Exploring patient perceptions of the current breast radiotherapy pathway and a future upright radiotherapy solution

Introduction

Breast cancer remains a major global health challenge. Around 60 % of patients receive radiotherapy as part of their treatment, typically in the supine position. Upright positioning offers an alternative, potentially reducing treatment room costs. This study explored patient perceptions of (i) conventional supine treatments and (ii) upright positioning.

Methods

Women with lived experience of breast radiotherapy joined a participatory co-design workshop with healthcare practitioners, academics, and industry researchers. The workshop included three stages: 1) Sharing Experiences, participants discussed lying-down radiotherapy, including positioning aids and in-room experience; 2) Improving Experience, the group explored ideas to enhance patient experience; 3) Upright Experience, participants sat for 10 min in a demonstrator upright radiotherapy chair, provided comfort scores, comments, and completed short questionnaires comparing it to supine treatment. Discussions were audio-recorded, transcribed, and analysed using framework analysis. A live-drawing artist captured key themes. Participants sense-checked reported themes to ensure trustworthiness.

Results

Ten women aged 37–69 years participated; 80 % were white British and 20 % mixed heritage. Time since radiotherapy ranged from 9 months to 4 years. Six themes emerged: 1) Everyone has a different journey, 2) The whole journey is hard, 3)“Radiotherapy will be a breeze”, 4) Understanding positioning and environment, 5) The ‘worst’ radiotherapy service: what might that look like? 6) The ‘best’ radiotherapy service: what might that look like? Overall, upright positioning was viewed favourably: 77.8 % of participants found the upright demonstrator chair comfortable, compared with 11.1 % for supine position experienced for treatment (n = 9).

Conclusion

This study reinforces previous research findings on the emotional and physical experiences of supine radiotherapy; new insights were patient-determined service improvements.

Implications for practice

Upright radiotherapy may improve comfort and emotional well-being, offering new opportunities for patient-centred radiotherapy.

Patient Views on Upright vs. Traditional Breast Radiotherapy: Comfort and Experience Insights

What is it about?

The study explored the potential for improving breast cancer radiotherapy through the use of upright (sitting in a chair) patient positioning as opposed to the conventional supine (lying down) method. The methodology involved a participatory co-design workshop with women who had experienced radiotherapy following a breast cancer diagnosis and healthcare professionals to gather insights on patient experiences and preferences. The workshop included discussions on the experience of supine radiotherapy, ideas for improving patient experiences, and a hands-on evaluation of an upright radiotherapy chair. Ten women participated, providing comfort scores and feedback on both supine and upright positioning. The study identified six key themes from the discussions and found that 77.8% of participants preferred the comfort of the upright positioning compared to the experience they had lying down for radiotherapy. This research offers insights into patient-centered improvements in radiotherapy by highlighting the potential benefits of upright positioning in terms of comfort and emotional well-being.

Why is it important?

This study is important as it explores an innovative approach to breast cancer radiotherapy by examining the potential benefits of upright positioning over the conventional supine method. By focusing on patient experiences, the research highlights opportunities for enhancing patient comfort and emotional well-being during treatment. The findings suggest that upright radiotherapy could for this patient group improve patient-centred care, offering a significant advancement in the management of breast cancer. This study underscores the importance of integrating patient feedback into the development of new radiotherapy techniques, potentially leading to more personalized and effective cancer treatments.

Key Takeaways:

1. Patient Comfort: The study reveals that 77.8% of participants found the upright radiotherapy chair comfortable compared to only 11.1% who found the supine position comfortable, indicating a preference for upright positioning during treatment.

2. Diverse Experiences: The research underscores the variability in patient journeys, emphasizing that each individual's experience with radiotherapy is unique, which can inform tailored approaches to treatment and support.

3. Service Improvement Insights: Participants identified key features of both the 'best' and 'worst' radiotherapy services, providing valuable insights into patient-determined service improvements and highlighting the importance of patient-centered care in enhancing the overall treatment experience.