Radiotherapy effects may have a debilitating impact on an individual's quality of life, and the severity and frequency of adverse effects may affect treatment delivery. The effect of radiation is a complex series of interactions that can occur within a fraction of a second or several years after treatment.57
While radiotherapy affects all body tissues in the path of the radiation treatment beam, every person will react differently to the radiotherapy due to a range of treatment factors and individual characteristics.58 Factors influencing responses to ionising radiation include:7
- body site
- treatment intent (curative/palliative)
- dose
- treatment volume
- machine energy
- neoadjuvant chemotherapy.
People affected by cancer may experience varying degrees of emotional distress associated with the cancer itself, changing social roles and relationships, or existential concerns.59 The individual's emotional response to radiotherapy may be impacted by:
- the severity of symptoms and specific side effects of treatment60, 61
- the need to be accommodated away from home for the duration of the radiation treatment
- difficulties managing in an unfamiliar environment, separated from supports
- long distance travel for treatment each day62, 63
- limited knowledge or resources to manage these problems.19, 64, 65
Radiation treatment effects can be divided into acute and late reactions. Acute radiotherapy reactions occur within days to weeks after commencing treatment, and late effects occurring from weeks to years after completing treatment.66 Healthy tissue responds to radiotherapy with an inflammatory response. The greatest adverse effects occur in tissues that are radiosensitive such as the skin and mucous membranes.7, 23 The severity of effects is related to the cumulative radiation dose over time.67, 68
It has been identified that there is a lack of standardised assessment in the monitoring of radiation side-effects and cancer treatment toxicity. Symptoms develop in several stages, further compromising effective assessment and monitoring of toxicities associated with radiotherapy.30
Learning activity
Appraise current assessment tools in your health care facility for their capacity to effectively assess the following effects:
- Radiation skin reactions
- Xerostomia
- Psychological distress.