"When you have benign conditions, we're actually treating 3 gray, so a significant difference [versus doses of 60 gray for brain cancer]. Typically, when you treat at a high dose, the goal is to destroy tissue, like cancer tissue or cancer cells. But when we give a low dose, the goal is actually to modulate inflammation. And what it does is it slows down those inflammatory cells or those cells that release the chemicals that cause pain and inflammation," Amanda Meyer, DNP, APRN, CNP, family nurse practitioner in the Department of Radiation Oncology at the Mayo Clinic in Rochester, MN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radiation therapy for noncancer indications.
Music Credit: "Fireflies and Stardust" by Kevin MacLeod
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Learning outcome: Learners will report an increase in knowledge about the use of radiation to treat noncancerous conditions.
Episode Notes
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Highlights From This Episode
"We always typically think of it as cancer treatment, but we can use radiation for noncancerous conditions, as well. And radiation was actually used for benign diseases right after the discovery of x-rays. By the 1920s it was used a lot for different types of musculoskeletal, dermatologic issues, and different types of inflammatory conditions. And over time, since the 1920s, we've actually really gotten a really good understanding of it." TS 1:37
"When we're looking at what are good candidate characteristics, we do typically like older patients, so patients over the age of 65. And the rationale behind that is we know that there is a potential for a secondary risk of a skin cancer about 20 to 30 years after getting low-dose radiation, like a basal cell or squamous cell skin cancer. The older the patient is, the less likely they are to have any adverse effects from that." TS 8:22
"When we do the low-dose radiation, they've tried other measures that haven't been successful. However, we don't want a patient who is so severe that they're ready for surgery, when they're bone on bone, because we know that radiation isn't as effective when they are that severe. So there's this sweet window where low-dose radiation works best in these patients." TS 9:39
"When we're treating with a little bit higher dose for like a Dupuytren's or a Ledderhose, because it's an anti-proliferative dose, those patients, they do get more skin redness, more dry skin. That's very temporary, and it resolves within a week or two after treatment. But really, we don't see any acute side effects. The long-term side effect of the radiation-induced malignancy, again, is a very low—0.05% according to some of the European guidelines." TS 12:34
"I really wish people appreciated how interdisciplinary this is. We need to get referrals from family medicine and from primary care and internal medicine and pain medicine physicians and inflammatory physicians and podiatry and pain specialists. And we really need to use this multidisciplinary approach to get earlier referrals for patients because there is this sweet window of time where low-dose radiation works the best." TS 18:40