Ensinar e aprender na consulta de enfermagem em braquiterapia ginecológica: perspectivas dos enfermeiros / Teaching and learning in the gynecological brachytherapy nursing appointment: the nurses' perspectives / Enseñar y aprender en la consulta de enfermería en braquiterapia ginecológica: perspectivas de los enfermeros

Objetivos: identificar as expectativas dos enfermeiros em ensinar e aprender na consulta de enfermagem em braquiterapia ginecológica e discutir os nexos entre as intencionalidades expressas por estes profissionais. Método: estudo descritivo, embasado na Fenomenologia Sociológica e realizado no período de janeiro a maio de 2012. Os participantes foram seis enfermeiros que atuam em dois serviços de referência em radioterapia. Os dados foram obtidos por meio de entrevistas fenomenológicas. Resultados: da análise dos depoimentos emergiram duas categorias concretas do vivido: Atender à singularidade dos sujeitos no tratamento e Valorizar o cuidado técnico. Conclusão: o tipo vivido dos enfermeiros é o de profissionais com sensibilidade para adaptar o cuidado individual à tecnologia, em que o ensinar e aprender na consulta de enfermagem subsidiam o enfermeiro a compreender cada cliente com seu grau de entendimento, o que exige personalizar o atendimento, a fim de que haja qualidade de vida no tratamento.

Objectives: to identify nurses' expectations in teaching and learning in the gynecological brachytherapy nursing appointment and to discuss the links between the intentionalities expressed by these professionals. Method: this descriptive study, based on Sociological Phenomenology, was conducted from January to May 2012. The participants were six nurses working in two radiotherapy referral services. Data were obtained by phenomenological interview. Results: analysis of the declarations yielded two concrete categories of lived experience: Contemplating the uniqueness of each subject in treatment; and Giving due value to the technical care. Conclusion: the lived experience of nurses is that of professionals with the sensitivity to adapt individual care to the technology, where teaching and learning in the nursing appointment provides nurses with input to understanding each client with their own degree of understanding, which is what demands personalized care, so that there is quality of life in the treatment.

Objetivos: identificar las expectativas de los enfermeros en enseñar y aprender durante la consulta de enfermería en braquiterapia ginecológica y discutir los nexos entre las intenciones expresadas por estos profesionales. Método: estudio descriptivo, basado en la Fenomenología Sociológica y llevado a cabo de enero a mayo de 2012. Los participantes fueron seis enfermeros que trabajan en dos servicios de referencia en radioterapia. Los datos se obtuvieron a través de entrevistas fenomenológicas. Resultados: del análisis de las declaraciones emergieron dos categorías concretas de experiencias: Atender a la singularidad de los sujetos en el tratamiento y valorar el cuidado técnico. Conclusión: los enfermeros se mostraron profesionales con sensibilidad para adaptar el cuidado individual a la tecnología, en la cual el enseñar y el aprender en la consulta de enfermería subsidian al enfermero a comprender a cada cliente con su nivel de entendimiento, lo que requiere personalizar la atención para que haya calidad de vida en el tratamiento.

Comportamento sexual das mulheres em tratamento radioterápico / Sexual behavior of women in radiotherapytreatment

Women with cancer undergoing radiotherapy, radiotherapy and / or brachytherapy may change in sexual behavior, with influence on psychosocial, sexual and functional aspects as well as quality of life. This study aims to analyze the scientific evidence related to sexual behavior and quality of life of women who underwent radiotherapy. It is literature type integrative review. Data collection was conducted in May 2014 and was carried out through the Virtual Health Library, from the bottom of LILACS and MEDLINE, by combining the descriptors: "sexual behavior and radiotherapy" and "sexual behavior and brachytherapy". They selected 23 studies for the sample with no time limit. With the intention of promoting the contributions the production of knowledge about sexual behavior / symptoms after cancer treatment in women with brachytherapy and radiation, emerging two main themes: psychosocial, sexual and functional changes; quality of life. Identifies what is needed directed multidisciplinary action women with cancer in relation to sexuality, there are weaknesses in the care geared to these. Such assistance needs to be planned for the woman and her partner, so that living with cancer and treatment is quality.

