The patient pathway towards the delivery of external beam radiation (EBR) is an intricate system of phases. Each reliant consecutively with accuracy being the principal objective. Diagnosis, localization, immobilization, treatment planning, verification and treatment delivery are the main phases of the pathway. Each co-dependent and essential in the delivery of accurate EBR and yet also potentially equally inhibiting.
A recent study by Cancer Research UK (2013) as cited by O'Hara (2014) suggests that on average 25 individuals are diagnosed per day in Northern Ireland. Hence a vast number of patients are being introduced to this pathway.
As stated by Eyre, Smith et al. (2000) early detection truly is the solution to the survival of patients enabling increased treatment success. Hence diagnosis, the initial phase in delivery of EBR, begins prior to contact with a Radiotherapy centre. This phase cannot be assessed or evaluated with a time frame, a prominent struggle faced. And hence a quality restraining the ability to deliver EBR accurately.
Public Health England (2014) have proposed that the diagnosis phase may commence via; a managed route (GP referrals) or an emergency presentation route (emergency GP referrals or A&E admittance). GP referrals result mainly from a patient's presentation of looming symptoms whilst emergency presentation usually are late, unobserved symptoms. Thus illustrating how this "initial" phase can commence at any given stage of disease, therefore effecting the outcome considerably.
Diagnosis from these routes are enabled by various investigations and tests. Via blood tests, prescribed diagnostic scans and x-rays or the referral to a specialist consultant. Their complete reliability somewhat questionabl...
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...y of EBR. For example, the imaging of patients for their first three daily treatments. This employs the principles of verification yet throughout the "final" stage.
Patient review during treatment is another aspect employed to monitor the accurate delivery. Monitoring patients bloods and electrolytes help examine the patients response to treatment and thus signify any signs of inaccurate treatment.
The close compliance of these phases enabling the continuous creditability of external beam radiation as one of the most successful modalities in the treatment of cancer, as suggested by Watson, Barrett et al. (2001). Arguably the delivery of the treatment can be seen to be the most important phase in the accurate delivery of EBR as the radiation is being administered. However without the previous phases, or links in the EBR chain, the accuracy would not be achievable.
Cancer is one of the 9 National Health Priority Areas (NHPA), areas which account for a significant portion of the burden of disease, but have sizeable potential for improvement. In Australia, CRC is the second most common cancer, after prostate (in men) and breast cancer (in women) (AIHW, Cancer incidence projections). The incidence has gradually increased (by 13% in males from 1982-2007) (AIHW, Cancer in Australia an overview). This is compounded by the ageing population and population growth, with 14,860 new cases in 2010 (http://www.cancer.org.au/about-cancer/types-of-cancer/bowel-cancer). This graph demonstrates this upward trend ((AIHW, Cancer incidence projections):
2. External Beam Radiation Therapy (EBRT) which is usually offered when the lung cancer is either considered to be primary, or when it has metastasized (spread to other organs). This form of treatment uses a linear accelerator machine to focus a precise beam of radiation on a given area of the body for a precise period of time to kill off cancerous cells.
requiered to determine treatment. Lab tests or imaging is often requiered as well. It’s chronic,
At this day in age we are constantly trying to improve the field of medicine in any way that we possibly can. We cherish every birthday and continually try to prolong life. Not only through every field of medicine, especially in terms of cancer. The American Cancer Society is “the official sponsor of birthdays” and is making leaps and bounds in the types of care that cancer patients receive. One of these many breakthroughs is the practice of Stereotactic (Body) Radiotherapy or S(B)RT. SBRT and other radiation therapies have the ability to greatly improve the way that we treat the issue of cancer and the variation of treatment options; however, they have raised the concerns of long term effects from radiation and cost-effectiveness. As research has begun to show, radiation therapies are having great success in curing cancer.
chartings in the medical record of a patient, taking the patients vitals and reporting abnormal to
Susan G. Komen for the Cure, (2009). Radiation Therapy and Side Effects. Susan G. Koman for the Cure. Retrieved from:
“External radiation uses a machine that directs high-energy rays from outside the body into the tumor and some normal nearby tissue.” (American Cancer Society p. 5) After this treatment the patient will not be radioactive, but treatment is delivered in small doses and can last several weeks. “Internal radiation or brachytherapy, uses a radioactive source, called an implant, that’s put inside the body in or near the tumor.” (American Cancer Society p. 9) It may be placed in an organ or in the cancerous tumor. The patient will be radioactive for a short time. Due to the implant being near the source of cancer a larger dose can be delivered to the patient. “Systemic radiation uses radioactive drugs to treat certain type of cancer.” (American Cancer Society p. 12) The drugs used are called radiopharmaceuticals and can be delivered orally or intravenously. “They collect where the cancer is to give off their radiation and kill the cancer cells.” (American Cancer Society p. 12) After this treatment the patient will be radioactive, and will take a few days to be removed from the patients
The purpose of the paper is to discuss the activities involved during the evaluation of a patient. Evaluation of a patient can be seen as the process of examining a patient critically. It comprises of gathering and analyzing data about a patient and the illness (Allan, 2012). The core reason is to make judgment about the disease one is suffering from. Such judgment will guarantee proper treatment and diagnosis. Typically, gathering of information from the patient is the role of nurses while making judgment and prescription is the doctor’s role (Jacques, 1988). In any case all practitioners are required to know how to evaluate a patient.
As a starting point in CT diagnostic imaging the form of radiation used to provide an image are x-rays photons , this can also be called an external radiation dose which detect a pathological condition of an organ or tissue and therefore it is more organ specific. However the physics process can be described as the radiation passes through the body it is received by a detector and then integrated by a computer to obtain a cross-sectional image (axial). In this case the ability of a CT scanner is to create only axial two dimensional images using a mathematical algorithm for image reconstruction. In contrast in RNI the main property for producing a diagnostic image involves the administration of small amounts of radiotracers or usually called radiopharmaceutical drugs to the patient by injection or oral. Radio meaning the emitted of gamma rays and pharmaceutical represents the compound to which a nuclide is bounded or attached. Unlike CT has the ability to give information about the physiological function of a body system. The radiopharmaceutical often referred to as a nuclide has the ability to emit ga...
The Atomic Energy of Canada Limited (AECL) created the Therac-25 radiation therapy machine (Death and Denial). The major innovation of this machine is that it was much more computer-controlled than the previous machines of its kind. This enabled technicians to spend less time setting up the machine and more time working directly with patients. The reduced setup time also increased the number of patients that were able to be treated in one day (ComputingCases). Patients undergoing treatment from the Therac-25 are in communication with the machine operator (located in a separate room) through AV monitors (Death and Denial).
The process of EBP has several models with common elements that start from uncertainty in the clinical setting, and lead to making an informed decision by assessing and implementing the latest research evidence into practice (Stevens, 2013). Melnyk and Fineout-Overholt (2010) define the seven step process of EBP as:
Another treatment that is used to help a cancer patients overcome the disease is radiation therapy. Although very affective and used commonly, thi...
Observe, record, and report to physician patient's condition, treatment provided, and reactions to drugs and treatment
A proper classification method removes the guess work for diagnosis. It serves as a guide to reach a precise diagnosis. Diagnostic criterion helps the clinician to make an interim diagnosis and clarify it in further assessments.
A detailed patient history including history of any recent trauma or systemic disease such as renal or cardiovascular problems should be taken. The diagnosis is usually reached by a high clinical suspicion through the history and physical examination.