Palliative Radiotherapy for

Symptom Control

Dr Reena George
Visiting Clinical Fellow
Department of Palliative Medicine
University of Sheffield
 Palliative Radiotherapy for
Symptom Control
When?

Why?

How?
 Background
Treatment modalities include
Surgery
Drugs ( chemotherapy/ hormones)
Radiation therapy

Some forms of cancer treatment are directed

only at a local site. Others act on tumour
cells throughout the body
 Treatment modalities
Local Systemic

Surgery----------------+
Chemotherapy--------------------------+
Radiation therapy-- -+
 Indications for radiation therapy
Bleeding B leeding

Ulcer U lcer

Pressure M ass effect

Pain
P ain
 Radiation therapy

Radiation therapy can be used for both

primary and metastatic disease but acts only
on tumour cells within the area irradiated,
For example, lung cancer with bone
metastases
 Indications for palliative
radiotherapy
It is worth considering palliative radiation
therapy in situations where the tumour mass
is causing significant pain, pressure,
bleeding or fungation
Indications for Radiation Therapy
B.U.M.P
Bleeding Ulcer
Haemoptysis Skin
Haematuria Breast
Vaginal bleeding Nodes

M ass effect Pain

spinal cord compression bone metastases
SVC obstruction
Nerve compression
nerve compression
brain secondaries
 What is radiation therapy?
Radiation therapy: The use of ionising
radiation in the treatment of cancer

Forms of physical energy , such as X rays

and electrons, that are powerful enough to
penetrate the body and be absorbed by
cancer cells and normal tissues.
 How does radiation therapy
shrink tumours
Absorbed radiation can damage DNA in the
cell, as a result of which the cell cannot
multiply and tumour growth slows down.
As old cancer cells die a natural death, the
tumour shrinks.
Different tumours vary greatly in their
response to radiation therapy
 Curative versus Palliative
Radiotherapy
Radical Palliative

Aim cure comfort

Dose high low
Duration weeks days
Side effects ++ +/-
Technique Precise Simple