<p><a href="https://peterattiamd.com/sanjaymehta/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250407-pod-sanjaymehta&utm_content=250407-pod-sanjaymehta-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250407-pod-sanjaymehta&utm_content=250407-pod-sanjaymehta-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250407-pod-sanjaymehta&utm_content=250407-pod-sanjaymehta-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>Sanjay Mehta is a radiation oncologist with over 25 years of experience, and is currently the president of Century Cancer Centers in Houston, Texas (<a href="drsanjaymehta.com">drsanjaymehta.com</a>). In this episode, Sanjay explores the rapidly evolving field of radiation oncology, addressing common misconceptions about radiation exposure. He delves into radiation's critical role in modern oncology, examining recent advancements that precisely target tumors while minimizing damage to surrounding healthy tissues and reducing side effects, with specific insights into breast, prostate, and brain cancers. Sanjay discusses fascinating international practices involving low-dose radiation therapy for inflammatory conditions such as arthritis, tendonitis, and sports injuries, highlighting its effectiveness and potential for wider adoption in the United States. Wrapping up on a lighter note, Peter and Sanjay discuss their mutual passion for cars and reveal how this shared interest first brought them together.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>How radiation oncology became a distinct, rapidly evolving medical specialty [2:45];</li> <li>Defining radiation, ionizing vs. non-ionizing, and common misconceptions about radiation exposure [5:30];</li> <li>How radiation doses are measured, real-world examples of radiation exposure, and safety practices [9:00];</li> <li>Radiation doses from common medical imaging tests, and why benefits of routine imaging outweigh risks [14:15];</li> <li>Therapeutic radiation oncology: the evolution of breast cancer treatment toward less invasive surgery combined with targeted radiation [23:30];</li> <li>Modern radiation oncology treatments for breast cancer—minimizing risks and maximizing patient comfort and outcomes [27:15];</li> <li>How advances in radiation dosing, technology, and treatment precision have significantly reduced side effects [39:45];</li> <li>How breast implants affect radiation treatment [44:45];</li> <li>Radiation therapy for prostate cancer: advancements in precision, effectiveness, and patient selection criteria [48:00];</li> <li>Radiation therapy options for inoperable prostate cancer or those seeking alternatives to surgery, and a remarkable patient case study [55:15];</li> <li>How patients can effectively evaluate and select a high-quality radiation oncologist [1:05:45];</li> <li>Radiation therapy for brain cancer: the shift toward precise, targeted techniques that minimize cognitive side effects, and remaining challenges [1:08:30];</li> <li>The origins of radiophobia and how it influenced perceptions of radiation use in medicine [1:18:00];</li> <li>Treating chronic inflammatory conditions such as tendinitis, arthritis, and more with very low-dose radiation [1:23:45];</li> <li>Using low-dose radiation to treat spine injuries, scar tissue, fibrosis, keloids, and more [1:30:00];</li> <li>The current barriers preventing widespread adoption of low-dose radiation therapy for inflammatory conditions [1:35:45];</li> <li>The durability and versatility of low-dose radiation therapy in treating chronic inflammatory and arthritic conditions [1:40:45];</li> <li>Sanjay's talent as a drummer [1:44:45];</li> <li>Peter and Sanjay's shared passion for cars and racing [1:47:15]; and</li> <li>More.</li> </ul> <p>Connect With Peter on <a href="https://twitter.com/PeterAttiaMD">Twitter</a>, <a href="https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>
Actionable Insights
1. Low-Dose Radiation for Inflammatory Pain
Consider low-dose radiation (0.5 gray, three times a week for two weeks, totaling 3 gray) for chronic inflammatory conditions like tendinitis, osteoarthritis, bursitis, or plantar fasciitis, as it offers a long-lasting anti-inflammatory effect with 60-80% success and potential for retreatment after 12 weeks.
