Decision Making
How is the decision made as to whether to continue with radiation treatments?

Several factors are taken into account when deciding whether to continue radiation treatments:

  • the wishes of the person who’s ill;
  • the amount of radiation already delivered to the target area;
  • the overall strength and energy of the person who’s ill.

Patient’s wishes

The main consideration is what the patient wants. If the person doesn’t want further treatments, then other issues are irrelevant.

Amount of radiation already received

The health care team needs to consider how much radiation the target area has already had. There’s a point where more radiation simply causes damage, and the damage can be worse than the problem being treated. Each part of the body can take only so much radiation over a lifetime. A radiation oncologist monitors the amount given, and doesn’t go beyond the lifetime limit. The spine and brain are areas of special concern, as radiation damage to those areas causes loss of nerve function.

Overall strength and energy

Although radiation is given only to a specific area, it takes a toll on the whole body. It usually makes people feel tired and drains overall energy. This is usually temporary, but if someone’s energy reserve is very low, it’s hard to bounce back. There are times when radiation will not cause local damage, as levels are still below the lifetime amount, but the person is too weak to tolerate more treatments. This is a difficult assessment. It’s based on overall strength, independence, and how quickly things are changing.

Sometimes when people are told that they won’t receive more of a particular treatment, they worry that it means there’s nothing more to be done. This is far from true. It’s simply that the focus of care shifts. The person’s comfort becomes more important than the illness. There’s much that can be done to improve comfort and quality of life.