External Beam Radiation Therapy
Page Medically Reviewed and Edited by Anne Courtney, AOCNP, DNP This page has been fact-checked by a Doctor of nursing practice specializing in Oncology and has experience working with mesothelioma patients.
Sources of information are listed at the bottom of the article. We make every attempt to keep our information accurate and up-to-date.
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External beam radiation therapy uses high-energy particles to kill cancer cells. It is one of several types of treatment doctors may use for patients with mesothelioma, and it is often used before or after chemotherapy or surgery.[1] Radiation therapy may cause side effects, but decades of research have made it safer.[2]
Types of Radiation Therapy
Radiation therapy works by targeting tumors with a high-energy beam that kills living cells. High-energy radiation affects both cancerous and healthy cells; although, healthy cells recover better. Radiation can also cause cancer in healthy cells. Because it damages healthy tissue, radiation therapy causes several side effects.[3]
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External beam radiation is one main type of radiation therapy. This method uses external radiation aimed at the part of the body that contains the tumor. A machine, usually a linear accelerator, produces X-rays or another type of high-energy radiation, focuses it into a beam, and aims it at the correct spot on a cancer patient’s body.[3]
Another type of radiation therapy is brachytherapy. Brachytherapy uses a radiation-emitting device planted inside the patient’s body.
The small brachytherapy device is strategically placed next to a tumor. It may be permanent or temporary. Once implanted, the radiation travels only a short distance and is more focused on the tumor.[3]
Types of External Beam Radiation Therapy
There are several types of external beam radiation. Most techniques developed from recent advances allowing medical professionals to deliver external radiation more safely and accurately.
- Three-dimensional conformal radiation therapy uses imaging scans to create a three-dimensional model of a tumor before treatment. This model allows the medical team to use a computer to conform radiation delivery to the tumor’s shape. This conformity results in less damage to healthy tissue. Modulating radiation intensity improves precision even more.[4]
- Another type of external beam radiation uses proton beams rather than the photons of traditional radiation treatment. This method damages less healthy tissue than the traditional method.[4]
- Image-guided radiation uses imaging scans or small transponders implanted in the body to guide radiation to the tumor.[4]
External Radiation Therapy for Mesothelioma
External radiation is the most common type of radiation therapy used to treat cancers, including mesothelioma. It is either used after surgery or for palliative care and sometimes before surgery.
After surgery, radiation is used to destroy the remaining cancer cells. Surgery is one of the most effective ways to eliminate mesothelioma tumors; however, it is often impossible for a surgeon to remove every cancer cell.
Radiation after surgery can effectively “clean up” the area, killing any remaining cancer cells. This method extends life expectancy in patients who have undergone an extrapleural pneumonectomy.[5]
Recent research shows that using radiation before extrapleural pneumonectomy is a promising strategy. Called the SMART protocol (Surgery for Mesothelioma After Radiation Therapy), this treatment approach needs more study, but experts recommend it for some patients.[5]
Radiation treatment is also important for palliative care. When a cure is no longer possible, palliative treatments help make the patient more comfortable. External beam radiation can shrink tumors.
Cancer that infiltrates the bone can be quite uncomfortable, and radiation is generally very effective at improving this pain. As a result, patients may breathe easier or experience a reduction in pain and swelling. This is referred to as palliative radiation since the goal is the improvement of symptoms.[6]
What to Expect
If you undergo external beam radiation therapy, you can expect several steps:[7]
- The first step involves consultation by a radiation oncologist. Like the rest of your team, it is helpful to choose a radiation oncologist with experience treating mesothelioma.
- Next, you will probably need imaging scans. This could involve CT scans or MRIs, depending on the type of therapy your doctor intends.
- Technicians may mark your skin with ink to help aim the radiation beam.
- They may also fit body molds to help you stay in the correct position during the treatment. These molds also help guide the radiation beam. During the treatment, you will be guided to the correct position and put into the molds.
- Then the technician or doctor will leave the room. For their safety, they will watch from a monitor or window during treatment.
- While radiation therapy does not cause initial pain, you will be required to sit still.
The procedure only takes about fifteen to thirty minutes. You may have several such sessions on different days.
Side Effects of External Beam Radiation
Radiation therapy may cause side effects, most of which are temporary. Guided radiation, such as three-dimensional and intensity-modulated radiation, minimize damage to healthy tissues.
Because fewer healthy cells are affected, there are milder side effects. Possible acute side effects include irritation, burning, and hair loss at the radiation site.[7]
Patients undergoing radiation will often experience a loss of energy. Therapy to the chest area, as when treating pleural mesothelioma, can cause inflammation of the lungs. Lung inflammation can lead to cough or breathing difficulty.
For peritoneal mesothelioma, radiation to the abdomen can harm the bowels or bladder, leading to digestive issues or incontinence. Rarely, radiation therapy leads to secondary cancer.[8]
External beam radiation is an important part of a multi-modal treatment for mesothelioma. It can cause side effects, but more advanced radiation strategies lower risks. For someone with mesothelioma, radiation may be crucial for extending life after surgery. Radiation therapy can also help keep patients living with cancer more comfortable.
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.