A male patient is receiving external radiation to the neck for cancer of the larynx. The most likely side effect to be expected is ?

Appeared in: Chitranjjan National Cancer Institute Kolkata - 2021

Explanation

External beam radiation therapy (EBRT) primarily causes side effects localized to the specific area being treated.
For laryngeal cancer, the radiation field includes the neck, directly exposing the pharynx and larynx.
Radiation damages the rapidly dividing cells of the mucous membranes in the throat, causing inflammation known as mucositis or pharyngitis.
This inflammation clinically presents as a sore throat, pain, and difficulty swallowing (dysphagia), making it the most common and predictable side effect.

Option A: Dyspnoea (difficulty breathing) is a sign of a more severe complication, such as significant laryngeal edema, rather than the most common initial side effect.
Option B: Diarrhoea is a side effect related to the irritation of the lower gastrointestinal tract.
Option D: Constipation is not a direct side effect of radiation to the neck. It could occur secondarily due to opioid pain medication or poor fluid/fiber intake, but it is not a primary radiation effect.

Clinical Relevance

Nursing practice connection: Use the key finding related to Side effects of localized radiation therapy to guide bedside assessment, documentation, and the next nursing action.
Nurses play a crucial role in educating patients about the expected side effects of radiation, such as a sore throat. This preparation helps reduce patient anxiety and improves adherence to the treatment plan.
Proactive management of mucositis with appropriate oral care, dietary modifications, and pain relief is a key nursing responsibility to maintain the patient's nutritional status and quality of life.
What if? If the patient reported not just a sore throat but also stridor (a high-pitched breathing sound) and increasing dyspnoea, the priority would shift immediately. This would indicate a potential airway emergency from severe laryngeal edema, requiring urgent medical intervention to secure the airway.

How to Approach the Question

First, identify the key elements of the question: the treatment is 'external radiation', the location is the 'neck', and the question asks for the 'most likely side effect'.
Recall the fundamental principle of radiation therapy: its effects are primarily local to the treatment area.
Analyze the options in the context of the neck region. The throat is within the neck.
Evaluate each option: A sore throat is a direct inflammatory response of the throat tissue to radiation.
Eliminate the other options: Dyspnoea is a possible but more severe, less common effect. Diarrhoea and constipation are related to the lower GI tract, which is not in the radiation field.
Conclude that the most direct and common consequence of irradiating the neck is inflammation of the throat, leading to a sore throat.

Concept Tested & Keywords

Concept Tested: Side effects of localized radiation therapy
Stem keywords: external radiation, neck, cancer of the larynx, side effect
Lead-in keywords: most likely
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

QMkb8QGBmixErhG4CcSNGj

E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 p. 1-3

Practise the full Chitranjjan National Cancer Institute Kolkata - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.