"Radiation therapy is often extremely well tolerated in colorectal cancer. Technology has really changed things. But location of the tumor can affect side effects, such as radiation dermatitis. If a patient has a low-lying tumor, if it's less than six centimeters from the anal verge, the patient is likely to have some skin reaction. It's good to be proactive if that's the case," ONS member Lorraine Drapek, DNP, FNP-BC, AOCNP®, nurse practitioner in the Department of Radiation Oncology at Massachusetts General Hospital in Boston, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radiation side effects in colorectal cancer. Music Credit: "Fireflies and Stardust" by Kevin MacLeod
Licensed under Creative Commons by Attribution 3.0
Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by June 5, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.
Learning outcome: Learners will report an increase in knowledge related to the side effects of radiation to treat colorectal cancer.
Episode Notes
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Highlights From This Episode
"In recent years, there has been more nonsurgical management of rectal cancer, especially in what we call the low-lying population. This is the population of patients who would likely end up with a permanent colostomy because their cancer is so low in terms of being close to or involving the anal verge. There is now a regimen where these patients can get their chemotherapy followed by their chemoradiation and then be monitored on close surveillance without surgery." TS 2:23
"Another assessment would be to assess what effects have they had from their chemotherapy that they're bringing with them. FOLFOX-based treatment is commonly used, and the platinum therapy oxaliplatin often causes peripheral neuropathy. What is the patient having? What are those symptoms like? Are they having peripheral neuropathy? If they are that is likely not going to get better or improve during their whole course of radiation. In fact, sometimes when oxaliplatin therapy stops, the peripheral neuropathy can get worse as patients are going through other treatments." TS 5:42
"If the patient has a low-lying tumor, if it's less than six centimeters from the anal verge, the patient is likely to have some skin reaction. It's good to be proactive if that's the case. And then proactively minimizing radiation dermatitis effects, such as keeping the area clean, good washing of the area, and prophylactically starting them on or having someone start them on steroid creams a couple of times a day to minimize that radiation dermatitis effect in the long run." TS 7:25
"I have a sexual health clinic for women with these effects. It's very important as nurses that if you can develop the comfort to ask patients about their sexual activity—it's hard, but it really needs to be done. And I will tell you that the healthcare providers are not doing it. They don't have time, and like us as nurses, we don't get this in school, and neither do they. The other providers don't get it in school either, but it's important. Patients are getting more and more worried about their sexual health. They're coming to us at a younger age, and this is really, really important to address." TS 15:35
"I would say that working with your advanced practice providers and education for advanced practice providers has definitely been focusing on [sexual health] more. Your PAs and your NPs—I think they're going to have the ears and the wherewithal to be able to be your allies and colleagues in this. By and large, it's my APP colleagues and nursing that I talk to the most about this. … Again, it's not an easy thing to bring forward, having dilators in place. But I will tell you in the department that I work in, it was me and couple of nurses who pushed this issue with the physicians for two years and finally got it put in place. It can be done. There's a lot more centers out there doing that." TS 21:51
