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Patient experiences of brachytherapy for locally advanced cervical cancer: Hearing the patient voice through qualitative interviews

Humphrey, Pauline; Dures, Emma; Hoskin, Peter; Cramp, Fiona

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Authors

Pauline Humphrey

Emma Dures Emma2.Dures@uwe.ac.uk
Professor in Rheumatology and Self-management

Peter Hoskin

Fiona Cramp Fiona.Cramp@uwe.ac.uk
Professor in Long Term Conditions



Abstract

Purpose: Brachytherapy for gynecological cancer is reported to cause pain, anxiety, and distress with no clear guidance for optimizing patient experiences. The aim of this study was to explore patient experiences of brachytherapy and views on improvement. Methods and Materials: Semistructured interviews were undertaken with patients who had received brachytherapy for locally advanced cervical cancer. Two cohorts were recruited: cohort 1 had recently had brachytherapy, and cohort 2 was a year post brachytherapy. Four recruitment sites were selected, where brachytherapy is given in different ways, some with short day case procedures and others having 1 or 2 overnight stays with applicators in place. Consecutive patients were invited to interview. Participants were asked to retell their brachytherapy story, with views on their care and ideas for improvement. Interviews were audio recorded, transcribed, and data analyzed following Braun and Clarke's method for reflexive thematic analysis. Results: Thirty-five interviews were conducted (20 in cohort 1 and 15 in cohort 2). Participant's ages ranged from 28 to 87 years. The interview duration ranged from 22 to 78 minutes. Difficult and traumatic experiences were reported, including periods of severe pain and perceptions of poor care. However, some participants described positive experiences and what went well. Three themes were developed: (1) how the patient got through it, (2) unpleasantness, discomfort, and the aftermath, and (3) emotional consequences and trauma. Some aspects of medium and long duration brachytherapy were found to be more problematic compared with short duration brachytherapy. Exploring experiences at 1-year post brachytherapy has provided insights into the long-lasting impact of brachytherapy experiences. Conclusions: Hearing the patient voice has demonstrated that further work is needed to improve patient care in modern brachytherapy techniques using different regimens and durations, to minimize difficult and traumatic patient experiences. Study insights will inform future work to develop clinical care recommendations.

Journal Article Type Article
Acceptance Date Dec 15, 2023
Online Publication Date Dec 26, 2023
Publication Date Jul 1, 2024
Deposit Date Feb 5, 2024
Publicly Available Date Feb 6, 2024
Journal International Journal of Radiation Oncology Biology Physics
Print ISSN 0360-3016
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 119
Issue 3
Pages 902-911
DOI https://doi.org/10.1016/j.ijrobp.2023.12.016
Keywords Brachytherapy; Locally advanced cervical cancer; patient interviews; patient experiences; thematic analysis; qualitative
Public URL https://uwe-repository.worktribe.com/output/11543753
Publisher URL https://doi.org/10.1016/j.ijrobp.2023.12.016

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