Communicating the benefits/risks of radiation therapy: maintaining context, perspective, and reassurance

When communicating the benefits and risks of radiation therapy, it is important to provide context, perspective, and reassurance. Radiation is inherently frightening. While this may make discussions about medical radiation's benefits-risks challenging, it also reinforces our responsibility for meaningful and clear discussions with patients, families, colleagues in non-radiation fields, and the public. We need to clearly acknowledge the risks of radiation but also reinforce therapeutic benefits of radiation. For most clinical situations, the benefit-risk ratio is favorable for radiation. Further, we must provide reassurance that we are doing what we can to minimize the risks. This approach helps to build confidence in the radiation team. Obtaining informed consent for patients recently diagnosed with cancer is challenging, since receiving the diagnosis is often extraordinarily stressful. Many patients do not remember or understand verbal discussions at the time of initial consultation. Thus, it is often helpful to provide written information that can be digested by the patient over time. Formal benefit-risk discussions often continue throughout the course of radiation. Further, patients' interactions with all members of the radiation team (e.g., asking questions, understanding the processes) help to augment these formal discussions and build confidence in the entire team-a critical component of informed consent. Since many of the risks of radiation occur months to years post-treatment, discussions with patients need also to consider their prognosis and longevity.