As mulheres com câncer submetidas à radioterapia, teleterapia e/ou braquiterapia podem ter alteração nocomportamento sexual, com influência nos aspectos psicossociais, sexuais e funcionais, bem como na qualidade de vida. Este estudo tem como objetivo analisar as evidências científicas relacionadas ao comportamento sexual e qualidade de vida de mulheres que realizaram tratamento com radioterapia. Trata-se de pesquisa bibliográfica do tipo revisão integrativa. A coleta dos dados foi realizada no mês de maio de 2014, e ocorreu por meio da Biblioteca Virtual em Saúde, a partir das bases de dados LILACS e MEDLINE, através da combinação dos descritores: "sexual behaviorandradiotherapy" e "sexual behaviorandbrachytherapy". Foram selecionados 23 estudos para compor a amostra sem tempo limite. Com a intenção de promover os contributos da produção do conhecimento sobre o comportamento sexual/sintomas após tratamento de câncer em mulheres com braquiterapia e radioterapia, emergindo dois eixos temáticos: alterações psicossociais, sexuais e funcionais; qualidade de vida. Identifica-se que é necessária ação multidisciplinar direcionada as mulheres com câncer em relação à sexualidade, há fragilidade no cuidado voltado a essas. Tal assistência necessita ser planejada para a mulher e seu parceiro, de forma que a convivência com o câncer e tratamento seja de qualidade.

O custo da cura: vivências de conforto e desconforto de mulheres submetidas à braquiterapia / The healing cost: comfort and discomfort experiences of women undergoing brachytherapy / El costo de la curación: experiencias de comodidad e incomodidad de mujeres sometidas a la braquiterapia

Objetivo: Descrever as vivências de conforto e desconforto de mulheres que se submeteram à braquiterapia para tratamento de câncer do colo uterino. Métodos: Estudo qualitativo, desenvolvido em 2013, embasado na Teoria do Conforto de Kolcaba e realizado por meio de entrevistas semiestruturadas com oito mulheres que concluíram o tratamento há, no mínimo, seis meses. Resultados: Sobressaíram os seguintes desconfortos: dor do procedimento e dos efeitos pós-tratamento, no contexto físico; medo do desconhecido e do sofrimento, falta de acompanhante, estresse por sentir-se constrangida durante o tratamento, baixa autoestima e trauma psicológico pós-terapia, no contexto psicoespiritual. As medidas de conforto consistiram no diálogo com o profissional, administração de medicações e uso da fé e espiritualidade. Conclusão: Os resultados oferecem subsídios para a prática de profissionais de saúde em relação aos confortos e desconfortos que merecem ser alvo de intervenções na assistência à mulher com câncer.

Objective: To describe the experiences of comfort and discomfort in women who underwent brachytherapy for the treatmentof cervical cancer. Methods: Qualitative study carried out in 2013, based on Kolcaba comfort theory and conducted throughsemi-structured interviews with eight women who have completed treatment, at least, six months ago. Results: The followingdiscomforts stood out: pain in the procedure and in the post-treatment effects, in the physical context; fear of the unknown andsuffering; lack of a companion; stress due to embarrassment during treatment; low self-esteem; and post-therapy psychologicaltrauma, in the psycho-spiritual context. Comfort measures consisted in dialogue with the professional, medication managementand use of faith and spirituality. Conclusion: The results provide support for the practice of health professionals in relation tocomfort and discomfort that deserve to be the target of intervention in terms of the assistance to women with cancer.

