A Radiation Therapist's Fight Against Cancer

Having a career in radiation therapy consists of numerous responsibilities and generally requires earning a bachelor's degree, associate degree, or certification and in many states licensing. Radiation therapists generally work in hospitals, cancer treatment centers, or physician offices. Radiation therapy can be prescribed by a physician in an effort to completely eliminate or reduce the size of a benign or malignant tumor and is often used in conjunction with surgery and/or chemotherapy. There are three ways radiation therapy is mostly used, which is external beam therapy, brachytherapy or intraoperative. External beam therapy is administered with a linear accelerator machine using either high energy x-rays, electrons, protons or gamma rays. Brachytherapy involves the use of a radioactive source being placed directly inside or near the tumor site inside the body. And intraoperative allows radiation to be delivered to a surgically exposed tumor. One of the main responsibilities of a radiation therapist is to administer doses of radiation to infected areas using radiation therapy equipment according to standards. Being a radiation therapist requires many skills such as, good interpersonal and communication skills with co-workers and patients, empathic attitude, data entry and record maintenance. Also, a radiation therapist must be physically, mentally and emotionally sound due to the physical positioning of patients and the emotions involved with treating ill or terminally ill patients. The two most common tasks of a radiation therapist are simulation, and treatment delivery.

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Once a patient is diagnosed, the first step is to develop an effective treatment plan for radiation therapy delivery, this happens in simulation. In simulation the radiation therapist uses an x-ray imaging machine or computer tomography (CT) scan to define and map out the exact location of the tumor and the treatment parameters so that radiation exposure is mostly limited to the tumor cells, in an effort to spare normal cells. Next, one of the most important steps are taken, positioning and constructing immobilization devices such as, casts, molds, headrests and other devices. Immobilization devices are used to help with the accuracy of the positioning during the actual treatment. The therapist will be dealing with patients of all different sizes and weight; some may also be disabled so he/she must take caution in positioning the patient to decrease chances of injury to them self or the patient. Measurements from simulation are then recorded and used in the treatment planning. The radiation therapist may assist in the treatment planning but the majority of it is done by a medical dosimetrist (a technician who calculates the dose of radiation that will be used for treatment, using complex mathematical calculations), and a radiation oncologist (a physician who specializes in therapeutic radiology). The therapist will then explain the plan of treatment and answers any questions that the patient may have, and makes sure the patient knows the risks and the expected result.

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The results of treatment will vary from patient to patient. Approximately 1,437,180 people are diagnosed with cancer each year and about 1 in 4 will die of cancer. Radiation therapists deal daily with terminally ill patients and must understand the emotions and mental state of their patients and themselves. Providing emotional support is within the scope of practice for the radiation therapist. Those with terminal illness usually experience "The Grief Cycle" which includes shock, denial, anger, bargaining, depression, testing, and finally acceptance. Some terminally ill patients may wish to refuse treatment and die in dignity. Some patients may receive palliative treatment (noncurative treatment used to relive pain) in an attempt to increase quality of life. The physician and therapist must respect autonomy and follow the patient's wishes. Stressful conditions due to meeting deadlines, the amount of patients requiring treatment and the emotional stress of dealing with patients that may not be responding well to treatment are dealt with everyday. The therapist must maintain a healthy lifestyle and positive attitude to avoid burnout, which can negatively affect patient care.

Survival rate of cancer patients has increased dramatically over the last 30 years, with an approximate 61% survival rate currently. With more knowledge and technological advancements the survival rate should continue to increase. About half of the patients diagnosed with cancer will require some form of radiation therapy. Treatment delivery from the therapist begins with positioning the patient and adjusting the linear accelerator according to the parameters established in simulation. Then, the therapist will deliver the prescribed type and dose of radiation by operating the linear accelerator from a separate protected room while monitoring the patient's condition through a TV monitor and an intercom. Treatment can take anywhere from 10 to 30 minutes and is usually administered once a day, 5 days a week, for 2 to 9 weeks. The radiation therapist will monitor the physical condition of the patient to determine if any side effects are taking place, and be aware of the patient's emotional well being. Detailed records are made about the patients' treatments including, radiation dose, the amount used to date, the area treated, and the patient's reactions. The radiation oncologist and dosimetrist review these records to ensure that the treatment plan is working. Adjustments may be made accordingly.

In conclusion there are many skills, responsibilities and tasks a radiation therapist must perform. The therapist must possess good communication skills, provide emotional support to the patient, and maintain a healthy lifestyle and positive attitude. Some of the responsibilities include assisting with treatment planning, monitoring the patients overall well being and recording information about the treatment. And the most common tasks performed by the radiation therapist are simulation and treatment delivery. Although dealing with terminally ill patients is common there are many rewards such as playing an integral role in patients' recovery, overcoming challenges that arise in cancer treatment and opportunity for advancement. A radiation therapist may go on to become a dosimetrist, medical physicist a radiation oncologist or even perform research at a university and try to develop a cure for cancer. In my opinion any position in the field of oncology can be rewarding due to the satisfaction each team member gets from being responsible for the survival of or even possibly curing a cancer patient.

A Radiation Therapist's Fight Against Cancer
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