The evolving role of radiation: advancements in cancer treatment, emerging low-dose treatments for arthritis, tendonitis, and injuries, and addressing misconceptions | Sanjay Mehta, M.D.

Peter Attia

Apr 7, 2025

Episode description

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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 selec

Episode description

View the Show Notes Page for This Episode

Become a Member to Receive Exclusive Content

Sign Up to Receive Peter’s Weekly Newsletter

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 selec

Mindsip insights from this episode:

Address radiophobia rooted in US Cold War fears

The intense fear of radiation is largely a US-based phenomenon, partly fueled by Cold War fears and lobbying from the oil industry against nuclear power.

Utilize adjuvant radiation therapy to prevent keloid scar recurrence

For debilitating keloid scars, adjuvant radiation therapy (e.g., 12 Gray) immediately after surgical resection is highly effective at preventing the fibroblasts from causing a recurrence.

Utilize IMRT to protect brain areas during radiation therapy

Using intensity-modulated radiation therapy (IMRT), it's now possible to treat the whole brain while carving out and protecting critical areas like the hippocampi to prevent cognitive decline.

Survive bone-only cancer with modern treatments

Patients with cancer that has metastasized only to the bones, even with widespread disease and extremely high tumor markers, can sometimes live for a very long time with modern treatments.

Reevaluate flawed linear no-threshold model for radiation risk

The widely accepted 'linear no-threshold' model for radiation risk, which assumes any dose is harmful, is likely erroneous and based on disproven fruit fly studies from the 1940s.

Utilize AI tests to reduce unnecessary prostate therapy

New AI-based tests like Artera can analyze pathology slides to better stratify risk, potentially allowing a quarter of intermediate-risk prostate cancer patients to avoid androgen deprivation therapy.

Utilize low-dose radiation to heal injuries and reduce inflammation

Routinely used in Germany, a low dose of radiation—typically 3 Gray total over six sessions—has a powerful anti-inflammatory effect for treating tendinitis, arthritis, and plantar fasciitis.

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