Radiation Therapy

Question 1

How does radiation work?

Answer 1

1. Goal is to destroy tumor cells while sparing normal cells
2. Breaks chromosomes so cells cannot divide and then die
3. 60% of all patient receive radiation therapy

Question 2

Cancer cells don’t repair as well as ___

Answer 2

regular cells

Question 3

tumor cells are ___ sensitive and ____ rapidly dividing

Answer 3

more sensitive

more rapidly dividing

Question 4

radio resistance

Answer 4

chemo makes cancer cells more sensitive

*after fx of rad, higher dose/fx

Question 5

three roles of rad in cancer treatment

Answer 5

currative 
neoadjuvant
adjuvant
prophylactic
palliative

Question 6

Two types of radiation

Answer 6

teletherapy- tx at a distance
brachytherapy- tx at a very short distance
*usually used as a boost
* Pt is radioactive

Question 7

4R’s of rad bio

Answer 7

Repair- cancer cells don’t repair as well
Repopulaiton- tumors dont do it as well
Redistribution- delays cells from going to mitotic phase
Reoxygenation- happens between fx doses

Question 8

ALARA

Answer 8

As Low As Reasonably Achievable

time, distance, shielding

Question 9

Planning rad therapy

Answer 9

• construction of pt immobilization devices
• simulation
• delineation of tumor volume and evaluation of field arrangements
• organ shielding and beam modification

Question 10

treatment field ____ than tumor

Answer 10

larger

Question 11

When is the patient radioactive?

Answer 11

not in external beam pt’s

yes in brachytherapy pts

Question 12

Acute Side effects

* Prep the pt mentally and tell them how to handle it

Answer 12

• occur during treatment and can be predicted form the volume of normal tissue exposed to the beam, the total dose delivered, and the sensitivity of the normal tissue to radiation
• usually clear up after the completion of treatment
• can be managed with medication

Question 13

Chronic Side effects

Answer 13

• late side effects are local, usually permanant reactions that may develop several months to years after radiation
• daily fraction tends to predict severity of chronic side effects

Question 14

Encouraging Patients

Answer 14

• educate them about TX and disease
• acknowledge their feelings
• include them as primary members or planners in their healthcare
• provide nonjudgemental support

Question 15

Radiosensitizers: IV

chemo drugs

Answer 15

• 5FU
• cisplatin
• mitomycin

** along with or before exposure

Question 16

Oral side effects

*greater risk for infection

Answer 16

-swelling and irradiation
rinse with baking soda
liquid nonsteroidal anti-inflammatory drugs
mylanta and lidocaine
some may need a break
** maintain caloric intake 
-weight and blood

Question 17

Assesment

Answer 17

-daily assessment for potential reactions
-weighing patients
-dietician
blood counts

Question 18

skin reaction focuses on

Answer 18

• pt comfort
• promotion of healing
• prevention of infection

Question 19

What contributes to fatigue

Answer 19

pain
anemia
insufficient intake
decreased activity
fever
anxiety/ depression

Question 20

Why do we use palliative radiation?

Answer 20

• reduce tumor volume/ pain
• open airway/ esophagus
• brain irradiation/ headaches, seizures, loss of motor control
• spine to relieve pain/ paralysis
• relieve bleeding/ obstruction

Question 21

childhood radiaiton

Answer 21

• greater risk of toxicity
• developmental problems
• chance of second cancer increases
• usually requires sedation

Question 22

hyperthermia tx

Answer 22

add heat

hard to get heat where you want it

Question 23

Pt teaching priorities

Answer 23

• explain process
• time frame for all procedures
• side effects to expect from tx
• how to minimize tx side effects

Question 24

geriatric considerations

Answer 24

• side effects can develop sooner and with greater severity
• increased fatigue
• social concerns
• -can be expensive
• -create hardships