+ Patients requiring palliative care
- Palliative care consists of the treatment after diagnosis of incurable malignancy.1,2
- Palliative radiation therapy may be prescribed with the intention of improving patient quality of life and prolonging life1
- This may be achieved by slowing the progression of disease, and/or by reducing pain, bleeding, cough, airway obstruction or neurological symptoms2
- Palliative care is varied and may include:3
- Emergency or non-emergency care
- Short course or conventional course therapy
- Simple or complex techniques
- Effectiveness of palliation may require an expedited care delivery model (e.g., a rapid response program or same day treatment clinic).
+ Appropriateness of treatment
- The Radiation therapist must liaise with the Radiation oncologist to balance treatment intent with patient condition and the complexity of the overall treatment plan.
- The advantages of more sophisticated planning and delivery must be weighed against the disadvantages of taking additional time to design and deliver the treatment.
- The Radiation therapist must use clinical judgement in treatment set up and delivery by balancing efficiency, technical tolerance, and patient status
+ Change in performance status or disease progression
- Patients receiving treatment with palliative intent may experience a change in disease progression.3
- If the Radiation therapist's professional decision is that the current plan is unsuitable for the patient undergoing palliative treatment (change in performance status or disease progression) they must consult with the Radiation oncologist to discuss possible modifications.
- The Radiation therapist may alter the treatment set-up to reflect the patient’s change as necessary (for example to minimize pain) with consideration of dosimetric impact
- Other modifications may also be considered, such as a change in the patient’s medication regimen or appointment time
- Sepúlveda C, Marlin A, Yoshida T, Ullrich A. Palliative Care: The World Health Organization’s Global Perspective. J Pain Symp Mgmt 2002;24(2):91-96.
- Tisdale BA. When to Consider Radiation Therapy for Your Patient. Am Fam Phys 1999;;59(5):1177-1184.
- World Health Organization. Radiation therapy for symptom palliation in cancer. Cancer Pain Release 2008;21(3-4). Available at: http://www.whocancerpain.wisc.edu/?q=node/322. Accessed October 26, 2012.