation therapy is not widely used in Australia for mesothelioma.
Another type of radiation is intraoperative radiation therapy (IORT) that is administered alongside surgery to try and eliminate any mesothelioma that can’t be removed surgically. It’s a quick procedure that takes just about a minute to complete.
Intensity-modulated Radiation Therapy (IMRT)
IMRT is a procedure that allows doctors to treat the tumor without causing harm to healthy tissue. It is a method of treatment that uses a medical linear accelerator (LINAC) machine that creates radiation, or photons to target the tumor and its surrounding tissue. The machine rotates to allow the beam to be positioned at different angles, ensuring that all areas are treated. This allows the doctor to deliver a higher dose to the tumor, while shielding the surrounding healthy tissues from being damaged.
IMRT is utilized in combination with Image-Guided Radiation Therapy (IGRT) which allows the doctor to pinpoint the exact location of the cancer. IGRT uses computerized images, like CT scans, X-rays and MRI scans if available, to help the radiation oncologist identify the mesothelioma accurately. Once the target area has been located, the IMRT can be used to develop an effective treatment plan that targets the mesothelioma precisely.
The IMRT system also allows the doctor to tailor the treatment according to each patient’s unique anatomy which minimizes the adverse effects. Radiation oncologists typically give patients five daily IMRT treatments every week, lasting between five and eight consecutive weeks. Each session is between 15 and 30 minutes. The daily dose of radiation helps to protect the body’s normal tissue. It is also important to note that a break on weekends is usually required so that the body’s healthy tissues are able to recover.
The IMRT technique has shown good results for patients with mesothelioma that affects the neck and head. It is especially useful for tumors that are located near radiosensitive structures like the parotid glands. As the results of a recent study show that IMRT allows a significant dose to be delivered to the tumor while avoiding the parotid gland. The parotids that were protected were able to recover to 63% of their pre-treatment levels compared to only 3% in patients who received conventional radiation. This is a very promising result, but further research needs to be conducted. Large-scale studies using IMRT will be required to confirm the early findings.
Brachytherapy
Radiation can shrink a tumor and decrease symptoms if doctors are unable to eliminate the mesothelioma. Palliative care is what this is known as. Doctors use it in conjunction with other treatments like chemotherapy and neoadjuvant treatments to extend the life duration.
Radiation therapy uses x-rays from a machine outside of the body to kill cancer cells. New methods, such as IMRT, allow doctors to better target the area around the tumor and limit radiation damage.
Certain types of radiation may also be used inside the body to kill cancer cells. In brachytherapy, doctors insert a sealed radioactive source within or near the mesothelioma. This can be done using an applicator or catheter. Doctors can administer radiation doses via a device situated outside the body in order to target the source. This is called external radiation therapy (EBRT).
Doctors can use either high-dose or pulsed-dose radiation for the brachytherapy. In the first, patients stay in the hospital and can receive 10 minutes of sessions each day for a period of 2 weeks. High-dose brachytherapy is a procedure that requires a larger machine with longer exposure times, is not as common.
Protons are used in a different type of brachytherapy that is not x rays. Protons are physical particles and therefore less likely to be absorbed by tissue. This could result in less damage to the surrounding area. However, this kind of radiation is more expensive and is not as widely available as xrays.
Mesothelioma patients might need to undergo radiation therapy for several weeks or more. This could be very difficult to endure. Patients should talk to their doctors about any side effects that they may encounter during treatment. They should also consult their doctors for suggestions on minimizing adverse effects.
As part of a multimodal treatment plan mesothelioma patients can also benefit from immunotherapy and genetic therapy. Immunotherapy can boost the immune system and mesothelioma patients who have received chemotherapy may benefit from using immunotherapies to boost their chemotherapy regimen.
Mesothelioma researchers are also looking into ways to improve the mesothelioma outcome using radiation treatment. Combining brachytherapy with immunotherapy is possible through injecting cells infused with Yervoy directly into the chest cavity. Clinical trials have demonstrated that this treatment is effective. Gene therapy is an alternative approach that involves fixing or replacing genes in mesothelioma cells in order to stop their growth or make them susceptible to chemotherapies.
The treatment of radiation after surgery
Radiation therapy is not a cure for mesothelioma however, it can significantly improve the patient’s chances of survival. When used as part of a multimodal treatment plan that includes radiation therapy, it can shrink mesothelioma tumors and decrease the discomfort and pain caused by the cancer. It can also reduce the chance of mesothelioma cells spreading during surgery or after the removal of a lung tumor (known as « seeding »).
treatment for sarcomatoid mesothelioma for about 30 minutes. The treatment can be uncomfortable since the radiation oncologist needs to place and hold the patient in place.
Before the session begins patients should dress in a comfortable way. Avoid wearing anything that is made of metal since it could interfere with the precision and accuracy of the equipment. Additionally, patients should consume six small meals throughout the day to prevent nausea from the treatments.
Depending on a patient’s condition depending on the patient’s condition, they could receive either a conventional type of radiation or brachytherapy. During conventional radiation treatment doctors utilize an accelerator machine to deliver radiation. This is the most popular mesothelioma type of radiation therapy. It is typically used for pleural mesothelioma, which is a cancer that develops in the lining of the lungs.
Brachytherapy is a sophisticated treatment that makes use of an energy source that is placed within the body. The implant could be placed for a short period or permanently. When placing the implant, the doctor must ensure that only cancerous tissue is targeted and not the organs surrounding it.
Researchers are exploring the possibility of combining radiation therapy with surgical procedures in mesothelioma trials that are aimed at patients suffering from mesothelioma that is resectable. One example is the SMART trial. This experimental treatment plan consists of giving patients hemithoracic radiation prior to when they undergo extrapleural pneumonectomy (EPP). This combination of treatments allows physicians to give the patient more radiation doses and decrease the risk of post-surgical mesothelioma seeding.
A mesothelioma sufferer can experience full or partial remission, which means that the tumor has decreased in size or even disappeared completely. Some patients have been in remission for several years and have lived to the end of their initial prognosis.
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