Objetivo: Describir la experiencia de comodidad e incomodidad en mujeres que se sometieron a la braquiterapia para tratarel cáncer de cuello uterino. Métodos: Estudio cualitativo realizado en 2013, basado en la teoría de comodidade de Kolcabay realizado con ocho mujeres que completaron el tratamiento hace por lo menos seis meses. Resultados: Se destacan lasincomodidades: dolor del procedimiento y de los efectos después del tratamiento, en el contexto físico; miedo a lo desconocidoy al sufrimiento, el estrés por sentirse avergonzada durante el tratamento y baja autoestima y trauma psicológico después dela terapia, en el contexto psicoespiritual. Las medidas para sentirse confortables consistieron en el diálogo com el profesional,administración de medicamentos y el uso de la fe y la espiritualidad. Conclusiones: Los resultados proporcionan subsídiospara la práctica de los profesionales de la salud relacionada con las comodidades e incomodidades que merecen intervencionesen la atención de las mujeres con cáncer.

Calidad de vida en pacientes con cáncer de próstata: Validación de un instrumento para la práctica clínica / Quality of life in patients with prostate cancer: validation of an instrument for clinical practice

OBJETIVO: Actualmente existen instrumentos para evaluar los distintos aspectos en el impacto sobre la calidad de vida en aquellos pacientes portadores de cáncer de próstata que son sometidos a algún tipo de tratamiento, pero la mayoría son de 50 o más preguntas y de difícil aplicación en la práctica clínica. Recientemente se ha publicado la validación en inglés de una versión acortada del instrumento más utilizado para medir la calidad de vida en pacientes con cáncer de próstata: EPIC (Expanded Prostate Cancer Composite). Esta versión denominada EPIC-CP (Expanded Prostata Cancer Composite-Clinical Practice) consiste en 16 preguntas dispuestas en una página, de fácil y rápida aplicación clínica. El objetivo primario de este trabajo fue desarrollar y validar el cuestionario EPIC-CP en español como instrumento de evaluación de calidad de vida en pacientes con cáncer de próstata (CaP). Un objetivo secundario fue la observación de las diferencias de los aspectos que impactan en la calidad de vida entre los pacientes tratados y los candidatos a tratamiento. MÉTODOS: Se realizó una traducción inversa-directa al español de la versión original de la encuesta. Se aplicaron 128 cuestionarios de calidad de vida EPIC-CP y EQ5D (cuestionario de salud del EuroQuol Group Association) a 46 (40%) pacientes candidatos a ser sometidos a diferentes tratamientos - Prostatectomía abierta (PA), Prostatectomía robótica (PR), Braquiterapia (Br) o Radioterapia Conformacional (RC)- y a 82 (64%) pacientes ya tratados (9 PA, 13 PR, 7 Br y 4 RC). Para evaluar la confiabilidad se evaluó la consistencia interna a través del Coeficiente Alfa de Cronbach para cada categoría de la EPIC-CP. Para valorar la sensibilidad al cambio se compararon las puntuaciones en pacientes tratados y no tratados con el test de Suma de Rangos de Wilcoxon. RESULTADOS: En todos los dominios de la EPIC-CP, se obtuvo un consistencia interna elevada (alfa de Cronbach 0,66-0,9). No se encontraron diferencias significativas en la edad ni en el nivel educacional entre pacientes tratados y no tratados. Se encontraron diferencias significativas en la puntuación total de la EPIC CP entre pacientes tratados y no tratados en los dominios incontinencia urinaria (p = 0,0002), función intestinal (p = 0,04), sexual (p < 0,0001) y función hormonal (p = 0,002). CONCLUSIÓN: La versión en del EPIC-CP es confiable y válida, por lo que resulta una herramienta útil para medir la calidad de vida en pacientes con CaP, así como el impacto de distintos tratamientos en ella

