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Apr 2025
2h 12m

#343 – The evolving role of radiation: a...

Peter Attia, MD
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Sanjay Mehta is a radiation oncologist with over 25 years of experience, and is currently the president of Century Cancer Centers in Houston, Texas (drsanjaymehta.com). 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.

We discuss:

  • How radiation oncology became a distinct, rapidly evolving medical specialty [2:45];
  • Defining radiation, ionizing vs. non-ionizing, and common misconceptions about radiation exposure [5:30];
  • How radiation doses are measured, real-world examples of radiation exposure, and safety practices [9:00];
  • Radiation doses from common medical imaging tests, and why benefits of routine imaging outweigh risks [14:15];
  • Therapeutic radiation oncology: the evolution of breast cancer treatment toward less invasive surgery combined with targeted radiation [23:30];
  • Modern radiation oncology treatments for breast cancer—minimizing risks and maximizing patient comfort and outcomes [27:15];
  • How advances in radiation dosing, technology, and treatment precision have significantly reduced side effects [39:45];
  • How breast implants affect radiation treatment [44:45];
  • Radiation therapy for prostate cancer: advancements in precision, effectiveness, and patient selection criteria [48:00];
  • Radiation therapy options for inoperable prostate cancer or those seeking alternatives to surgery, and a remarkable patient case study [55:15];
  • How patients can effectively evaluate and select a high-quality radiation oncologist [1:05:45];
  • Radiation therapy for brain cancer: the shift toward precise, targeted techniques that minimize cognitive side effects, and remaining challenges [1:08:30];
  • The origins of radiophobia and how it influenced perceptions of radiation use in medicine [1:18:00];
  • Treating chronic inflammatory conditions such as tendinitis, arthritis, and more with very low-dose radiation [1:23:45];
  • Using low-dose radiation to treat spine injuries, scar tissue, fibrosis, keloids, and more [1:30:00];
  • The current barriers preventing widespread adoption of low-dose radiation therapy for inflammatory conditions [1:35:45];
  • The durability and versatility of low-dose radiation therapy in treating chronic inflammatory and arthritic conditions [1:40:45];
  • Sanjay's talent as a drummer [1:44:45];
  • Peter and Sanjay's shared passion for cars and racing [1:47:15]; and
  • More.

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