Health systems articulate value in terms of quality and patient satisfaction, which is typically measured by factors such as caregiver communication, staff responsiveness, adequacy of pain management and acceptability of the environment. These factors become integral parts of the experience during your patient’s breast cancer journey.1
With so much emphasis on the patient experience, we want to share new insights on women undergoing radiation therapy for breast cancer, and outline five simple questions you can answer to keep your patients better informed about breast brachytherapy.
The March 7, 2018, issue of Breast Cancer News reported on a recent study published in CANCER, a scientific journal of the American Cancer Society., In the article, “The Patient’s Perspective on Breast Radiotherapy: Initial Fears and Expectations Versus Reality”, researchers at the University of California Los Angeles (UCLA) share insights from a survey of patients treated for breast cancer between 2012 and 2016.2
Among the 327 patients who responded to the survey, a majority (about 83%) underwent breast conservation surgery, or a lumpectomy and radiation therapy; others underwent a mastectomy. The following is an excerpt of the findings:
A majority of respondents — 68% or 221 patients — had little or no knowledge of radiation therapy prior to treatment. 47% — 152 patients — acknowledged hearing unsettling and frightening reports.2
Post-treatment, however, an overwhelming majority of those treated with breast conservation therapy (92% or 247 patients) agreed with the statement: “If future patients knew the real truth about radiation therapy, they would be less scared about treatment.”2
These findings were attributed to the significant advances over the past twenty years that allow radiation to be delivered in a modern modality that spares healthy tissue and major organs such as the heart and lungs. Physicians are also able to create an individual plan for each patient, and to deliver treatment on more convenient schedules.
A simple way to communicate with patients about modern radiation treatments like brachytherapy is with these easy-to-remember 5 W’s: Who, What, Where, When and Why.
Who will be the team? Patients should know all the members of the surgical, oncological and radiation therapy team that will be involved in their care. If possible, make sure they meet all the team member before treatment starts.
What type of treatment is recommended? APBI brachytherapy is recommended as an attractive treatment approach with a high level of precision, versatility and flexibility. It has proven efficacy and multiple studies have shown it is equivalent to whole breast irradiation (WBI).3 The benefits of APBI brachytherapy include an at least four-fold reduction in total radiation exposure to healthy surrounding tissue and nearby structures, preservation of future treatment options; and a shorter course of therapy.4
Where does the treatment take place? The location and environment are important. If possible, have them see the radiation center in advance. Let them know the process each day they will come for radiation. If they have options on locations, patients can choose the location that best fit into their daily schedule. Consider your patients’ lifestyle and daily demands. Convenience is important.
When would the treatment take place–how often and for how long? Brachytherapy is delivered for a five days (2 times a day) – a new study is currently being completed that looks at shortening that to a total of three fractions delivered in only two 2 days.
Why is this the treatment that is being recommended? This is perhaps the most important of all the questions. Help patients understand the relevance of the treatment to their personal diagnosis and why it is the most effective treatment for their individual type of cancer.
- Hospitals and Health Networks, The Five Key Elements to a Hospital’s Value Proposition, Kaufman, Oct, 2015
- Breast Cancer News, Radiation Therapy ‘Less Scary’ Than Expected, Breast Cancer Patients Agree in Survey, Carolina Henriques, March 7, 2018
- Strnad V, Ott OJ, Hildebrandt G, et al. 5-year results of accelerated partial breast irradiation using sole interstitial multicatheter brachytherapy versus whole-breast irradiation with boost after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: a randomised, phase 3, non-inferiority trial. Lancet. 2016;387(10015):229-38.
- Cianna Medical press release, New Data Demonstrate Accelerated Partial Breast Irradiation with Multicatheter Brachytherapy is Clinically Equivalent to Whole Breast Irradiation in Treating Early Stage Cancer, October 2015