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Brachytherapy is a type of radiation therapy that can be used to treat mesothelioma and asbestos-related lung cancer. This type of therapy involves inserting a small object inside or near a tumor to irradiate it from the inside. This differs from traditional radiation therapy which involves an external beam of radiation aimed at a tumor that must penetrate healthy tissue to get to cancer cells.
Brachytherapy is not often used to treat mesothelioma. Research suggests it is better suited for treating lung cancer. Using radiation internally is not standard treatment, and studies are mixed results that this treatment has the potential to increase life expectancy for patients with mesothelioma or lung cancer.
Radiation and Brachytherapy
Radiation therapy, which utilizes concentrated energy to kill cancer cells, is one of three main kinds of treatments used for patients with cancer. Usually, radiation is used to kill cancer cells by aiming a high-energy beam at the part of the body with the tumor. This means the radiation must penetrate healthy skin and other tissues in order to reach the tumor cells.
In some ways, radiation therapy is more targeted than chemotherapy, a treatment in which drugs are given systemically. Chemotherapy drugs can circulate through the whole body, killing cancer cells and healthy cells alike. However, radiation still poses a significant risk of harming healthy tissue, especially if the tumor is deep and hard to reach. Radiation can also damage genetic material in healthy cells, increasing the risk of those healthy cells becoming cancerous. Patients have developed secondary cancers after undergoing radiation therapy.
One way to make radiation more targeted is to implant a small device inside a tumor. The implanted device then gives off radiation from within, killing those tumor cells. The type of radiation emitted by the device does not travel far, making risk to healthy cells minimal and highly localized.
Brachytherapy is often combined with surgery or traditional radiation therapy.
Benefits of Brachytherapy
There are important benefits of brachytherapy, especially when compared to traditional radiation therapy. Because brachytherapy places radioactive material directly inside or near the tumor, higher radiation doses can be administered more directly to cancer cells. Traditional radiation therapy is directed from outside the body, often damaging healthy cells. This requires a lower dosage. With higher doses used in brachytherapy, treatment may shrink tumors more effectively.
Other benefits of brachytherapy are typically fewer side effects, again because healthy cells are less affected and the therapy is more focused. Treatment and recovery time may also be shorter with brachytherapy. In studies of brachytherapy on lung cancer patients, survival times were extended when compared to patients who did not receive this type of therapy. Brachytherapy may also help patients with mesothelioma or lung cancer find relief from symptoms by shrinking tumor size.
Risks and Complications
One benefit of brachytherapy is fewer side effects. Because radiation is more localized, it harms fewer healthy cells. Damage to healthy cells is a major source of side effects in traditional radiation therapy.
With brachytherapy, surgery is required to insert the device. Surgery of any type can lead to infections, pain, bleeding, and other complications.
The most common side effect of brachytherapy is pain and tenderness at the insertion site. Temporary brachytherapy implants may cause a patient to give off radiation, meaning a hospital stay with limited visitors may be necessary to protect others. In most cases, however, the amount of radiation is limited and mostly restricted to the area of the tumor.
Types of Brachytherapy
Different types of brachytherapy may be used to treat lung cancer or mesothelioma, including low-dose or high-dose, and permanent or temporary brachytherapy. The most common type used for these cancers is low-dose permanent brachytherapy. Low-dose therapy uses low doses of radiation over a long period of time.
Permanent brachytherapy involves the insertion of implants called seed implants that are left in the body. These are implanted in a woven surgical mesh during the tumor removal initial surgery. The seeds give off low doses of radiation for up to three months. The amount of radiation emitted will slowly decrease and seeds remain permanently in the chest cavity.
For temporary brachytherapy, the radioactive device is inserted into the body and left there for a short period of time before being removed. With high-dose radiation, the device is usually inserted through a small incision and left there for about 20 minutes before being removed. The insertion site may be sore, but this procedure does not usually cause lasting pain or complications. While fatigue may be an issue, the patient can return to normal activities immediately.
Brachytherapy for Lung Cancer and Mesothelioma
Few studies have been conducted to determine the effectiveness of brachytherapy in treating mesothelioma, yielding mixed results. In one study, brachytherapy combined with surgery was not found to slow or stop the growth of mesothelioma. More research is anticipated, especially since brachytherapy shows promise for treating lung cancer.
Lung cancer responds well to brachytherapy treatments. In a study of over 100 patients, approximately 25 percent survived more than five years after the treatment. With more traditional lung cancer treatments, only about 15 percent survive that long.
Brachytherapy is a treatment that delivers radiation to tumor cells without the use of an external beam. Instead, radiation is targeted and localized, minimizing side effects and damage to healthy tissue. Brachytherapy may also kill more cancer cells. However, it does need to be combined with surgery. While results mixed and inconclusive for treating mesothelioma, brachytherapy does show great promise as a treatment, especially for those patients living with lung cancer caused by asbestos.
Page Medically Reviewed and Edited by Anne Courtney, AOCNP, DNP
Anne Courtney has a Doctor of Nursing Practice degree and is an Advanced Oncology Certified Nurse Practitioner. She has years of oncology experience working with patients with malignant mesothelioma, as well as other types of cancer. Dr. Courtney currently works at University of Texas LIVESTRONG Cancer Institutes.