ASTRO 2026: Early Radiation in Head and Neck Cancer Care

At the American Society for Radiation Oncology (ASTRO) 2026 Annual Meeting, oncology nursing leaders highlighted the pivotal role of advanced practice providers (APPs) in optimizing care coordination for complex solid tumors.

In an on-site interview with Oncology Nursing News, John V. Hillson, DNP, AGPCNP-BC, OCN, RN, Nurse Practitioner in Radiation Oncology at Atrium Health Wake Forest Baptist, detailed a targeted quality improvement initiative aimed at improving timeliness and preparedness for head and neck cancer patients requiring adjuvant radiation therapy.

Hillson emphasized that bridging communication gaps between inpatient surgical floor teams and outpatient radiation oncology clinics is critical to clinical success.

Key Takeaways for Oncology Nursing Practice

• Strict Post-Surgical Timeline: Head and neck cancer patients achieve superior clinical outcomes and survival rates when adjuvant radiation therapy initiates within 6 weeks of surgery.
• Early Inpatient Counseling: Pre-discharge counseling by radiation APPs—often initiated before final pathology reports return—allows patients time to digest complex treatment expectations.
• Interprofessional Alignment: Educating inpatient surgical floor staff regarding radiation treatment timelines resolves knowledge gaps across care teams.
• Proactive Symptom Preparation: Early discussion regarding functional impacts, including dysphagia and nutritional challenges affecting medication administration, empowers patients and caregivers to prepare effectively.

Initiating Early Counseling and Interprofessional Synergy

Clinical evidence indicates that delaying post-operative radiation therapy beyond the recommended 6-week window compromises local control and overall survival in head and neck malignancies. However, operational disconnects between inpatient surgical floors and outpatient radiation clinics frequently impede care transitions.

To eliminate these barriers, Hillson instituted proactive inpatient visits shortly after surgical resection. By reviewing operative findings and high-risk pathological features before discharge, radiation oncology APPs introduce treatment rationales well in advance of outpatient consultation.

"I'll now go and see patients a few days after surgery and go and discuss the need for radiation with them," Hillson stated. "And even if the pathology is not back, we'll see features that let us know that radiation is required.”

Fostering Psychological Readiness and Treatment Adherence

Head and neck radiation therapy carries substantial acute toxicities, including severe mucositis, xerostomia, and dysphagia, which frequently threaten treatment adherence and nutritional intake.

Initiating discussions while patients recover on the inpatient unit affords individuals and families vital time to process side effect management, emergency contact protocols, and dietary modifications.

"If we go and [make sure] the patient is actually aware of the necessity for the radiation therapy, knowing the side effects, knowing the context, we can actually have a greater positive outcome," Hillson noted. "We can have better survival rates... the patient has a month to think about the necessity and to come to terms with something that they maybe never heard of.”

Hillson emphasized that early notification allows patients and caregivers to establish necessary support systems before treatment-related toxicities emerge.

"Preparing for a cancer treatment that might make it difficult to eat and drink and take your medications that takes time for a patient to come to terms with that," Hillson concluded. "And to hear that as early as possible really makes the outcomes a lot stronger for them.”

References

1. Hillson JV. The Growing Role and Opportunities for Nurses and Advanced Practitioners in Radiation Oncology. Presented at: American Society for Radiation Oncology (ASTRO) 2026 Annual Meeting; September 26-30, 2026; Boston, MA. Session EDU 10.