Brachytherapy
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Brachytherapy is a type of radiation therapy that can be used to treat mesothelioma and asbestos-related lung cancer. Doctors place a small object near a tumor to irradiate it from the inside of the body, which allows the radiation to be more targeted. Traditional radiation therapy uses an external beam that must penetrate healthy tissue to get to cancer cells.[1]
Radiation and Brachytherapy
Radiation therapy, which utilizes concentrated energy to kill cancer cells, is one of the three main treatments used for cancer patients. Usually, radiation kills 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 to reach the tumor cells.[2]
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 poses a significant risk of harming healthy tissue, especially if the tumor is deep and hard to reach.
Radiation can also damage the genetic material in healthy cells, increasing the risk of those healthy cells becoming cancerous. Patients have developed secondary cancers after undergoing radiation therapy.[3]
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 the risk to healthy cells minimal and highly localized. This is called brachytherapy.[4]
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.[1]
Brachytherapy typically causes fewer side effects because healthy cells are less affected, and the therapy is more focused.[1] Treatment and recovery time may also be shorter with brachytherapy.
In studies of brachytherapy on lung cancer patients, survival times were extended compared to patients who did not receive this type of therapy.[5] 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.[4]
Types of Brachytherapy
Brachytherapy can be delivered in different ways. The most common type used for mesothelioma is low-dose, permanent brachytherapy. Low-dose therapy uses low doses of radiation over a long period of time.[4]
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 initial tumor removal 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 in the chest cavity permanently.[4]
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 twenty 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.[4]
Brachytherapy for Lung Cancer and Mesothelioma
Few studies exist to determine the effectiveness of brachytherapy in treating mesothelioma. In one study, brachytherapy combined with surgery was not found to slow or stop the growth of mesothelioma.[6] 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% survived more than five years after the treatment. With more traditional lung cancer treatments, only about 15% survive that long.[5]
Brachytherapy is a treatment that delivers radiation to tumor cells without using 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 are 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.
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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.