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Brachytherapy is a type of radiation therapy that can be used to treat mesothelioma and asbestos-related lung cancer. It involves inserting a small object inside or near a tumor to irradiate it from the inside. This is as opposed to traditional radiation therapy in which an external beam of radiation is aimed at a tumor, but has to penetrate through healthy tissue to get to the cancer cells.

This internal type of radiation has had some success in treating mesothelioma, but research shows it is better for treating lung cancer. Using radiation internally is not standard treatment, but studies are beginning to make it clear that this treatment has the potential to increase life expectancy for someone with mesothelioma or lung cancer.

Radiation and Brachytherapy

Radiation therapy is one of the three main kinds of treatments used for patients with cancer, including those with mesothelioma. Radiation is a type of energy and it can be used to kill living cells. The standard way of using radiation to kill cancer cells and shrink tumors is to aim a beam of high-energy radiation at the part of the body with the tumor. This means that the radiation has to penetrate healthy skin and other tissues to get to the tumor and kill cells.

In some ways this is more targeted than chemotherapy, in which drugs are given systemically. The drugs can circulate through the whole body killing cancer cells and healthy cells. Radiation therapy is more targeted, but there is still a significant risk of harming healthy tissue, especially if the tumor is deep within the body and hard to reach. Radiation can kill healthy cells, but can also damage the genetic material in healthy cells, which increases the risk of those cells becoming cancerous. Patients have developed secondary cancers after undergoing radiation therapy.

One way to make radiation even more targeted is to implant a small device inside a tumor. The device then gives off radiation from within the tumor, killing those cells. The type of radiation emitted by the device does not travel very far, so any risk of harm to healthy cells is minimal and highly localized. Brachytherapy is often combined with surgery. The surgery is usually done first to remove as much of the tumors as possible. It may also be combined with traditional radiation therapy.

Benefits of Brachytherapy

As compared to traditional radiation therapy, there are some important benefits of brachytherapy. Because the radioactive material is placed directly inside the tumor or inside the body near the tumor, higher doses of radiation can be administered more directly to the cancer cells. Traditional therapy is directed from outside the body, and puts healthy cells at risk of damage. This means that lower doses must be used. With higher doses used in brachytherapy, the treatment may be more effective at shrinking the tumor.

Other benefits are that there are typically fewer side effects with brachytherapy, again because healthy cells are less affected by the radiation. Treatment and recovery time may also be shorter with brachytherapy than with traditional radiation therapy. In studies of brachytherapy used for lung cancer patients, survival times were extended as compared to patients who did not receive this type of therapy. Brachytherapy may also help patients with mesothelioma or lung cancer get relief from symptoms by shrinking the sizes of tumors.

Risks and Complications

One of the benefits of brachytherapy is that it causes fewer side effects for most patients than traditional radiation therapy does. Because the radiation is more localized it harms fewer healthy cells, a major source of side effects in traditional radiation therapy. One of the major sources of complications with brachytherapy is the surgery needed to insert the device. Surgery of any type can lead to infections, pain, bleeding, and other complications.

Still, the side effects are minimal with brachytherapy. The most common side effect is pain and tenderness at the site of the insertion of the device. Temporary brachytherapy implants may cause a patient to give off radiation, which means that a hospital stay with limited visitors may be necessary to protect other people. In most cases, though, the amount of radiation given off is limited and is mostly restricted to the area of the tumor.

Types of Brachytherapy

There are a few different types of brachytherapy that 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 place in the body. These are implanted in a woven surgical mesh during the initial surgery done to remove tumors. The seeds give off low doses of radiation for up to three months. The amount of radiation emitted will slowly decrease and the seeds will 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 again. With high-dose radiation, the device is usually inserted through a small incision and left there for about 20 minutes before being pulled out again. The insertion site may be a little sore, but this procedure does not usually cause lasting pain or complications. The patient can return to normal activities right away, although fatigue may be an issue.

Brachytherapy for Lung Cancer and Mesothelioma

Few studies have been conducted to determine the effectiveness of brachytherapy in treating mesothelioma. For those that have been done the results are mixed, but show potential. In one study, for instance, brachytherapy combined with surgery was not found to slow or stop the growth of mesothelioma in a group of patients. More research is expected to be done, especially since brachytherapy shows such promise for treating lung cancer.

Lung cancer seems to respond well to treatment with brachytherapy. In one study of over 100 patients found that about 25 percent survived more than five years after the treatment. With more traditional treatments, only about 15 percent of lung cancer patients survive that long.

Brachytherapy is a treatment that aims to deliver radiation to tumor cells without the need for using an external beam. The radiation is targeted and more localized, which minimizes side effects and damage to healthy tissue. It also may help kill more cancer cells, but it does need to be combined with surgery. While the results are so far mixed for treating mesothelioma, brachytherapy does show great promise as a treatment, especially for those patients living with lung cancer caused by asbestos.

Page edited by Dave Foster

Dave has been a mesothelioma Patient Advocate for over 10 years. He consistently attends all major national and international mesothelioma meetings. In doing so, he is able to stay on top of the latest treatments, clinical trials, and research results. He also personally meets with mesothelioma patients and their families and connects them with the best medical specialists and legal representatives available.

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