OBJECTIVES: Currently there are instruments to evaluate the different features of the impact on quality of life in those patients with prostate cancer undergoing any type of treatment, but most of them have 50 or more questions and they are difficult to apply in clinical practice. An English validation of a shortened version of the EPIC (Expanded Prostate Cancer Composite), the most used instrument to measure the quality of life in patients with prostate cancer, has been published recently. This version called EPIC-CP (Expanded Prostate Cancer Composite-Clinical Practice) consists of 16 questions arranged in a page, for easy and rapid clinical application. The objective of this work is to validate a Spanish version of the EPIC-CP. METHOD: An inversa-directa Spanish translation of the original version was performed. The EPIC-CP and EQ5D questionnaires were applied to 46 patients eligible to be subjected to different treatments - open prostatectomy (OP), Robotic Prostatectomy (RP), brachytherapy (Br) or conformational radiotherapy (CR) - and 82 patients already treated (9 OP, 13 RP, 7 Br, 4 CR). For reliability evaluation, the Cronbach's alpha was used to test the internal consistency for each domain of the EPIC-CP. Treated and untreated patients' scores were compared with the Wilcoxon range sum test to assess the sensitivity to change. RESULTS: Cronbach's alpha was elevated in all the EPIC-CP domains (near or greater than 0.7), indicating a high internal consistency. There was no significant difference in age and educational level between treated and untreated patients. We found significant differences between treated and untreated patients in the total EPIC CP score, in the domains of urinary incontinence, bowel function, sexual function and hormonal function. CONCLUSIÓN: The Spanish version of the EPIC-CP is reliable and valid, so it is a useful tool to measure the quality of life in patients with prostate cancer, as well as the impact of different treatments

Dose rate in brachytherapy using after-loading machine: pulsed or high-dose rate?

Since February 2014, it is no longer possible to use low-dose rate 192 iridium wires due to the end of industrial production of IRF1 and IRF2 sources. The Brachytherapy Group of the French society of radiation oncology (GC-SFRO) has recommended switching from iridium wires to after-loading machines. Two types of after-loading machines are currently available, based on the dose rate used: pulsed-dose rate or high-dose rate. In this article, we propose a comparative analysis between pulsed-dose rate and high-dose rate brachytherapy, based on biological, technological, organizational and financial considerations.

Profile and predictors of global distress: can the DT guide nursing practice in prostate cancer?

OBJECTIVE: This study examines the ability of the distress thermometer to accurately identify patients with higher symptoms, unmet needs and psychological morbidity. METHODS: Baseline data collected as part of a randomized controlled trial evaluating a nurse-led supportive care intervention for men with prostate cancer commencing radiotherapy at a specialist cancer hospital in Melbourne, Australia. Measures assessed global distress (DT), anxious and depressive symptomatology (HADS), prostate-cancer specific quality of life (EPIC-26), unmet supportive care needs (SCNS-SF34R) and cancer treatment-related concerns (CATS). Following descriptive and correlational analysis, hierarchical multiple regression was employed to examine the contribution of variable sets to explaining variance in DT scores. RESULTS: Less than 20% of men reported DT scores of 4 or higher, indicating overall low distress. The DT accurately identified almost all men reporting HADS score indicative of anxious or depressive symptomatology, suggesting it accurately identifies psychological morbidity. Importantly, the DT identified a further group of distressed men, not identified by HADS, whose distress related to unmet needs and prostate cancer-specific issues, indicating the DT is superior in identifying other forms of distress. While the hierarchical multiple regression confirmed anxious and depressive symptomatology as the best predictor of distress score, many other scales are also good predictors of DT scores, supporting the argument that distress is multi-determined. SIGNIFICANCE OF RESULTS: Nurses can be confident that the DT accurately identifies patients with psychological morbidity and importantly identifies other patients with distress who may require intervention. A distress score of 4 or higher identified participants with higher physical symptomatology, higher unmet needs, more concerns about treatment and poorer quality of life. The low prevalence of distress reaching cut off scores suggests nurses would not be overwhelmed by the outcomes of screening and could use the score to prioritise the patients who need greater attention at entry to radiotherapy services.

Mitochondria-related gene expression changes are associated with fatigue in patients with nonmetastatic prostate cancer receiving external beam radiation therapy.

