Radiation Therapy for Mesothelioma: When is it Used?
Radiation Therapy for Mesothelioma: When is it Used?
Introduction
Mesothelioma is a rare and aggressive form of cancer primarily caused by asbestos exposure. It affects the thin layer of tissue that covers the majority of internal organs, particularly the lungs. Treatment options for mesothelioma typically include surgery, chemotherapy, and radiation therapy. This article delves into the specifics of radiation therapy for mesothelioma, understanding its role, the different techniques employed, potential side effects, and its efficacy in the treatment regimen.
Radiation Therapy Overview
Radiation therapy uses high doses of radiation to kill cancer cells. It works by damaging the DNA within the targeted cells, which prevents them from growing and dividing[1]. While damage can also occur in healthy cells, they usually recover more efficiently than cancer cells.
When is Radiation Therapy Used for Mesothelioma?
1. Palliative Treatment: Radiation is often used to relieve symptoms in patients with advanced mesothelioma, making it a palliative treatment. It helps reduce the tumor size, which can alleviate pain, breathing difficulties, and other symptoms[2].
2. After Surgery: Postoperative radiation aims to kill any remaining mesothelioma cells after surgical tumor removal. This approach can decrease the chances of local recurrence[3].
3. Prevention: After certain surgeries, radiation may be employed to prevent mesothelioma from occurring at the surgical sites, a phenomenon termed as "track seeding" where cancer cells might latch onto surgical incisions[4].
4. Sole Treatment: For patients who aren't surgical candidates due to health reasons or the stage of the disease, radiation might be used as the primary treatment.
Types of Radiation Therapy for Mesothelioma
1. External Beam Radiation Therapy (EBRT): This is the most common form of radiation therapy used for mesothelioma. A machine directs high-energy beams of radiation at the cancer. The machine rotates around the patient, sending radiation from many angles, focusing on the tumor while sparing as much of the surrounding healthy tissue as possible[5].
2. Intensity-Modulated Radiation Therapy (IMRT): A subtype of EBRT, IMRT allows different parts of the tumor to receive different radiation doses, making it a more precise form of treatment. It's especially useful in treating irregularly shaped tumors or those located close to vital organs[6].
3. Brachytherapy: This involves placing radioactive materials directly into or near the tumor. It's less common for mesothelioma but can be effective in certain scenarios.
Potential Side Effects
Radiation therapy is generally well-tolerated, but it does come with potential side effects[7]:
- Fatigue
- Skin redness or irritation at the radiation site
- Difficulty swallowing
- Shortness of breath
- Chest pain
- Loss of appetite
It's vital for patients to communicate any side effects they're experiencing to their healthcare team, as many can be managed or alleviated with appropriate interventions.
Efficacy of Radiation in Mesothelioma
The effectiveness of radiation therapy for mesothelioma varies based on several factors, including the disease stage, overall health of the patient, and whether radiation is combined with other treatments. Studies have shown that combining radiation therapy with surgery and/or chemotherapy---known as multimodal therapy---can improve survival rates[8]. However, due to the aggressive nature of mesothelioma, achieving complete remission solely with radiation is rare.
Recent Advances and Future Prospects
Technological advances in radiation therapy allow for more precise targeting of tumors, leading to better outcomes and fewer side effects. Techniques such as stereotactic body radiation therapy (SBRT) deliver high doses of radiation to the tumor in fewer sessions, offering another viable option for certain mesothelioma patients[9].
Additionally, ongoing research is evaluating the combination of radiation therapy with novel treatments, such as immunotherapy, to potentially boost the body's response against the cancer[10].
Conclusion
Radiation therapy remains a valuable tool in the multifaceted approach to mesothelioma treatment. While challenges exist, such as the aggressive nature of the disease and potential side effects, advancements in radiation techniques and the combination of treatments provide hope for improved patient outcomes.
Bibliography
[1]: Delaney, G., Jacob, S., Featherstone, C., & Barton, M. (2005). The role of radiotherapy in cancer treatment. *Cancer*, 104(6), 1129-1137.
[2]: Chapman, E., Berenstein, E. G., Diehl, V., & Hillerdal, G. (1997). Palliative radiotherapy in malignant mesothelioma. *Clinical Oncology*, 9(3), 189-193.
[3]: Rusch, V. W. (1995). A proposed new international TNM staging system for malignant pleural mesothelioma. *Chest*, 108(4), 1122-112