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The Peter Attia Drive

#343 – 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.

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.77.3K Ratings

🗓️ 7 April 2025

⏱️ 132 minutes

🧾️ Download transcript

Summary

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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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Transcript

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0:00.0

Hey everyone. Welcome to the Drive podcast. I'm your host, Peter Attia. This podcast, my website, and my weekly newsletter all focus on the goal of translating the science of longevity

0:21.5

into something accessible for everyone. Our goal is to provide the best content in health and

0:26.7

wellness, and we've established a great team of analysts to make this happen. It is extremely

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important to me to provide all of this content without relying on paid ads. To do this,

0:36.6

our work is made entirely possible

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by our members, and in return, we offer exclusive member-only content and benefits above and beyond

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what is available for free. If you want to take your knowledge of this space to the next level,

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it's our goal to ensure members get back much more than the price of the subscription. If you want to

0:55.0

learn more about the benefits of our premium membership, head over to peteratia md.com forward slash

1:01.6

subscribe. My guest this week is Dr. Sanjay Mehta. Sanjay is a radiation oncologist at St. Joseph's

1:09.5

Medical Center in Houston, Texas, where he's been in practice for more than 20 years.

1:13.2

I wanted to have Sanjay on the podcast to talk about all things pertaining to radiation oncology, but also the history and some of the misconceptions around radiation exposure and radiophobia.

1:22.6

We talk about some of the very interesting applications that I only learned about recently that are very common outside of the

1:28.9

United States that involve low-dose radiation to treat inflammatory conditions and athletic

1:35.0

injuries. Now, of course, those of you who are interested may recall that because this podcast is

1:39.9

called The Drive, I do occasionally talk about cars. And given that Sanjay and I have a shared

1:45.6

passion for them, and in fact, that's how Sanjay and I met, we do end this discussion with a

1:50.9

little bit of a deep dive into cars. But of course, back to the main point of this discussion,

1:55.4

we talk about the evolution of breast cancer, including the shift from radical mastectomies

1:59.6

to more conservative approaches like lumpectomies and sentinel node biopsies.

2:03.7

We talk more broadly about the role that radiation plays in modern oncology, how doses have

2:07.7

changed, and how advancements in targeting tumors while minimizing damage to surrounding

...

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