Mod 3

• Radiation therapy (RT) is a key component of a comprehensive cancer treatment program, with the potential to contribute to effective and appropriate care in 50 percent of all cancer cases, alone or in combination with surgery and/or chemotherapy
• Patient's rights

  • Informed consent
  • Confidentiality
  • Patient's bill of rights
• Types of patient preparation

  • Physical
  • Psychological
  • Physiological
• Informed consent


  The process of obtaining a patient's permission before conducting health care interventions
• Oral consent


  A patient verbally agrees to treatment
• Implied consent


  A patient complies with the intervention
• Written consent


  Planned, patient is stable and capable
• Guidelines in writing informed consent

  • Patient must be of legal age
  • Patient must be competent
  • Paper must not be blank
  • Non-transferrable
  • No erasures
  • Can be canceled anytime
• In radiation therapy, written consent is generally required for

  • External beam irradiation
  • Brachytherapy
  • Radiopharmaceutical therapy
• Radiation oncologist


  Explains treatment options, the benefits as well as the consequences of radiotherapy treatment before obtaining written consent
• The rights of the patients

  • Right to Appropriate Medical Care and Humane Treatment
  • Right to Informed Consent
  • Right to Privacy and Confidentiality
  • Right to Information
  • The Right to Choose Health Care Provider and Facility
  • Right to Self-Determination
  • Right to Religious Belief
  • Right to Medical Records
  • Right to Leave
  • Right to Refuse Participation In Medical Research
  • Right to Express Grievances
  • Right to be Informed of His Rights and Obligations as a Patient
• Stages of emotions as patients adjust to living with a cancer diagnosis

  • Denial
  • Anger
  • Bargaining
  • Depression
  • Acceptance
• Duty of care


  A set of good medical practices expected of health care workers. Health care workers have an obligation to provide services to patients to the best of their ability.
• Common legal terminology

  • Battery
  • Negligence
  • Malpractice
• Legal doctrines

  • Respondaet superior
  • Res ipsa loquitor
• Treatment side effects


  • Signs and symptoms
  • Causes
  • Management
• Early effects of radiation therapy

  • Skin changes
  • Fatigue
  • Diarrhea
  • Hair loss
  • Mouth problems & trouble swallowing
  • Nausea & vomiting
  • Sexual changes
  • Urinary & bladder changes
• Skin changes


  Due to radiation damaging healthy skin cells in the treatment area. Skin changes may include dryness, pruritus (itching), sunburn as well as peeling.
• Fatigue


  Being tired or weak, due to factors like anemia, medications, activity level, infection, and emotional factors.
• Diarrhea


  Frequent soft, loose or watery bowel movements, due to irradiation of the abdomen and/or pelvis.
• Hair loss


  The medical term is alopecia. Hair loss occurs in areas irradiated since radiation damages rapidly growing hair roots.
• Mouth problems & trouble swallowing


  Radiation therapy kills and damages healthy cells in the mouth, airways, and lungs, leading to issues like mouth sores, infections, dry mouth, thick saliva, stiffness, and loss of taste.
• Hair may never grow back or may begin to reappear some 3 to 6 months after irradiation. The new hair growth can be different than hair present prior to radiation therapy.
• Treatment to the head and neck can cause mouth problems and trouble swallowing. Radiation therapy kills as well as damages healthy cells in the mouth, airways, and lung. This radiation damage may extend to the parotid glands that make saliva and the moist linings of the mouth, airway, and lungs.
• Common mouth problems

  • Mouth sores or ulcers
  • Infections
  • Xerostomia
  • Tooth loss and / or tooth decay
  • Thick saliva
  • Stiffness
  • Loss of taste
• Swallowing troubles tend to appear some 2 to 3 weeks after the onset of radiation and tend to resolves some 4 to 6 weeks after treatment. Throat changes may relate to throat soreness as well as trouble swallowing due to irradiation of the epiglottis.
• Mouth sores tend to go away after radiation therapy treatment. Taste issues as well as xerostomia may resolve after several months or may remain permanent.
• Radiation therapy to portions of the small intestine, large intestine, colon, as well as parts of the brain can cause nausea and vomiting.
• Pelvic radiation may cause tissue scaring based on the dose as well as location of irradiation. Changes also include hormonal changes and are different for men and women.
• Sexual changes for men

  • Erectile dysfunction
  • Inability to father children
• Sexual changes for women

  • Uncomfortable sex
  • Vaginal dryness
  • Vaginal stenosis
  • Menopause
  • Inability to bear children
• Pelvic radiation may cause tissue cystitis (inflammation), ulcers, and infection based on the dose as well as location of irradiation. Issues may include painful urination, difficult emptying the bladder, incontinence, blood in the urine, as well as spasms.
• Late side effects begin 6 months or more after radiation therapy is over. These late side effects depend on the body site treated as well as the radiation dose received.
• Some late side effects


  • Brain changes
  • Lymphedema
  • Infertility
  • Xerostomia
  • Joint problems
  • Secondary cancer
• Brain necrosis


  Brain cells dying and forming a mass
• Late brain effects

  • Memory loss
  • Visual changes
  • Trouble thinking
  • Personality changes
• Management of brain necrosis

  1. Counseling

  2. Medications

  3. Surgery
• Infarct


  Dead cells of the brain, blockage causing lack of air delivery and necrosis (irreversible)
• Management of joint problems

  1. Exercise

  2. Physical therapy
• Factors affecting blood values of Cancer patients

  • Chemotherapy
  • Intravenous contrast