Can Radiation Be Used to Treat Noncancerous Conditions? 

Low-dose radiation therapy can be an innovative treatment option for chronic pain and inflammation. 

Radiation therapy is most often associated with cancer treatment and has been used to treat tumors for over 100 years. But radiation, at very low doses, is now also being used for difficult-to-treat noncancerous conditions. Low-dose radiation can reduce inflammation, ease pain and improve movement in noncancerous conditions such as arthritis. Below, Elizabeth Zhang-Velten, MD, PhD, a radiation oncologist with Keck Medicine of USC, who sees patients at Keck Medicine of USC – Newport Beach Radiation Oncology and Imaging and Keck Medicine of USC – Buena Park Radiation Oncology, answers the most common questions from patients about low-dose radiation therapy. 

What kind of doctor performs low-dose radiation therapy? 

Dr. Zhang-Velten: A radiation oncologist performs low-dose radiation therapy. Although we have ‘oncology’ in our title, we also treat a lot of noncancerous conditions. 

What types of noncancerous conditions can low-dose radiation therapy be used to treat? 

Dr. Zhang-Velten: There are several. The most common is osteoarthritis. Most people who have arthritis have osteoarthritis, which is the wear-and-tear kind of arthritis that many people end up getting in their knees, hands and/or hips as they age. Low-dose radiation therapy can be a good option for you if medications and physical therapy have not worked to treat your osteoarthritis, and if you are unable to have surgery on the affected joint. 

Low-dose radiation therapy can also be used to treat plantar fasciitis, tendinopathy, trochanteric bursitis, Dupuytren’s contracture and other chronic inflammatory musculoskeletal disorders.  

What constitutes a “low dose” of radiation? 

Dr. Zhang-Velten: The dose of radiation that low-dose radiation therapy uses is much, much lower than what you would typically see used for cancer treatment. For instance, if someone has prostate cancer, they may receive up to nine weeks of daily radiation treatment, adding up to about 80 units of radiation. Whereas for osteoarthritis, a person would get a total of six treatments, and the total radiation dose would be 3 units. So, it’s a lot lower.  

Does radiation cause side effects? 

Dr. Zhang-Velten: The benefit of low-dose radiation therapy is that side effects are lowered when you get such a tiny dose of radiation. In fact, most people do not have any acute side effects and can resume normal activities immediately after their appointments. 

How does low-dose radiation work? 

Dr. Zhang-Velten: The radiation targets the immune cells that are driving these inflammatory conditions such as osteoarthritis. For example, in patients with osteoarthritis of the knee, the inflammatory process causes the immune cells to attack and damage the knee cartilage. Not only that, but a loop is created where the immune cells react to that cartilage damage and attack the cartilage even more.  

How does low-dose radiation therapy compare to other treatments for osteoarthritis? 

Dr. Zhang-Velten: Some over-the-counter medications, such as ibuprofen, can have unintended side effects with long-term use because they affect the whole body, not just the arthritic area. For example, some people can develop gastric ulcers from long-term use of these types of medicines. For these people, low-dose radiation therapy can be a great option because it targets just the problem area, not the whole body. 

Who is a good candidate for low-dose radiation therapy? 

Dr. Zhang-Velten: We would recommend low-dose radiation therapy for patients 50 years and older who have chronic pain caused by an inflammatory condition, such as osteoarthritis in the hands, knees, hips and, in some cases, the spine. It can be a good option for people who have not found relief with anti-inflammatory medications, physical therapy or injections and those who are not candidates for surgery. 

We do not recommend low-dose radiation therapy for anyone who is pregnant or has a genetic condition that makes them sensitive to radiation, such as scleroderma. 

How many times do I need to come in for low-dose radiation therapy? 

Dr. Zhang-Velten: Most patients come in for one preparation appointment, during which we do an initial mapping CT scan of the area we are going to be treating with radiation. Behind the scenes, I draw on the CT images to create a 3-D model of your unique anatomy, which we use to optimize how the beams of radiation will be arranged. Then, for most conditions we treat with low-dose-radiation therapy, you can expect to have about five to six actual treatment appointments that last about 15 minutes each over the course of about two weeks.  

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