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** (0:11)
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My guest this week is Dr. Sanjay Mehta. Sanjay is a radiation oncologist at St. Joseph's Medical Center in Houston, Texas, where he's been in practice for more than 20 years. 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. We talk about some of the very interesting applications that I only learned about recently that are very common outside of the United States that involve low-dose radiation to treat inflammatory conditions and athletic injuries. Now, of course, those of you who are interested may recall that because this podcast is called The Drive, I do occasionally talk about cars. Given that Sanjay and I have a shared passion for them, and in fact, that's how Sanjay and I met, we do end this discussion with a little bit of a deep dive into cars. But of course, back to the main point of this discussion, we talk about the evolution of breast cancer, including the shift from radical mastectomies to more conservative approaches like lumpectomies and sentinel node biopsies. We talk more broadly about the role that radiation plays in modern oncology, how doses have changed, and how advancements in targeting tumors while minimizing damage to surrounding tissues have rendered side effects much more rare, certainly more rare than they were even 20 to 25 years ago. Sanjay talks about the role of low dose radiation for inflammatory conditions such as arthritis and tendonitis, and how this approach is more widely used outside of the US, and why it's his hope and mine that becomes more adopted here in the US. We speak about the history and misconceptions of radiation exposure, including radiophobia, nuclear accidents, and early uses of radiation. So without further delay, please enjoy my conversation with Dr. Sanjay Mehta.
Sanjay, welcome back to Austin.

**Sanjay Mehta** (2:51)
Thank you, Peter. Pleasure to be here.

**Peter Attia** (2:53)
I think this is the first time we're together not driving, right?

**Sanjay Mehta** (2:56)
I think so, yeah. That is true.

**Peter Attia** (2:59)
I don't know, somehow we're going to resist the urge for most of this discussion to not talk about cars.

**Sanjay Mehta** (3:04)
Don't want to bore your audience.

**Peter Attia** (3:05)
I know. It is called the drive.

**Sanjay Mehta** (3:07)
This is true.

**Peter Attia** (3:08)
So I feel like we will reserve the right to have some automotive discussions at the end. For listeners, Sanjay might be one of the most knowledgeable human beings on cars. He's also a very dangerous friend to have because he's always the bad one on the shoulder when you're contemplating a new set of wheels or a new something for your cars. But in his other life, in addition to being the founder of MD Motorheads, right?

**Sanjay Mehta** (3:38)
That's right.

**Peter Attia** (3:38)
Yeah. Which is a Facebook group of doctors who are gearheads.

**Sanjay Mehta** (3:43)
We're about to crack 3,000 members. It's exploded. Yeah.

**Peter Attia** (3:46)
That's awesome. So shout out to MD Motorheads. You're also a radiation oncologist, which we also spend some time talking about.

**Sanjay Mehta** (3:52)
Right.

**Peter Attia** (3:53)
I guess we thought it would be a really fun idea to do a podcast for a couple of reasons. One is just the bread and butter of what you do as a radiation oncologist is a bit of a black box to many people. Myself included, if I'm going to be completely truthful, even training in surgical oncology, I feel like I had much more familiarity with the medical side of oncology than I did with the radiation side of oncology. So for myself, for the audience, I think it will be wonderful to understand more as it's a field that has evolved a lot. I'm guessing the last 25 years has seen a lot of change.