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Friday, June 3, 2011

2011 New Advances in Mesothelioma Radiation Therapy



Mesothelioma is a serious cancer, most commonly found in the outer lining of the lungs called the mesothelium that occurs in individuals exposed to airborne asbestos fibers. Mesothelioma is highly aggressive and is resistant to many standard cancer treatments making it a difficult disease to treat effectively.

Even after decades of mesothelioma treatments, there are still no cures for the disease and historical methods for controlling its progression have not been very effective.  The prognosis for patients is usually grim: the average survival time varies from 4 – 18 months after diagnosis.

1. Radiation


This is one of the primary treatments for mesothelioma, lung cancer and many other cancers.  It is used to control the growth or spread of the cancer, attempt to cure cancer and for palliative care to reduce pain or other symptoms caused by cancer.  Now, according to the National Lung Cancer Partnership, advances in radiation therapy have made this treatment option “much safer and more focused than ever before.” Malignant pleural mesothelioma, a pulmonary cancer directly related to inhaling asbestos fibers, often has a complex growth pattern making surgery and radiation therapy difficult since pinpointing the malignant cells is difficult.  The mesothelioma tumors are often located close to other organ which limits the ability of the oncologists to order radiation treatment in high enough doses to successfully attack the cancer.  However, the latest innovations in radiation offer tools to allow these deep-seated tumors to be targeted with greater precision, limiting damage to the surrounding tissue.  Some of the latest radiation options that enable highly accurate treatments that are fine-tuned to treat cancer and avoid healthy tissues include:

2. Stereotactic Body Radiation Therapy. 



SBRT uses three-dimensional coordinates which offers a high degree of precision offering very high doses of extremely precise, ionizing radiation.  The accuracy maximizes the cell-killing effect on the targeted cells while sparing adjacent normal tissues.   While SBRT is used in some practices, some believe it needs further research to prove its effectiveness.

3. Proton Therapy
  



Proton beam therapy is now touted as one of the most effective ways to irradiate tumors in mesothelioma patients and lung cancer patients.  Proton therapy in mesothelioma patients can be used to give a better limitation of the dose in lung tissue and the tissue can thus, facilitate a higher tumor dose.  Patients treated with proton therapy also experience minimal to no side effects. Proton therapy uses a beam of protons instead of x-rays to deliver the radiation to the tumor site.

4. Intensity-Modulated Radiation Therapy (IMRT)



IMRT is advancement on 3-Dimensional Conformal Radiation (3DCRT) that allows even more accurate delivery of radiation, as well as more fine-grained control of the dose delivered. IMRT enables the radiation oncologist to conform the radiation beams to tumors that are actually wrapped around other structures.   The real-world effects of IMRT are still being investigated.

While radiation is used as part of a tri-modal treatment including surgery and chemotherapy, it is also often used for palliative care for end-stage mesothelioma and lung cancer patients.  At this point, radiation is intended to control pain, stop bleeding, and relieve pressure, even though the cancer can no longer be controlled. These innovations, however, offer hope that radiation therapy can eventually lead to a curative treatment for mesothelioma.

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