Radiation Therapy

Radiation refers to the emission and wavelike propagation of energy into space or through a material medium. X-ray therapy is also known as radiotherapy. It is the application of ionizing radiation for medical purposes in order to control cancerous cells.

At some point during the course of their illness, radiotherapy is administered to more than 80% of all cancer patients.

 The principal radiation agents are:

• X-ray which consists of electromagnetic radiation produced by waves of electrical energy traveling at a very high speed.
• Radium, which is a radioactive isotope occurring freely in nature and the artificially induced radioactive isotopes.
• They are produced by bombarding the isotopes of elements with highly energized particles in a cyclotron.
• The radiation used medically consists of alpha, beta and gamma rays.

Radiotherapy may be used as a primary, an adjuvant or a palliative treatment.

1. Primary modality: It is the sole method of treatment and tries to eradicate cancer locally (including early-stage Hodgkin's disease, skin cancer, prostate cancer, and cervix carcinoma).

1. As an Adjuvant treatment, RT can be applied either before or after surgery to further the elimination of cancer cells. Additionally, it can be used in conjunction with chemotherapy to treat disease in locations like the brain that are difficult to reach for systematic chemotherapy.

1. As a Palliative treatment modality, RT can be used to reduce pain caused by obstruction, pathologic fracture, spinal cord compression and metastasis. It can be applied as a therapeutic or palliative measure.

Types of Radiation Therapy

• External beam radiation therapy
  • The administration of radiation from a source that is some distance away from the target site is known as teletherapy or external beam RT.
  • In the RT department, high energy X-ray or gamma-ray machines are used to administer it.
  • High energy radiation has a skin sparing effect, which means that the majority of the radiation's effects occur inside tumors rather than on the skin's surface.

• Internal Radiation Therapy
  Internal radiation, also known as brachytherapy, is the process of dispersing radioactive substances like radium within tissues or body cavities or by giving them to patients orally or intravenously.

• Multi- field therapy
  The main objective of this therapy is to kill the lesion while causing minimal damage to the healthy tissue.

• Conformal radiation therapy
  In order to produce a high dose area of radiation that conforms to the shape of the target, such as the prostate, it refers to a method of treatment delivery that combines rigid immobilization and three-dimensional computer planning and treatment system.

Side Effects of RT

• Radiodermatitis: Acute and ongoing skin inflammation may be brought on by radiation.
• Cancer of skin: Many workers have developed skin cancer as a result of their exposure to radium and X-rays.
• GI response: Enteritis, diarrhea, and cramps may result from RT's significant effects on the patient's capacity to consume, digest, and absorb nutrients.
• Nervous system: Radiation edema in the CNS, which is easily treated by steroids and painkillers, may cause an increase in ICP.
• GU system: The symptoms of radiation cystitis and urethritis include frequent urination, urgency, and dysuria.
• Respiratory system: Radiation pneumonitis, which is characterized by a dry, hacking cough and fever, may appear 2–3 months after the start of treatment.
• CVS: Chest wall radiation can occasionally result in rare complications like pericarditis and myocarditis.
• Psycho-emotional:
  • Fatigue; as cancer cells are destroyed by RT, waste products are released into the bloodstream, which causes fatigue.
  • Pain is brought on by tissue necrosis.

 Care of Patients Undergoing Radiation Therapy

 External RT:

• Nursing treatment focuses on reducing GI discomfort, avoiding infection, and preventing skin disintegration.
• Heavy metal-containing medications shouldn't be used topically because they can enhance radiation exposure.
• During the initial treatment, the radiologist will typically tattoo or outline the treatment region. The patient is recommended to stay away from extremes of temperature, whether hot or cold, if the radiation dose was high and skin blanching or discoloration was the result.
• Apply cornstarch to dry, itchy skin.
• Hair loss could happen if any area of the head is treated. The quantity of radiation a person receives determines the extent of their alopecia. Scarves and cute wigs might be useful.

References

• https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/radiation/radiation-therapy-guide/what-is-radiation-therapy.html
• https://www.cancer.gov/about-cancer/treatment/types/radiation-therapy/radiation-fact-sheet
• www.cancer.net › Navigating Cancer Care › How Cancer is Treated
• Mandal, G. (August 2013). A Textbook of Adult Health Nursing (2nd ed.). Dilllibazar kathmandu: Makalu publication house. Retrieved August 2013
• www.webmd.com › Lung Cancer › Guide