Radiation therapy for mesothelioma

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is sometimes used to treat mesothelioma. Because mesothelioma spreads along and through the tissue, it is hard to focus the radiation beams on it to treat it completely. Your healthcare team will consider your personal needs to plan the type and amount of radiation, and when and how it is given.

Radiation therapy is most often given to relieve pain or control the symptoms of advanced pleural and peritoneal mesothelioma (called palliative therapy).

Canadian researchers have found that giving radiation therapy before surgery for pleural mesothelioma can significantly improve survival for pleural mesothelioma, when compared to giving radiation therapy after surgery.

Radiation therapy is not used after surgery for peritoneal mesothelioma because many of the organs in the abdomen can be damaged by radiation.

The following types of radiation therapy are most commonly used to treat mesothelioma.

External beam radiation therapy

During external beam radiation therapy, a machine directs radiation through the skin to the tumour and some of the tissue around it.

After extrapleural pneumonectomy surgery, radiation may be given to the side of the chest where the mesothelioma and the lung were removed in order to reduce the chance of recurrence.

External beam radiation therapy is not given after a pleurectomy and decortication because of the possible damage to the lung that can be caused by radiation.

Intensity-modulated radiation therapy (IMRT)

IMRT is a way of giving radiation by changing the strength, shape and pattern of the radiation beams. This helps protect surrounding tissue from radiation while giving the radiation to the areas that need the most treatment.

IMRT may be used to treat pleural mesothelioma after surgery.

Side effects

Side effects can happen with any type of treatment for mesothelioma, but everyone’s experience is different. Some people have many side effects. Other people have only a few side effects.

During radiation therapy, the healthcare team protects healthy cells in the treatment area as much as possible. But damage to healthy cells can happen and may cause side effects. If you develop side effects, they can happen any time during, immediately after or a few days or weeks after radiation therapy. Sometimes late side effects develop months or years after radiation therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of radiation therapy will depend mainly on the size of the area being treated, the specific area or organs being treated, the total dose of radiation and the treatment schedule. Some common side effects of radiation therapy used for mesothelioma are:

Tell your healthcare team if you have these side effects or others you think might be from radiation therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Questions to ask about radiation therapy

Find out more about radiation therapy and side effects of radiation therapy. To make the decisions that are right for you, ask your healthcare team questions about radiation therapy.

Expert review and references

  • Alexander HR Jr., Burk AP . Diagnosis and management of patients with malignant peritoneal mesothelioma. Journal of Gastrointestinal Oncology. 2016.
  • American Cancer Society. Malignant mesothelioma. 2016.
  • Cho BC, Feld R, Leighl O, Anraku M, Tsao MS, Hwang DM, Hope A, de Perrot M . A feasibility study evaluating Surgery for Mesothelioma After Radiation Therapy: the "SMART" approach for resectable malignant pleural mesothelioma. Journal of Thoracic Oncology. 2014: http://www.jto.org/article/S1556-0864(15)30223-9/pdf.
  • de Perrot M, Feld R, Leighl NB, Hope A, Waddell TK, Keshavjee S, Cho BC . Accelerated hemithoracic radiation followed by extrapleural pneumonectomy for malignant pleural mesothelioma. Journal of Thoracic Cardiovascular Surgery. 2016.
  • Deraco M, Elias DM, Glehen O, Helm CW, Sugarbaker PH, Verwaal VJ . Peritoneal metastases and peritoneal mesothelioma. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 115: 1761-1769.
  • Kondola S, Manners D, Nowak AK . Malignant pleural mesothelioma: an update on diagnosis and treatment options. Therapeutic Advances in Respiratory Disease. 2016.
  • National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Malignant Pleural Mesothelioma (Version 1.2016).
  • Opitz I . Management of malignant pleural mesothelioma - the European experience. Journal of Thoracic Disease. 2014.
  • Pass HI, Carbone M, King LM, Rosenzweig KE . Benign and malignant mesothelioma. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 114: 1738-1760.
  • Raza A, Huan WC, Takabe K . Advances in the management of peritoneal mesothelioma. World Journal of Gastroenterology. 2014.
  • Shukla A, Shukla A . Current therapies for malignant mesothelioma. Journal of Cancer Science and Therapy. 2014.
  • Stahel RA, Weder W, Lievens Y, Felip E . Malignant pleural mesothelioma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2010.

Medical disclaimer

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