2. Radiation for Fibrotic Conditions
For Dupuytren’s contracture or Ledderhose disease, consider radiation (3 gray per fraction for five fractions, repeated after a few weeks for a total of 30 gray). For keloids, pursue adjuvant radiation (4 gray per fraction for three treatments, totaling 12 gray) immediately after surgical resection to prevent recurrence.
3. Long-Term Relief from Low-Dose Radiation
For inflammatory conditions, low-dose radiation may provide relief lasting for months to years, with some anecdotal cases reporting over a decade of relief without retreatment.
4. Advocate for Low-Dose Radiation
If suffering from chronic inflammatory or fibrotic conditions, be your own advocate and seek out radiation oncologists who offer low-dose radiation therapy, as public awareness and physician adoption are still growing.
5. Prostate Cancer Treatment Choice
When choosing prostate cancer treatment, consider radiation therapy as it offers cure rates essentially equivalent to surgery, with significant quality of life advantages such as reduced risk of incontinence and impotence.
For brain metastases, advocate for stereotactic radiosurgery (SRS) to treat only the metastatic lesions, or if whole-brain radiation is necessary, inquire about Intensity Modulated Radiation Therapy (IMRT) to spare critical areas like the hippocampus and preserve cognitive function.
7. Breast Conservation Therapy
For early-stage breast cancer, consider a lumpectomy followed by radiation therapy (approximately 40 gray in 15 fractions over three weeks) as it offers comparable survival outcomes to a mastectomy with minimized heart and lung exposure.
8. Tailor Prostate ADT with Biomarkers
For Gleason 3+4 prostate cancer, utilize Decipher or Artera AI tests to stratify risk, as favorable intermediate-risk patients may potentially avoid androgen deprivation therapy (ADT) when undergoing radiation.
9. Optimize Prostate Radiation Outcomes
To minimize side effects during prostate radiation, consistently arrive with a full bladder and empty bowel, as this separates the bladder and rectum from the prostate, allowing for more precise radiation delivery.
10. Reframe Radiation Risk Perception
Understand that the Linear No Threshold (LNT) model for radiation risk has been largely disproven; at very low doses (below 50 millisieverts), there’s almost no incidence of biological damage, and a hormesis effect may even occur.
11. Prioritize Diagnostic Scans
Do not avoid necessary diagnostic procedures like dental x-rays, mammograms, or cardiac CTs, as their benefits in detecting health issues far outweigh the minimal radiation risk.
12. Leverage Hormesis for Resilience
Engage in activities that cause a small amount of cellular damage, such as low-dose radiation, cold plunges, or saunas, as the body’s repair mechanisms can make it stronger than before the exposure.
13. Select an Experienced Radiation Oncologist
When choosing a radiation oncologist, prioritize experience in your specific cancer type, interview them thoroughly, and seek a doctor who transparently discusses all potential outcomes and side effects.
14. Localized Radiation Boost for Breast Cancer
After whole breast radiation, a localized boost of an additional 10 gray (2 gray over five days) to the lumpectomy cavity can improve local control for breast cancer patients.
15. Manage Breast Radiation Skin Reaction
Expect mild redness or sunburn-like skin reactions from modern breast radiation; use normal skincare products like Aquaphor or aloe vera, as severe dermatitis is rare compared to older treatments.
16. Prophylactic Brain Radiation for Small Cell
If diagnosed with small cell lung cancer and achieving a complete response to primary treatment, discuss prophylactic cranial irradiation (PCI) (20 gray in five fractions) to significantly reduce CNS failures and improve quality of life.
17. Localized Pain Relief for Inflammatory Arthritis
For systemic inflammatory conditions like rheumatoid or gouty arthritis, low-dose radiation can effectively reduce pain in specific affected joints, though it won’t cure the underlying systemic disease.
18. Subscribe to Premium Membership
Consider subscribing to the premium membership at peteratiyahmd.com/subscribe to take your knowledge of health and wellness to the next level and gain exclusive member-only content and benefits.