Radiotherapy for mesothelioma

Radiotherapy uses high energy rays to kill cancer cells. It is not usually used for peritoneal mesothelioma because it causes too many side effects. But you may have a course of intensity modulated radiotherapy treatments after surgery for early mesothelioma in the chest (pleural mesothelioma), to try to stop the cancer coming back. 

In advanced pleural mesothelioma, where surgery is not possible, some people may have radiotherapy. This is to try to slow the cancer down and keep it under control. Radiotherapy may also be used to try to control symptoms in advanced pleural mesothelioma. It can help to control pain.

Some people have a few radiotherapy treatments to the area where they have had biopsies through the skin or fluid drained from their chest. This aims to stop the mesothelioma cells growing in the scar tissue. A few small studies have shown that radiotherapy used in this way prevents the mesothelioma cells from growing. We need more research to confirm how helpful radiotherapy is in this situation.

The radiotherapy treatment is given in the hospital radiotherapy department. The treatment is usually given once a day from Monday to Friday with a rest over the weekend. The length of the treatment will depend on the area you are having treated.

Radiotherapy treatment is carefully planned. Doctors may use CT and other scans to plan your radiotherapy treatment, which is called virtual simulation. Or on your first visit, they may ask you to lie under a machine called a simulator which takes X-rays and CT scans. The doctor uses either of these methods to work out exactly where to give the treatment.

During the planning session, the radiographer may make marks on your skin. They use these skin marks to line up the radiotherapy machine when you have your daily treatment.

The actual treatment only takes a few minutes. The radiographer will position you on the couch and make sure that you are comfortable. You will be left alone while you have your treatment, but the radiographer will be able to hear and see you on CCTV.

Radiotherapy doesn't hurt. You will not be able to feel it, but will have to lie quite still for a few minutes while you have treatment.

Radiotherapy for mesothelioma does not make you radioactive. It is perfectly safe to be with other people, including children, throughout your course of treatment.

You are unlikely to get side effects if you are having radiotherapy to your scar or to control symptoms.

If you are having a few weeks of radiotherapy treatment after surgery for early mesothelioma the most common side effects are

• Reddening of the skin in the treatment area
• Loss of hair in the treatment area

The most common reaction is like a mild sunburn, with redness and irritation. Having radiotherapy with, or soon after, chemotherapy may make the skin reaction worse. To help stop your skin getting sore you need to wash the treatment area with plain water only. Don't use perfumed soap or washing products unless you have discussed this with your cancer specialist, radiotherapy nurse, or radiographer.

If your skin is getting sore, tell your radiographers so they can keep an eye on it. People have different reactions to radiotherapy. Your radiographers can take steps to lessen your soreness and discomfort if they know there is a problem. There is detailed information about skin care during radiotherapy in the main radiotherapy side effects section of CancerHelp UK.

Other side effects of radiotherapy vary depending on which part of your chest is being treated. If your lower chest is treated, you may feel sick or have diarrhoea. These side effects are usually controllable with anti sickness or anti diarrhoea medicines. Ask your radiotherapy doctor for these if you need them.

If your upper chest is being treated, it is quite common to develop a dry sore throat and to have difficulty in swallowing during the treatment. If this happens, you may find it difficult to eat, or to swallow certain liquids. If you are worried about eating and drinking, you can ask your doctor or specialist nurse to refer you to a dietician.

While you are having radiotherapy, your radiographer or a physiotherapist may ask you to do particular exercises. The exercises can help to prevent stiffness and aching in the chest and shoulder, which some people develop after the treatment ends.

Like the general side effects, specific side effects can get worse towards the end of your treatment and then gradually clear up after it has finished.

Look at the radiotherapy section of CancerHelp UK if you would like to know more about this type of treatment. It tells you about

• What radiotherapy involves
• How treatment is planned
• Possible side effects

If you would like more information about anything to do with radiotherapy for mesothelioma, contact one of the mesothelioma organisations. They will be happy to help. They often have free factsheets and booklets that they can send to you. You can find details of books and leaflets on our mesothelioma reading list.

You can also contact our cancer information nurses. They would be happy to help.