Palliative radiotherapy: what do nurses know?

Palliative radiotherapy is an effective modality of treatment for patients with advanced cancer for a wide range of distressing symptoms such as painful bone metastases, bleeding from tumour sites, dyspnoea caused by central airway obstruction and neurological compromise caused by spinal cord compression and brain metastases (Lutz, 2016). However, in reality, palliative radiotherapy continues to be underused (Lutz et al, 2004) and is frequently offered at too late a stage in the disease trajectory to realise the benefits intended (Berger et al, 2014). Lutz and Chow (2014) deemed research and education in palliative radiation oncology essential to maintain the connection between advanced radiation technology and the humanitarian skills required for palliative care. Ireland's Health Service Executive (Hollywood, 2003) recognised that oncology and palliative care nurses are vital multidisciplinary team members in the provision of radiation treatment, and have an integral part to play in the clinical care of patients who are both receiving and recovering from radiation. Likewise, Berrang and Samant (2008) acknowledged that nurses are the health professionals who care for patients on a day-to-day basis and therefore require the knowledge and skills to identify those that may benefit from referral. While nurses are not permitted as yet to independently refer patients for radiotherapy, as members of the multidisciplinary team, they can advocate for a patient who may benefit from palliative radiotherapy and use their knowledge to contribute to a registered medical practitioner's decision to refer them to radiation oncology.