Sharon’s Story: Cancer-Free and Back in Her Shoes

For years, Sharon Menashes has struggled with chronic aches and pains. Diagnosed with osteoarthritis in her 40s, Menashes, now 80, has faced frequent discomfort that no medication or cortisone shot could alleviate for long. Often, because of the pressure atop her feet, “I couldn't even put my shoes on,” she said. “They hurt that badly.” Osteoarthritis is a progressive disorder that typically presents with joint stiffness, pain and reduced mobility and can significantly affect quality of life. When she was diagnosed with breast cancer in 2022, the Newark, Delaware, woman chose to be treated close to home at ChristianaCare’s Helen F. Graham Cancer Center & Research Institute. During her time there, Menashes also found an unexpected solution for her arthritis. Radiation oncologist Timothy Kegelman, M.D., Ph.D., treated her with low-dose radiation therapy (LDRT), a reemerging option for relieving pain and restoring mobility. “I said, ‘If it works, why not? Let's give it a try,’” Menashes said. “Sure enough, this has given me some much-needed relief.” Today, she’s both cancer-free and back in her shoes.

At the Graham Cancer Center, innovative care extends beyond treating cancer alone — it’s about improving the whole patient’s health. Long overshadowed by pharmacological treatments in the United States, LDRT is making a comeback as a safe, effective anti-inflammatory solution for arthritis, thanks to forward-looking physicians who have embraced its evidence and potential. “Patients undergoing cancer treatment often face other medical challenges,” Kegelman said. “If we can help with something as straightforward as pain and mobility, it greatly improves their overall quality of life.”

LDRT has remained a common treatment in Germany and other parts of Europe, even as it fell out of favor in the U.S. over the past 40 years with the rise of new medications. A 2022 study reviewing international research found strong evidence that LDRT provides moderate to long-term pain relief and improves mobility in joints affected by osteoarthritis, with minimal side effects. In 2022, the Graham Cancer Center became one of the first in the U.S. to reintroduce the therapy, with other prominent institutions, including the Cleveland Clinic, launching their own LDRT treatment programs soon after.

A September 2024 paper in Practical Radiation Oncology highlighted that LDRT is particularly well-suited for older patients or those unable or unwilling to undergo invasive treatments like joint replacement surgery. The study reported significant pain relief and reduced morning stiffness after two rounds of radiation therapy, underscoring its anti-inflammatory effects and safety profile.

“Radiation works — that’s been proven,” said Laura Doyle, Ph.D., chief clinical physicist at the Graham Cancer Center. “People have been wary of using it for non-cancer conditions, but now that it’s shown to be effective, there’s a growing recognition of its value.” In addition to feet, LDRT can be used to treat hands, elbows, shoulders, knees, hips and even certain spinal cases, according to Kegelman. Cases of osteoarthritis in hands, knees and feet have responded especially well so far, he said. “It is a noninvasive way to reduce joint pain due to osteoarthritis, a very common problem for not only the U.S. population at large, but many of the patients we are treating for cancer diagnoses,” he said. Osteoarthritis patients do not need to have undergone cancer treatment at the Graham Cancer Center to be eligible for LRDT. Radiation is an approved treatment option, covered by most insurances, for joint pain that does not respond to physical therapy, medication and lifestyle changes.

At the Graham Cancer Center, LRDT follows a simple yet precise protocol: six short sessions spread over two to three weeks, with each delivering a fraction of the dose used in cancer treatments, Doyle explained. Treatments are administered using standard linear accelerators, which are widely available and familiar to radiation therapy departments, making the process both efficient and accessible. Some patients, like Menashes, may require a second cycle to achieve lasting relief. Menashes appreciated the brevity of the treatment sessions — “You’re in and out in 10 minutes or so” — and the option to return for a second round. She’s eager to schedule therapy for her left foot next. The relief has made a positive difference in Menashes’ daily life. Everyday tasks like grocery shopping are easier, and she can fully enjoy time with family and friends. The extra mobility has also made it easier to care for her energetic dog, Star.

“I’m not totally pain-free, but it’s way better than before,” she said. “I don’t feel like I constantly need to push through it.” ChristianaCare now offers LDRT at the Graham Cancer Center, and the Concord Health Center in Delaware County, Pennsylvania. To learn if LDRT is right for you, call 302-623-4800.