Oncology: Radiation
Monday, December 29, 2025
Oncology: Radiation
NCLEX Memory Hints © BrainyNurses.com
Radiation therapy may be external or internal depending on the type of cancer that is being treated. Medical professionals need to use radiation precautions when unsealed radiation is used.
External Radiation
External radiation is also known as teletherapy. It is done Monday through Friday for 15-30 minutes a day at a center. After 5 days, fatigue is a major side effect. Patients need the two-day period to rest and strengthen their immune system. The patient will not be radioactive after a treatment.
Tissue damage to the target area may be seen and precautions will need to be taken such as gently washing the areas with plain water and patting dry; soft, loose clothing over the area; and no rubbing or scratching the area.
Radiation pneumonia may develop with chest radiation. Pulmonary function tests will be performed prior to initiation of therapy and periodically. Lung injury may also occur with select chemotherapy drugs.
Targeted Tissue Damage
Radiation Pneumonia
Targeted Tissue Damage
Radiation Pneumonia
Internal Radiation
Internal radiation is also known as brachytherapy. The radiation dose is concentrated in the tumor and may be temporary or a permanent implant. It may also be sealed or unsealed. As an example, prostate cancer may be treated with temporary or permanent internal radiation.
Temporary (in prostate cancer)
Temporary-hollow needles or catheters filled with radioactive material are placed into the prostate gland for 5-15 minutes and then the material is removed. The process is repeated 2-3 times over several days.
Permanent (in prostate cancer)
Anywhere from 40-100 seeds are implanted in the prostate gland. After a couple of months, no radiation remains. In prostate cancer, it is used when the cancer is not very aggressive.
Sealed Radiation
Sealed radiation emits radiation, but excretions are not affected, and radiation precautions are not needed. Examples include prostate and breast cancer.
Unsealed Radiation
Unsealed radiation emits radiation in the excretions and radiation precautions are needed. Examples include oral seeds, implants, any injections, bladder instillation, and Iodine-131.
An internal, temporary implant may be used for cervical and endometrial (uterine) cancer. A complication is a fistula between the vagina and bladder or rectum. Bedrest, urinary catheter, and a low-residue diet is required. If dislodged, the radiation implant will be placed in a sealed box.
Bladder instillation (intravesical) is used for bladder cancer. Once instilled, the dwell time is 2 hours with shifting every 20 minutes. After being eliminated in the toilet, household bleach is used for disinfection for up to six hours.
Radiation Precautions (Memory Hint)
Radiation precautions are used for unsealed radiation.
Time: Limited with the patient and should be a maximum of 30 minutes in 8 hours.
Distance: Minimum distance of 6 feet is maintained when possible.
Shielding: Needed when longer time is spent or closer contact with the patient. Because of the design of the shield, the nurse must back away to avoid radiation exposure to the back.
Summary
In preparing for the NCLEX exam, know the broad implications about external and internal radiation. When it is unsealed radiation, “time, distance, and shielding” are the general principles. Also, be aware of the specifics for bladder instillation (intravesical).
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