RADIATION THERAPY

RADIATION
THERAPY &
RADIATION
ONCOLOGY
RADIOTHERAPY
HISTORICAL PERSPECTIVE
1895, NOVEMBER 8

1898
1922
1950’S

1970’S
1980’S
&
1990’S
Rad

Gray
(Gy)
PRINCIPLES
TUMORS AND TISSUES
RADIOSENSITIVITY
TYPES OF RADIATION THERAPY
& ADMINISTRATION
EXTERNAL
RADIATION
THERAPY
CONSULTATION
PLANNING
TREATMENT
GENERAL SIDE EFFECTS
SKIN
SITE-SPECIFIC SIDE EFFECTS
HEAD & NECK
CHEST
BREAST
ABDOMEN

RINV:
RADIATION-
INDUCED
NAUSEA &
VOMITING
PELVIS
BRAIN
INTERVENTIONS BY CANCER TYPE
OR RADIATION SITE
• Breast Radiation: Advise the patient to avoid bras with underwires, nylon, or
lace. Instead, recommend a breathable cotton bra or camisole. Tell patients
they may use deodorant but should avoid shaving the armpits to avoid skin
irritation.

• Head or neck: If the patient complains of dry mouth, suggest an oral

mouthwash, such as a solution of 1 qt of water, 1 tsp of salt, and 1 tsp of baking
soda. Instruct the patient to swish it in the mouth and spit it out, repeating
several times a day. Some patients may need a prescription mouthwash. If
appropriate, advise patients to see a dentist before radiation treatment starts to
check for severely decayed teeth or an oral infection, as these could be a source
of infection during treatment.
• Brain tumor: Assess the patient for neurologic impairment, such as a change
in level of consciousness, speech, vision, balance, or strength. Check for
numbness, tingling, and seizures. Recognize that any change from baseline
assessment findings requires intervention.

• Bone involvement: Assess the patient’s pain level; effectiveness of pain

management interventions; and extremity strength, numbness, tingling, and
range of motion. Caution patients that a bone tumor impairs bone integrity,
setting the stage for fractures.

• Pelvic cancer: For younger patients with pelvic cancers (both male and
female), provide information about sexuality and possible infertility before
radiation treatment begins. As appropriate, teach them about banking
sperm or egg-harvesting options
 NURSING MANAGEMENT

• Patient & family education

• Assessment & management of symptoms

• Coordination of care

• Providing emotional support

• Allow patients to verbalize fears

EXTERNAL RADIATION THERAPY
• What to expect during tx planning, treatment & ff-up
• Address patient & family’s questions
• Inform patient about the use of oral/IV contrast, tubes or catheters,
immobilization devices (if any)
• Simple information, written copy
• Provide emotional support
• Patient safety & comfort
• Tour in the treatment room
• Atleast once a week meeting & evaluation, esp. pt w/ special issues
BRACHYTHERAPY – Gynecological
Cancers
• Pt w/ LDR placed on low-fiber diets
• Diphenoxylate atropine – to prevent a bowel movement
• Post-op pain – oral/IV medications
HDR
• Provide instructions on possible side effects, when to contact Dr, self-
care measures
• Use of water-based lubricant
• Routine vaginal dilatation – 1 year (if not sexually active)
BRACHYTHERAPY – Breast Cancers

• Educate about possible side effects, S/Sx of Infx, when to call Dr, Self-

care including dressing change

BRACHYTHERAPY – Head & Neck
Cancers
• Minimize airway obstruction

• Pain management

• Oral care

• Facilitate communication

• Multidisciplinary care: dietary & occupational consults

BRACHYTHERAPY – Prostate
Cancers
• Filter urine for dislodged radioactive seeds
• Condom use
• Avoid close contact with pregnant women & children for designated
period
• The nurse informs them of what to expect
during treatment, planning, and follow-up.
• Some basic questions that should be
addressed.
• Let the patient know if oral or IV contrast
will be used, or if any tubes or catheters
will be necessary for planning .
• Inform them of any markings or tattoos
that they may expect.
• Patients may choose to have family
members or significant others present at
the time of consultation.
• If the patient is not capable of making
informed decisions a person who is
authorized to do must be available.
• Weigh patients weekly on the same scale. If appropriate, refer them to a
dietitian. Be aware that patients who have difficulty swallowing and
maintaining adequate nutrition and hydration may need a percutaneous
endoscopic gastrostomy tube.
• A dehydrated patient may require I.V. fluids. Teach the patient to report
dehydration signs and symptoms, such as weakness, dizziness, and decreased
urine output. If the patient reports diarrhea or vomiting, assess for volume
depletion and check orthostatic vital signs and weight. Document the color of
the patient’s urine. Be aware that patients who complain of dysuria may
require a urinalysis to rule out infection.
• If your patient has prolonged watery diarrhea, consult the primary healthcare
provider about ordering antidiarrheal drugs and perhaps a low-residue diet.
• Patients with prolonged nausea and vomiting need anti nausea medication to
prevent dehydration.
CONCLUSION