Reanne Booker on Factors to Consider When Discussing Palliative Radiation

There are a variety of factors to consider when discussing palliative radiation with a patient with cancer, explains Reanne Booker, MN, NP.

“It’s really important that we consider a patient’s goals and wishes and to make sure that our treatment aligns,” she said in an interview with Oncology Nursing News®.

Booker is a nurse practitioner with the palliative and end-of-life care services program at the Foothills Medical Centre at Alberta Health Services in Calgary, is a PhD candidate at the University of Victoria in British Columbia. She recently performed a literature review on palliative radiation, the findings of which were published in the Clinical Journal of Oncology Nursing.

In the discussion, Booker broke down some key factors to consider when helping a patient decide if palliative radiation would be beneficial for them. She outlined some potential reasons a patient might not need or benefit from this therapy, as well as some of the symptoms that may be alleviated with this this therapy.

Booker noted that it can take approximately 4 weeks for patients to realize the benefits of palliative radiation, so for patients who have a shorter prognosis (days or weeks), this may not be the best treatment. In addition, patients considering this treatment must be able to tolerate laying still on a hardtop table for at least 15 minutes. Some patients may have conditions which would make this intolerable, in which case, palliative radiation would not be appropriate.

Moreover, depending on the treatment site, it may be necessary to place a mask over the patient’s face, which can cause anxiety and claustrophobia for some. Patients and providers should also consider the logistics of traveling to and from the cancer center for palliative treatments. Depending on where a patient lives, and the amount of time they want to spend in transit, this can also represent a barrier to care.

There are many different symptoms and conditions which can be improved with palliative radiation, Booker noted. For example, patients with brain tumors may be able to better manage headaches, seizures, and neurologic dysfunction, and for patients with head and neck tumors, palliative radiation can help with pain or bleeding, difficulty swallowing, and shortness of breath.

Patients with lung tumors may experience improved pain, coughing, or bleeding symptoms. Palliative radiation may also help with obstructive pneumonia or superior vena cava syndrome. This treatment is also favored for patients with gynecological and genital urinary cancers, as it can help with pain, bleeding, reduce blood in the urine, and urinary outlet obstruction, and it has been known to improve these symptoms in patients with rectal cancers as well.

Reference

Booker R. Palliative radiation therapy: the role of radiation therapy in palliative and end-of-life care. Clin J Oncol Nurs. 2022;26(6):628-635. doi:10.1188/22.CJON.628-635