Radiotherapy is about more than technology

We are grateful to Russell Fitchett, radiographer manager at Norfolk & Norwich University Hospital, for contributing this guest blog post.

Over the last twenty years the number of new developments in radiotherapy has been unprecedented.

Radiotherapy relies on technology and the advancement of technology is accelerating. The machines we use to treat patients can now spare healthy organs and deliver higher doses to tumours. Patients can be imaged during treatment so that any movement of the tumour can be tracked and adjusted for. Patients can be scanned during treatment, so any changes in tumour size since their last treatment can be assessed. These developments have improved outcomes and reduced side-effects.

When I began as a radiographer, treatments often involved leaving a patient alone in a treatment room whilst they were exposed to a radioactive source. We would sticky-tape their head to the couch, bolster their body with sandbags and watch through a porthole from outside, hoping the patient would lie still. If the radioactive source was an old one, we might have been watching, waiting and hoping for up to twenty minutes. Nowadays, radioactive sources are uncommon. Such is today’s computing power, we can deliver complex treatments in under two minutes. Gone is the sticky-tape, gone are the sandbags.

Our tools for collecting patient experiences seem blunt

Each new development arrives with a plethora of publications assessing its impact. But, important as it is to quantify the effects of interventions, I wonder if we have made enough effort to ask patients how they feel about the changes.

Our tools for collecting patient experiences seem blunt. In 2013, NHS England conducted a national radiotherapy patient experience survey (1), using a questionnaire that was given to over 36,000 patients. But none of the 48 questions asked for comments, and there was no face-to-face follow up.

There is a lack of depth in this kind of data.

I’m lucky enough to be currently funded by the National Institute of Health Research (NIHR) to study for a master’s degree in clinical research. The course has opened my eyes to qualitative research. Qualitative research involves exploring the richness of experience and, importantly, it can give patients a voice. Good qualitative research tells us what it means to be human and face life-threatening illness. It allows us to hear the stories patients want to tell – isn’t that why most of us became healthcare workers in the first place?

Many years ago, as a student radiographer, I used sandbags and sticky-tape to set up elderly gentleman for radiotherapy to his brain. The treatment was palliative and when we helped him onto the couch for his first session he could barely move or speak. On his third day of treatment he sat up and talked to me lucidly about his granddaughter’s forthcoming wedding and how he planned to be there. It seemed like some kind of magic had taken place and I have never forgotten it.

Whatever new developments are on the horizon for radiotherapy, we must remember why they are important. We need research that offers in-depth stories of patient experience. We need to be talking about the magic.

Reference

1.Department of Health. National radiotherapy Patient Experience Survey 2013. (accessed 20th June 2017).