Radiation Appointments Are Numerous—And Necessary
New study shows impact of missed treatments.
By Marilyn Fenichel
Cancer patients undergoing radiation therapy typically have appointments scheduled five days a week for five to eight weeks. This may make it difficult to line up transportation or find child care, leading to missed appointments. It might seem like skipping a few appointments and tacking them on at the end won’t make a difference.
But a new study suggests that’s not the case. For some patients, missing two or more scheduled radiation therapy appointments can do more than extend treatment time. It can mean a greater risk of recurrence.
Nitin Ohri, a radiation oncologist at the Montefiore Einstein Center for Cancer Care in New York City, and his colleagues analyzed records of 1,227 patients who were scheduled for radiation therapy for cancers of the head and neck, breast, lung, cervix, uterus or rectum at the cancer center. The study, published online Jan. 29, 2016, in the International Journal of Radiation Oncology Biology Physics, found that 226 patients missed two or more appointments, which prolonged their treatment by an average of one week.
After about five years, 16 percent of patients who missed two or more appointments experienced a recurrence, compared with 7 percent of patients who missed one appointment or none.
For patients with head and neck or cervical cancer, skipping appointments may be especially risky. “These cancers grow fast, so they can gain ground if appointments are missed,” says Ohri.
Theodore Lawrence, a radiation oncologist at the University of Michigan Medical School in Ann Arbor, says this study confirms previous findings, pointing to the need to develop strategies to help patients—in particular those with head and neck or cervical cancer—“stay on track.”
As the study findings began to come to light, health care providers at Montefiore started asking patients why they were missing appointments.
“Based on our interviews, we found that transportation was the number one challenge,” says Krista McCarthy, an oncology social worker at Montefiore, who now proactively puts patients in touch with programs that help patients get to their appointments.
“We have strategies to help patients [at Montefiore] stay on course," says Ohri. “Our goal is to implement them so all patients can benefit from effective cancer treatments.”