BACKGROUND: Cancer-related fatigue (CRF) is associated with negative health outcomes and decreased health-related quality of life; however, few longitudinal studies have investigated molecular-genetic mechanisms of CRF. OBJECTIVE: The objective of this study was to describe relationships between mitochondria-related gene expression changes and self-reported fatigue in prostate cancer patients receiving external beam radiation therapy (EBRT). METHODS: A prospective, exploratory, and repeated-measures design was used. Self-report questionnaires and peripheral whole-blood samples were collected from 15 patients at 7 time points. Baseline data were compared against 15 healthy controls. The Human Mitochondria RT Profiler PCR Array was used to identify differential regulation of genes involved in mitochondrial biogenesis and function. RESULTS: Compared with baseline, there were significant increases in fatigue scores (P = .02-.04) and changes in mitochondria-related gene expression (P = .001-.05) over time. Mean fatigue scores were 1.66 (SD, 1.66) at baseline, 3.06 (SD, 1.95) at EBRT midpoint, 2.98 (SD, 2.20) at EBRT completion, and 2.64 (SD, 2.56) at 30 days after EBRT. Over time, 11 genes related to mitochondrial function and structure were differentially expressed. Of these 11 genes, 3 (BCL2L1, FIS1, SLC25A37) were more than 2.5 fold up-regulated, and 8 (AIFM2, BCL2, IMMP2L, MIPEP, MSTO1, NEFL, SLC25A23, SLC25A4) were greater than 2-fold down-regulated. Furthermore, 8 genes (AIFM2, BCL2, FIS1, IMMP2L, MSTO1, SLC25A23, SLC25A37, SLC25A4) were significantly associated with the changes in fatigue scores. CONCLUSION: This study provides preliminary evidence that 8 mitochondrial function genes were significantly associated with fatigue in prostate cancer patients during EBRT. IMPLICATIONS FOR PRACTICE: These findings identify possible pathways and early biomarkers for targeting novel interventions for CRF.

Vivências de mulheres submetidas à braquiterapia: compreensão existencial / Experiences of females when brachytherapy treatment has been undertaken: existential understanding

Neste estudo, busquei compreender as vivências de mulheres portadoras de câncer uterino antes de submeterem ao tratamento braquiterápico. Trata-se de uma pesquisa qualitativa embasada na fenomenologia existencial de Martin Heidegger que possibilitou a apreensão dos momentos vividos por esses seres. Para participar dessa pesquisa, procurei por mulheres que haviam iniciado algum tipo de tratamento para câncer uterino. Selecionei aquelas que se submeteram à radioterapia em uma clínica de radioterapia situada no noroeste do Paraná, e, a posteriori, seriam submetidas à braquiterapia no período compreendido entre os meses de abril a maio de 2006. Foram entrevistadas quatro mulheres em um hospital especialista em oncologia no norte do Paraná, antes de iniciarem a braquiterapia. Para buscar os discursos dos sujeitos, utilizei a seguinte questão norteadora: "O que você sente antes de vivenciar a braquiterapia?" Da interpretação emergiram três temáticas: O ser-com-o-outro inautêntico no convívio do hospital; angústia ante o desconhecimento do tratamento; religiosidade: o caminho da esperança. Os resultados obtidos revelam a importância do cuidado holístico ao Ser que vivencia esta facticidade, pois, muitas vezes, a subjetividade do cuidado fica absorvida pela massificação das regras e normas institucionais.

Experiences of females with uterine cancer have been analyzed prior to brachytherapy treatment. The qualitative research has been foregrounded on Martin Heideggerïs existential phenomenology which favors the understanding of instances experienced by the patients. Females who had already initiated some type of treatment for uterine cancer were investigated, although only those undertaken radiotherapy in a specific radiotherapy clinic in the northwestern section of the state of Paraná/Brazil, have been selected. They would later have to undergo brachytherapy treatment which occurred between April and May 2006. Four females were interviewed in an oncology hospital in the north of the state of Paraná, Brazil, prior to brachytherapy treatment. The following question was asked to elicit the subjectsï discourse: "What are your feelings prior to brachytherapy?" Three themes were categorized: the non-authentic being-with-the-other in the hospital; anxiety in the face of the unknown therapy; religiosity or the way to hope. Results show the importance of holistic care to the person experiencing the facts since the subjectivity of care is absorbed by the huge number of rules and institutional norms.

