Patient Perceptions and Expectations of Radiation Therapy

Abstract

<h3>Purpose/Objective(s)</h3> While patients obtain information about radiation therapy (RT) from their physician, they may receive information from multiple other sources. There is currently limited data regarding patient expectations related to RT. This study sought to identify expectations regarding RT and to determine the potential value of assessing these expectations prior to initial consultation. <h3>Materials/Methods</h3> Patients with no prior history of RT were invited to complete an investigator-developed anonymous electronic survey. Patients were queried about their perceptions of RT and potential fears/concerns. The content validity index for survey items were scored with adequate construct validity. Survey items were scored descriptively through summary statistics. Relationships between respondent variables and responses to survey questions were analyzed by univariate logistic regression. <h3>Results</h3> From September 2020 through January 2021, 117 patients completed the survey. The most common cancer diagnoses were hematologic malignancies (20%), breast cancer (15%), and lung cancer (12%). 35% percent of patients reported having read or heard stories about "bad side effects" from RT. 22% percent of patients identified friends/family as their main source of information about RT, while 20% reported the internet, 14% physicians, and 1% scientific articles. 41% percent of patients reported a complete lack of knowledge about RT. Common misconceptions included beliefs that they could only receive RT once (46%), they will give off radiation (38%), and radiation will be excreted in their urine/stool (33%). The most commonly reported fears/concerns included RT-induced pain (71%), risk of infection (71%), and memory loss (61%). Related to quality of life (QOL), patients were most concerned about RT-induced fatigue and inability to conduct routine daily activities (62%). Females were more likely to be concerned about RT-induced pain (OR = 2.58, <i>P</i> = 0.03), "skin burn" (OR = 2.31, <i>P</i> = 0.03), and infections (OR = 2.58, <i>P</i> = 0.03). Age > 81 yrs and being unmarried are associated with increased concern for daily transportation (OR = 25, <i>P</i> = 0.03 and OR = 2.86, <i>P</i> = 0.02, respectively). College educated or beyond individuals were less likely to be concerned about excreting radiation in urine/stool (OR = 0.12, <i>P</i> < 0.01). Individuals who identified as Hispanic were more concerned about giving off radiation (OR = 4.6, <i>P</i> < 0.01), secondary malignancies (OR = 4.56, <i>P</i> < 0.01), and memory loss (OR = 5.13, <i>P</i> < 0.01) compared to Caucasians. <h3>Conclusion</h3> Prior to initial consultation, a majority of patients acquire information about RT from non-physician sources, which results in misconceptions. Fears/concerns related to RT toxicities and impact on QOL were common. Routine pre-consultation assessment on patients' expectations regarding RT may help physicians address misconceptions and fears/concerns early, as well as potentially identify needs.