Keratoacanthomas following definitive volumetric modulated arc radiotherapy for skin field cancerization

Nurses play an important role in the RT of skin and its diseases. This is the third of four articles that attempts to provide a scientific basis for nurses to better understand skin RT patients, skin and its diseases, and acute RT skin reactions and how to care for them to achieve the best outcomes from RT treatments. The first paper outlined the role of the nurse as an integral part of the radiation oncology team and how to conduct an effective patient assessment to ensure the patient’s optimal journey to treatment completion. The second article described the anatomy, physiology, pathology and radiobiology of skin and its diseases. This third article describes the skin RT prescription and plan, especially in relation to volume and dose. The fourth paper will show how the nurse, by applying the knowledge from the previous articles, can predict, explain and care for any side effects that may arise. This knowledge is important for establishing patient expectations, preparing the patient for side effects, and giving scientifically based reasons for complying with care protocols. Hopefully, these articles will help support the nurse to deliver best care to skin RT patients. More prospective research is needed to elucidate the many remaining facets of nursing care for skin RT patients.

Section: Megavoltage (Mv) Photonsmentioning

confidence: 99%

A scientific approach to skin radiotherapy nursing Article 3 - The skin RT prescription and plan especially in relation to volume and dose

Fogarty¹,

Bell²,

Parker³

et al. 2022

“…This may happen in the penumbra and patients may be so concerned about hair loss that a change in modality or technique becomes necessary. 16 Penumbral issues in skin, like keratoacanthoma 17 and hair pigment change 18 have been reported.…”

Section: Care Of Specific Normal Tissues That May Be In a Radiation V...mentioning

confidence: 99%

A scientific approach to skin radiotherapy nursing Article 4 – How nurses can predict, explain, and care for the acute side effects that may arise during a course of skin radiotherapy

Fogarty¹,

Cooper²,

Hodson³

et al. 2022

Nurses play an important role in the care of patients treated with radiotherapy (RT) for skin conditions, such as skin cancers. This is the final article in a four-part series that aims to supplement general oncology nurse training by providing a scientific basis to better understand a) the use of RT in skin and its diseases; and b) the management of acute skin RT reactions to achieve best patient outcomes. The first article focused on the role of the nurse within the radiation oncology department and the initial patient assessment. The second article revised the anatomy, physiology, pathologies and radiobiology of skin. The third described the skin RT prescription and plan, especially in relation to volume and dose. The aim of this fourth article is to assist the nurse, by applying the knowledge from the previous articles, to predict, explain and care for the acute side effects that may arise during a course of skin radiotherapy.

“…The skin RO needs to keep up with new treatment modalities and techniques together with their toxicities. 20,21 Simulation then occurs. It is the ROs responsibility to ensure that simulation goes well.…”

Section: Planningmentioning

confidence: 99%

Experiences in growing a skin radiation therapy practice

Fogarty¹,

Christie²,

Wong³

et al. 2020

The successful treatment of skin disease decreases morbidity and mortality. Radiation therapy (RT) can cure skin disease and conserves tissue, possibly delivering better quality of life post treatment and so a superior survivorship. Modern RT delivers better dose conformality and homogeneity, and more is known about the radiobiology of skin and its diseases, enabling treatment personalisation. Skin, however, can be viewed in RT departments as not a serious subspecialty, even in Australia where the incidence of skin cancer is highest. Radiation oncology leaders are needed to carve out a niche for RT amongst a crowded field of skin carers. This article based on the cumulative experience of a group of Australian skin radiation oncologists (ROs), details how this may be achieved. First, focus is placed on growing a high-quality service. The RO needs to understand how patient, tumour and treatment factors impact the skin RT prescription. The particular nuances around skin RT planning, including immobilisation, simulation, contouring and the advantages and disadvantages of each RT modality in skin, are important to know. How skin reacts to RT when the skin is the target and the importance of fractionation is essential knowledge. Second, the RO needs to understand the needs of the skin stakeholders. These include those in the department who look to them for leadership. It includes those outside the department, that is, patients and other skin carers who could be future colleagues and even referrers. Third, the RO needs to use much needed research as a way to bring the disparate skin caring community together through completing high-quality research to guide therapy and post-treatment care.