Palliative Use of Ionizing Radiations

To cure sometimes To relieve often To comfort and support always TrudeauIonizing radiations can be very effective in the relief of symptoms and/or signs caused by/or associated with malignant tumors.In addition, many potential clinical problems, such as fracture of a tumor-weakened bone, can be anticipated and prevented.The assessment of the success of palliative treatment is much more difficult than it is for curative therapy, where tumor-free survival can be measured.It is difficult to measure the importance of accomplishments such as the relief of pain or the cessation of hemotysis for the shortened life span of a patient with uncontrolled tumor.While there is general agreement about the application of curative treatment for most cancers, there is much less agreement about protocols for palliative treatment.Each specific clinical problem, in the overall perspective of ultimately uncontrollable cancer, may be different than any seen before.This balancing of the pros and cons of treatment, expense, inconvenience and impact on the patient and family usually requires greater physical judgment than required for decisions related to curative therapy.There is no clinical situation where communication between the physician and the patient and family is more important.This communication requires: honesty; attention to signals from the patient about information desired; explanation of disease status, treatment aims and possible side-effects; and a realistic fostering of hope that such treatment can improve the quality of the patient's life.Indications for palliative radiation therapy for the patient with cancer include: relief of pain; maintenance of