Mesothelioma Brachytherapy

    Along with surgery and chemotherapy, radiation therapy is one of the most commonly recommended treatments for mesothelioma. Radiation has long been a standard treatment for many types of cancer and is often used in mesothelioma patients as a palliative measure (a form of therapy that helps reduce the pain of symptoms, but does not offer a cure for the disease).

What is Radiation Therapy?

    Radiation therapy uses a form of radiation called "ionizing radiation" that is designed to kill and control the growth of cancer cells. Radiation therapy is used as a curative treatment as well as a palliative therapy to provide symptomatic relief.

    Radiation therapy is often used in conjunction with other cancer treatments such as surgery and chemotherapy. For example, radiation therapy may be administered before surgery to shrink tumors, or in conjunction with chemotherapy to improve the success of both treatments.

   There are three main types of radiation therapy: external beam radiotherapy, unsealed source radiation therapy, and brachytherapy.

Brachytherapy Treatments for Mesothelioma

    Brachytherapy is a type of radiation therapy that involves the implantation of tiny radioactive rods in or near tumors. It is most commonly used to treat cervical, breast and prostate cancers, as well as cancers of the head and neck, but has also been used to treatmesothelioma.

    An advantage of brachytherapy is that the radioactive rods placed inside tumors (often referred to as "seeds") emit radiation across short distances of approximately one centimeter. This treatment allows for the delivery of a strong and highly-concentrated dose of radiation directly to tumor cells, but causes very little damage to surrounding healthy cells and tissue. Because of this, healthy tissue is spared and side effects are less severe.

    Brachytherapy seeds are very small (about the size of a grain of rice) and insertion of the seeds is carried out under general anesthetic. This means that patients must be evaluated to ensure they are fit enough to undergo surgery. Additional tests are done to determine the size and location of tumors so that seeds can be placed for maximum effect.

    The seeds may be implanted using one of two methods. Intracavitary treatment involves inserting radioactive seeds housed in small containers into body cavities. In interstitial treatment containers are not used, and instead the seeds are placed directly into cancer tumors. For this procedure, the seeds are inserted through the use of a thin needle.

Brachytherapy Types

    There are two main types of brachytherapy treatment for mesothelioma: temporary and permanent.

When a patient undergoes temporary brachytherapy treatment, radioactive seeds are placed inside tumors for a short period of time and are then removed. If the therapy is to be permanent, the seeds are never removed. However, over time the remaining seeds produce less radiation, until eventually radiation emission ceases. Depending on the type of radioactive material used in the treatment, radiation emission will most likely end within three to 12 months.

High Dose and Low Dose Brachytherapy

    Brachytherapy treatments for mesothelioma are separated into two further types according to the strength of the dose that is administered and the duration of the treatment.

    High dose brachytherapy is administered via a catheter, with the seeds being delivered into tumors one by one at regular intervals. This treatment takes place over the course of a single session that typically takes only a few minutes to complete, and is carried out as an out-patient procedure. Patients typically receive up to 12 separate treatments over the course of two or more weeks.

    Low dose brachytherapy administers continuous low-dose radiation over several hours or even days, but the patient is given only one treatment rather than several. This is carried out as an in-patient procedure and requires at least one overnight hospital stay.

Pros and Cons of Brachytherapy

    The immediate side effects of brachytherapy treatment for mesothelioma are pain, swelling and sometimes bruising at the treatment site. These symptoms are typically mild and last for just a few days. However, there are few other side effects, and the side effects of brachytherapy are much less severe than with other types of radiation therapy.

    Brachytherapy is a non-invasive procedure because of the delivery method used to administer treatment. Patients can typically resume normal levels of activity within just a few days. People who receive this treatment also benefit from a reduced risk of developing post-operative infections and other complications that may result from more invasive surgical procedures.

    Despite the lack of side effects for patients, there are some other concerns surrounding brachytherapy. The amount of radiation emitted by patients who receive brachytherapy is very low, but patients are still advised by their physicians to avoid contact with young children and pregnant women, who are typically more vulnerable to the effects of the radiation.

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