Exploring Radiation-Induced Toxicities from a Nursing Perspective

New Brunswick, N.J. – June 22, 2022 – Radiation therapy uses high doses of radiation to destroy cancer cells. Unfortunately, receiving this type of treatment for cancers in the pelvic region can cause painful inflammation of the rectum, called radiation proctitis (RP). Dorothy N. Pierce, DNP, NP-C, CRN, CBCN, a nurse practitioner in the Department of Radiation Oncology at Rutgers Cancer Institute of New Jersey, highlights the role of advanced practice nurses (APNs) in providing supportive care for patients experiencing RP, which will be presented as a poster at the upcoming 2022 American Association of Nurse Practitioner (AANP) National Conference in Orlando, Florida from June 21 to June 26.

Why is this topic important to explore?

Most patients diagnosed with cancer will receive radiation therapy sometime during their cancer journey. Regrettably, an unusual number of patients who receive pelvic radiation therapy for various pelvic malignancies suffer from significant radiation-induced toxicities that impact the patient’s quality of life (QOL). In addition, these survivors exhibit a range of psychological, physical, and supportive care needs that exist many years after diagnosis and completion of active treatment. Although new devices and emerging radiation therapy technologies exist, radiation side effects can occur months to years after treatment ends. Therefore, radiation oncology (RO) clinicians can best prepare survivors with education about long-term and late occurring effects such as RP. Likewise, non-oncology clinicians should be mindful of RP when assessing pelvic RT patients who present with diarrhea and bleeding.

What role do nurses play in providing support for patients suffering from RP?

Radiation oncology nurses play a crucial role in assessing contributing factors and providing effective symptoms management, information, and counseling about radiotherapy side effects to patients and their caregivers. Primarily patient-related risk factors may include genomic, previous abdominal surgery, tumor size, and inflammatory bowel disease. In addition, RO nurses are well situated to offer detailed education information to patients who received radiation therapy to the pelvic region.

What are the implications of your findings?

Many patients diagnosed with cancer face numerous psychosocial issues at diagnosis, pre-radiation, during, and post-treatment. The multidisciplinary team approach to cancer care is essential. The RO APNs have unique responsibilities such as disease-specific patient assessments, patient education, site-specific side effects management, and medication management, making active and post-treatment follow-up care essential. As radiotherapy continues to make technological advances and the opportunity for curative intent suggests that the role of RO nurses will become even more critical. Thus, advancing knowledge and research is paramount to site-specific side effects in this area to stay current.