Key takeaways: Mesothelioma is an aggressive cancer that is sometimes treated with radiation.
Radiation uses high-energy particles to target and kill cancerous cells, but previous studies have
claimed its harm negates its benefits. New forms of radiotherapy are emerging that are a.) more
targeted towards tumors, and b.) prove more useful than harmful in the treatment of
mesothelioma.
How Does Radiation Therapy for Mesothelioma Work?
Radiation is only one treatment option for mesothelioma. It utilizes high-energy forms of X-rays
or other charged particles in order to kill cancerous cells. This is different from chemotherapy
because the radiation is fixed to only attack cancerous cells; chemo is a systemic treatment,
meaning that both healthy and cancerous cells are affected. Although radiotherapy is more
specialized than other treatments (in terms of its impact), mesothelioma doesn’t typically
manifest in distinct tumors, which makes radiotherapy difficult. If a patient presents with an
early case of mesothelioma with no metastasis (spread), then radiotherapy might be a viable
option.
Another scenario in which radiation is used is called “adjuvant therapy.” Directly after surgery,
doctors administer radiation to the area in order to kill any small pockets of cancer that weren’t
removed in surgery.
Lastly, traditional radiotherapy is used in palliative care. This reduces discomfort for patients by
alleviating the pressure and pain caused by large tumors, but isn’t meant to be a long-term
treatment plan. Palliative care is likely the most common outlet of radiotherapy, as it has been
established that excess radiation exposure also has carcinogenic effects. So, if radiotherapy is
only used at end-of-life to reduce discomfort, then its carcinogenic effects are mitigated.
Intensity-Modulated Radiation Therapy (IMRT)
IMRT is a relatively new edition of radiotherapy, and it’s characterized as conformal. This means
that IMRT uses a 3-D visualization of the tumor in order to target the breadth and spread of the
tumor. The radiation is given in a high-dose, but it is extremely specialized: the dose size and
spread, again, is contingent on the tumor itself. This negates previous concerns about the
effectiveness of radiotherapy, as the treatment is tailored to each patient’s needs. Because IMRT
is also administered as conformal, the likelihood of it affecting other healthy tissues is very low.
A review study detailing the advancements in radiotherapy over the past 15 years noticed a trend
in IMRT: the median survival rate with IMRT used as adjuvant therapy increased patient survival
rate significantly. This is still a new form of radiotherapy, though, and clinical trials are still
working to affirm its benefits.
External Beam Radiation Therapy (EBRT)
EBRT is the traditional form of radiotherapy used to kill cancerous cells. It is the less-specific
version of IMRT–it’s not conformal, meaning its administration isn’t 3-D and its dose doesn’t
account for the size of the tumor. EBRT is used most commonly in palliative care to reduce sites
of pain and pressure from mesothelioma tumors, which is the common imagination of
radiotherapy. Ideally, as supplemented by information from clinical trials, IMRT will
overshadow EBRT as the dominant form of radiotherapy. Its specificity, high dosage, and
relatively lower risk makes it a treatment option comparable to chemotherapy or surgery.
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Sources:
Perrot, M. de, Wu, L., Wu, M., & Cho, B. C. J. (2017). Radiotherapy for the treatment of
malignant pleural mesothelioma. The Lancet Oncology, 18(9), e532–e542.
https://doi.org/10.1016/S1470-2045(17)30459-X
Radiation Therapy for Malignant Mesothelioma. (n.d.). Retrieved February 15, 2024, from
https://www.cancer.org/cancer/types/malignant-mesothelioma/treating/radiation.htm