Resumen: En este estudio, busqué comprender las vivencias de mujeres portadoras de cáncer uterino antes de someterse al tratamiento braquiterápico. Se trata de una investigación cualitativa embasada en la fenomenología existencial de Martín Heidegger que posibilitó la aprensión de los momentos vividos por esos seres. Para participar de esa investigación, busqué por mujeres que habían iniciado algún tipo de tratamiento para cáncer uterino. Seleccioné aquellas que se sometieron a la radioterapia en una clínica de radioterapia situada en el noroeste de Paraná, y, después, serían sometidas a braquiterapia en el período comprendido entre los meses de abril y mayo de 2006. Fueron encuestadas cuatro mujeres en un hospital especialista en oncología en el norte del Paraná, antes de iniciar la braquiterapia. Para buscar los discursos de los sujetos, utilicé la pregunta clave: "¿Qué siente usted antes de vivenciar la braquiterapia?" De la interpretación emergieron tres temáticas: El ser-con-el-otro inauténtico en el convivencia del hospital; angustia frente al desconocimiento del tratamiento; religiosidad: el camino de la esperanza. Los resultados obtenidos enseñaron la importancia del cuidado holístico al Ser que vivencia esta fatalidad, pues, muchas veces, la subjetividad del cuidado queda absorbida por la masificación de las reglas y normas institucionales.

The use of oral transmucosal fentanyl citrate during high-dose-rate gynecologic brachytherapy.

Gynecologic brachytherapy is a form of cancer treatment in which radioactive sources are placed into the pelvic organs via specialized applicators. Traditional low-dose-rate (LDR) brachytherapy has been performed over several days in a hospital setting. Since the 1990s, high-dose-rate (HDR) brachytherapy has been used increasingly because of its decreased treatment time, outpatient administration, and equal or superior efficacy compared with LDR treatment. However, the management of procedural pain in the radiation oncology setting has not been studied extensively. The purpose of this article is to discuss the use of oral transmucosal fentanyl citrate (OTFC) for the management of pain during gynecologic HDR brachytherapy. OTFC provides noninvasive, rapid analgesia with a low incidence of side effects and may be appropriate for other forms of procedure-related cancer pain.

PSA spike after brachytherapy For localized prostate cancer.

A common concern for patients who have undergone treatment for prostate cancer and their families is an elevation or spike in the PSA level following definitive treatment. A number of factors can be responsible for this, but often the PSA spike may be benign. An informed health care worker can reasonably assess whether this is the case, and can help to alleviate the fears of the patient and his family.

Vivências de mulheres submetidas à braquiterapia: compreensão existencial / Experiences of women submited to braquitherapy: existencial comprehension

Neste estudo, busquei compreender as vivências de mulheres portadoras de câncer uterino antes de submeterem ao tratamento braquiterápico. Trata-se de uma pesquisa qualitativa embasada na fenomenologia existencial de Martin Heidegger que possibilitou a apreensão dos momentos vividos por esses seres. Para participar dessa pesquisa, procurei por mulheres que haviam iniciado algum tipo de tratamento para câncer uterino. Selecionei aquelas que se submeteram à radioterapia em uma clínica de radioterapia situada no noroeste do Paraná, e, a posteriori, seriam submetidas à braquiterapia no período compreendido entre os meses de abril a maio de 2006. Foram entrevistadas quatro mulheres em um hospital especialista em oncologia no norte do Paraná, antes de iniciarem a braquiterapia. Para buscar os discursos dos sujeitos, utilizei a seguinte questão norteadora: “O que você sente antes de vivenciar a braquiterapia”? Da interpretação emergiram três temáticas: O ser-com-o-outro inautêntico no convívio do hospital; angústia ante o desconhecimento do tratamento;religiosidade: o caminho da esperança. Os resultados obtidos revelam a importância do cuidado holístico ao Ser que vivencia esta, facticidade, pois, muitas vezes, a subjetividade do cuidado fica absorvida pela massificação das regras e normas institucionais...

