What is the best way to support patients undergoing radiation therapy?

In this issue of the Journal of Medical Radiation Sciences, Sarah Lewis provides a personal account of her breast cancer journey. As medical radiation professionals it is confronting to experience loved ones going through cancer and radiation therapy; furthermore it is very difficult and challenging as trained medical radiation professionals to be faced with medical procedures, illness and receiving treatment. Sarah’s article brings home the importance of research focusing on patients’ perspectives and improving the way that we communicate and deliver education to patients throughout their cancer journey. Such a personal account presented extends our understanding of the journey patients have and the importance of considering this when we are communicating with patients, delivering education and preparing them for treatment. It may well be that patients are nervous or anxious when they present to radiation therapy because they have had a difficult experience in another health setting or perhaps have already experienced chemotherapy side effects. In a recent systematic review, Waller et al. highlighted the need for further research to be conducted to guide how we prepare patients for radiation therapy. The process of informing patients varies considerably between radiation therapy centres throughout Australia and New Zealand. We are currently conducting a study entitled ‘RT Prepare’ which focuses on whether tailored education and support provided by radiation therapists (RTs) at the time of computed tomography (CT) planning and day 1 of treatment reduces anxiety and improves patient preparedness for treatment. Prior to delivering the intervention RTs participate in two training sessions focusing on (1) eliciting and responding to emotional cues and (2) preparing patients for radiation therapy. Participating study sites are located in Victoria, South Australia and Western Australia. Our pilot study showed positive results and we aim to publish our findings from our larger trial later this year. Sarah reported that she was comfortable in the radiation therapy setting because of her medical radiation knowledge and the time RTs spent chatting with her on a daily basis. In our previous research we also found that patients placed high importance on RTs communicating effectively and were pleased when they were able to form a relationship with the RTs who treated them regularly throughout their treatment. RTs need to remember how important these relationships are for patients. Much of our time is focused on patients; however, involvement of family members is likely to improve the experience of patients and their loved ones. Research is warranted in exploring family members’ perspectives and whether their involvement in education sessions reduces both patient and family member anxiety. Sarah does not identify as a survivor and touches upon the possibility of recurrence. While Sarah does not report feeling anxious, cancer survivors often report an ongoing fear of cancer recurrence, and periods of depression and anxiety. These issues need to be recognised and addressed. A number of studies have been conducted on who can provide follow-up support and monitor treatment-related outcomes. However, further research is needed to ensure we meet the needs of patients, particularly with a greater number of patients being diagnosed with cancer and the increased workload in radiation therapy centres. In our initial research looking at the experiences of patients completing radiation therapy, we found that patients had many information needs relating to treatment completion and follow-up. End of treatment is now acknowledged as an important transition and there is debate about follow-up. Certainly at the end of radiation therapy there is a window for RTs and radiation oncology nurses to provide end of treatment information and support.