GPP05 Presentation Time: 9:36 AM

Abstract

Purpose

Gynecologic Brachytherapy is the standard of care for cervical cancer diagnoses and is critical to patient survival. Patients who have accessed brachytherapy have a significantly higher 5-year survival rate compared to patients who do not. However, brachytherapy treatment induces significant degrees of patient discomfort, anxiety, and physical and psychological distress. Limited patient experience research conducted, demonstrates the toll that current brachytherapy practices have on cervical cancer survivors’ ability to survive treatment and then face physical, mental, and sexual health side effects. This is documented in medical literature but has yet to influence brachytherapy procedure protocols in practice today. Knowledge and communication gaps coupled with inconsistent procedure preparation and administration leave patients underprepared for current treatment protocols and suffering in pain with long-term side effects. Improving patient treatment compliance and quality of life outcomes entails standardizing and implementing pain control, offering thorough patient education, and innovative technological advances. Thus, this study aims to 1) raise awareness for critical unmet needs in gynecologic brachytherapy; 2) assess the survivorship impact of current treatment practices; and 3) identify medical information, communication and tools necessary to improve quality of life outcomes.

Materials and Methods

Eighteen cervical cancer survivors who received brachytherapy treatment were interviewed on video in-person and in virtual video conferencing meetings. The semi-structured interview was conducted to document the patient experience and identify opportunities to address challenges both patients and providers face in care. Study group participants were recruited by connections with US and international patient advocacy and survivorship networks.

Results

Thematic review revealed a significant need for five critical unmet needs: 1) treatment safety and comfort challenges associated with current procedure medical device equipment, “I would love if the process was updated to something that was less like a torture device”; 2) establishing procedure pain management standard of care, “I wasn't under general aesthetic and they just put them in, which was super traumatic”; 3) all provider staff and patients educated to discuss the common physical, mental and sexual treatment side effects, “information wasn't necessarily communicated, so no, I was not informed on what that would entail for me”; 4) addressing mental and sexual health side effects and referring patients to supporting medical professionals, “every single woman that goes through cervical cancer treatment should be given as part of their aftercare, a sexual health therapist as well as just a therapist; and 5) provider training on gender and sensitivity competency to humanize care, “there are people behind these treatments. We're not just the tumor that they're trying to eliminate and that the people involved really need to be empathetic and compassionate.”

Conclusions

A preliminary conclusion from the thematic review demonstrates that the gynecologic brachytherapy patient and survivorship experience needs significant improvement. This issue warrants additional research and experimentation so cervical cancer survivors can access a standardized, higher quality of care that also produces an improved quality of life post-treatment.