Experiences of females with uterine cancer have been analyzed prior to brachytherapy treatment. The qualitative research has been foregrounded on Martin Heidegger’s existential phenomenology which favors the understanding of instances experienced by the patients. Females who had already initiated some type of treatment for uterine cancer were investigated, although only those undertaken radiotherapy in a specific radiotherapy clinic in the northwestern section of the state of Paraná/Brazil, have been selected. They would later have to undergo brachytherapy treatment which occurred between April and May 2006. Four females were interviewed in an oncology hospital in the north of the state of Paraná, Brazil, prior to brachytherapy treatment. The following question was asked to elicit the subjects’ discourse: “What are your feelings prior to brachytherapy?” Three themes were categorized: the non-authentic being-with-the other in the hospital; anxiety in the face of the unknown therapy; religiosity or the way to hope. Results show the importance of holistic care to the person experiencing the facts since the subjectivity of care is absorbed by the huge number of rules and institutional norms...

Advanced practice nursing in radiation oncology.

OBJECTIVES: To discuss the roles of advance practice nurses in radiation oncology. DATA SOURCES: Published articles and textbooks, personal communications, and authors' experience. CONCLUSION: Radiation oncology advance practice nurses (NP and CNS) are becoming essential members of the multidisciplinary team, with distinct roles and responsibilities. Providing direct patient care, involvement in specialized procedures, and conducting initial and/or follow-up visits allows advance practitioners to become more involved with patients undergoing radiation therapy. IMPLICATIONS FOR NURSING PRACTICE: As more combined modalities are being offered to patients undergoing oncology treatments and the complexity of patients are becoming more difficult, advance practice nurses can add value to the workload, quality patient care, and make a difference in patient's lives.

Factors affecting patient selection for prostate brachytherapy: what nurses should know.

Prostate brachytherapy is a proven treatment for clinically localized prostate cancer; however, many clinicians have multiple misconceptions regarding patient selection criteria. Although most patients are candidates for the procedure, contraindications do exist. This article examines criteria for patient selection and the need for adjuvant therapies, proposes management philosophies, and discusses the impact of each on treatment decisions. Nurses' role in the decision-making process and how they can facilitate patients and families in making informed choices also are discussed. Clinical studies seek to further define patient selection criteria and examine optimal choices for adjuvant treatment and isotope preference. Expanding the knowledge base of nurses helps enhance patient care.

Nursing considerations in brachytherapy-related erectile dysfunction.

Following definitive local treatment for early-stage prostate cancer, preservation of erectile function has been assumed to be most likely following brachytherapy. However, recent studies have demonstrated that brachytherapy-related erectile dysfunction (ED) is more common than initially reported. The exacerbation of brachytherapy-related ED is closely related to several clinical, treatment, and dosimetric parameters including pre-implant erectile function and radiation dose to the proximal penis. The majority of patients with brachytherapy-induced ED respond favorably to oral erectogenic agents.

High-dose brachytherapy for treating prostate cancer: nursing considerations.

Radiation oncology nurses must be adequately educated on the care and management of patients and families undergoing high-dose rate brachytherapy for early-stage prostate cancer. The application of advanced assessment skills, while incorporating the treatment aspects of radiation, provides a framework for standards of nursing practice in this field. Current methodologies of radiation therapy are recommended for overall professional growth and improvement of patient care.

Advances in brachytherapy: new approaches to target breast cancer.

Advances in breast brachytherapy techniques have led to the development of new approaches for treatment of patients with early-stage breast cancer. This article reviews the indications, clinical utility, and nursing interventions for the Mammosite Radiation Therapy System (Proxima Therapeutics, Alpharetta, GA) and INTRABEAM (Photoelectron Corporation, North Billerica, MA) radiation therapy system. Each uses a slightly different approach to provide definitive radiotherapy to the breast tumor bed following excision. Radiation oncology nurses should have an understanding of how each system works to provide optimal care as it pertains to education, side effect management, and catheter care for patients receiving each of these types of radiotherapy. These innovative alternatives will greatly reduce required treatment time if clinical studies find them to be equivocal or superior to traditional radiation therapy techniques. These treatment approaches also may make radiation treatments more convenient for women with early-stage breast cancer.