Radiation Therapy for Malignant Mesothelioma

Our doctors typically give radiation therapy to treat pleural mesothelioma after an extrapleural pneumonectomy, in which a lung is removed, along with parts of the lining of the heart and chest. Rarely, they give it after pleurectomy decortication, in which the cancerous lining of the chest wall and lung are removed. Radiation therapy can also be used to alleviate pain and shrink areas of local recurrences.

Radiation therapy is used less often to treat peritoneal mesothelioma, but it may be applied to the entire abdominal area after surgery.

Our radiation oncologists use CT scans of the tumor and the surrounding tissue, in conjunction with computer software, to create a personalized treatment plan for you. This software creates a three-dimensional image of the tumor and the surrounding organs, such as the heart, esophagus, and trachea, also called the windpipe. This allows our doctors to determine how to best target the cancer, while sparing healthy tissue.

Our doctors may also use frequent CT scans during treatment to ensure that the radiation targets the malignant mesothelioma and avoids other important organs.

This approach, which is called image-guided radiation therapy, helps compensate for the movement of the lungs during treatment. The technique also enables doctors to track the size and shape of the tumor over several weeks, as radiation therapy begins to shrink the cancer.

NYU Langone doctors may use intensity modulated radiation therapy to manage malignant mesothelioma. This is a form of highly targeted external beam radiation therapy, in which a machine called a linear accelerator treats the tumor. The machine rotates around you during therapy.

This approach enables doctors to divide radiation into many small, computer-controlled beams of different adjustable strengths. Together, these beams are sculpted in three dimensions to closely conform to the size, shape, and location of the cancer.

Doctors can adjust the radiation beams within millimeters to spare surrounding healthy tissue. Treatment is delivered once daily, five days a week, for several weeks, in doses called fractions.

NYU Langone doctors are often able to avoid the side effects of radiation therapy—such as damage to nearby organs, including the heart and esophagus—by using highly targeted treatments. Side effects such as fatigue, nausea, and vomiting can often be managed with medication or through NYU Langone’s support services and integrative health services.