[medicrnohio]

Hello! I am curious about something and thought maybe somebody on this board could help me. I am currently a nursing student (not too far along yet, haven't studied oncology) and I also work as a paramedic. We have a patient that we are transporting from home to radiation therapy and back. This patient is receiving intravenous radiation for bone cancer. My question is will transporting her expose us to radiation? Is there any precautions we should be taken other than the normal universal precautions? Is there anyone that should not be around this patient (ex. pregnant paramedics, people who are sick, etc.)? If someone could help me out with this I would appreciate it. Thanks so much.
Michelle

[jemb]

Not sure what you mean by IV radiation, unless the patient is receiving IV therapy (chemo or pain medication most likely) in addition to the radiation treatments. We have patients who receive radiation and chemo concurrently. Sometimes the chemo is administered via a pump that the patient keeps with them.

That said, no, you cannot be exposed to radiation by transporting a patient to and from treatment, or by being around a patient who is receiving radiation treatment by external beam.

The only time there is a concern of exposure is when the patient has an implanted radiation device, for which they would be in radiation isolation in a facility. For those patients, we wear radiation badges to measure our exposure, and there are limitaions on time allowed, distance to maintain, etc. Pregnant women do not take care of these patients.

[medicrnohio]

Thanks for your response. Basically all we were told is that this person was receiving an IV injection of radiation for diffuse bone cancer. They said that it was a pain relieving measure as it would travel throughout the body. From the little I could find while researching this topic, I think it is called brachytherapy. What I read said that basically this could include implants and injecting a radioactive isotope directly into the veins of a patient. As far as chemo, this patient is on hospice and is receiving the radiation for pain control purposes only, so no chemo for her.

We often transport patients who get external radiation and I have never been concerned about that. But this just seems like the patient would be excreting radiation through body fluids such as blood, urine, etc.

[jemb]

I haven't personally had a patient receiving brachytherapy. However, I do know that the radioactive 'seeds' used in this type of treatment are sealed, and are designed to be implanted directly into the tumor or affected area. The radiation level decreases as the distance from the seed increases, which is how this particular type of radiation therapy can kill the tumor cells without damaging tissues away from the tumor.

I looked for info for you re IV radiation, but found nothing useful.

Could you call the facility and ask whether you need to use any precautions beyond universal precautions for this patient? You could ask in a 'generic form'. so no one would have to wonder if answering the question for you would violate patient confidentiality. Or ask your supervisor to find out for you, so that whatever policy is stated will be 'official'. If your company contracted to transport the patient, they should have this information, don't you think?

[medicrnohio]

Thanks everyone for your responses. I am going to ask the hospital next time I am there. Unfortunately my company doesn't find that giving us this kind of information is important. It's all about the money and nothing more.

[das]

What I believe you are referring to would be strontium chloride Sr89. It is used for bony met pain from prostate or breast cancer. Patient have experienced relief for 4-16 months. It is administered in Radiation Oncology .

[efiebke]

Originally posted by das
What I believe you are referring to would be strontium chloride Sr89. It is used for bony met pain from prostate or breast cancer. Patient have experienced relief for 4-16 months. It is administered in Radiation Oncology .

Strontium Chloride Sr89.

It could be, actually. It's good stuff!! But I don't know if there's a radioactive component thingy to it.

Way back when I was doing onc/heme-onc/BMT type of nursing, we had a patient with very, very, very bad bone mets from metastatic breast cancer. She was receiving enough hydromorphone (Dilaudid) through drips & prn dosings to kill a heard of elephants!

Really!

And still the pain anquished her. Unable to walk, etc.

Around that time they were just beginning to investigate Strontium Chloride Sr89 for palliative boney-mets type of patients and she was picked to be part of the study. This anguished patient was given the Strontium and within a relatively short period of time she was able to be weened significantly down from the Dilaudid gtt. . . and she was able to walk with the aid of a walker!

Need to stress the word "palliative" here! There was no intent for cure at that time. Just pain relief by debulking the tumors within her bones.

It worked!

Since then, I had a co-worker whose father was in horrible bone pain from metastatice prostate cancer. I suggested Strontium Chloride Sr89 (which is now in Nursing Drug Book "2000 & something"). She took the suggestion, presented this treatment to her father oncology doc. . . and her father received the drug! It worked!

Again, stress the word "palliative"! Because, in both cases, the patients succumbed to their cancer. And, sadly, pain did return as well.

But hey. . . if a patient with metastatic bone cancer can receive even a few months of pain relief because of this and other therapies, then that is a good thing. Don't you think?!?

Ted