Radiographers to be trained in easing cancer survivors' fears

It is estimated that soon after treatment around 40 per cent of patients develop significant fears that their cancer will return which can have a severe impact on their quality of life.

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And in a recent Scottish pilot study, led at the Edinburgh Cancer Centre by Professor Gerry Humphris, researchers found that nearly a third of patients began to develop fears that their cancer would return even before they had completed radiotherapy.

The findings were based on the experiences of 100 breast patients and audio-recordings of their consultations with radiographers during treatment.

The study found that the conversations between patients and radiographers can have a "significant effect" on patients' mental wellbeing.

Now the team, led by Prof Humphris, are set to investigate whether radiographers could be trained to help prevent patients' long-term fears.

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Prof Humphris, of St Andrews University, said: “This is the first study dedicated to preventing patients developing long-term fears of their cancer returning before they finish treatment.

“Our initial study found that the way conversations between radiographers and patients are managed can have a significant impact, both positive and negative, on the mental wellbeing of patients and their perspective following breast cancer treatment."

Breast cancer is the most common form of the disease among women in Scotland, with around 4600 new cases every year.

He added: "On the whole, when we analysed these consultations we found that the exchanges were extremely well done, very positive. But there were occasions when radiographers - possibly due to time pressures - would have to end the session fairly quickly, knowing they would see the patients again the following week.

"But it's much more sensitive when it comes to the end of treatment. That's when the radiographers would like not to have such a pressure of time, so that they could pick up any concerns."

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Radiotherapy is usually the final stage of cancer treatment, with many patients already having endured surgery and chemotherapy.

Prof Humphris said this meant the question of whether the treatment had been effective would dominate patients' thoughts at this point.

He said: "That plays on the mind and feeds into the concern patients, understandably, have of 'will my cancer return?' - what we've termed the 'fear of recurrence'.

"It's something that for a lot of patients is quite manageable and we say to them, 'you're not alone to feel like that'. The majority of patients are worried about cancer returning.

"The biggest difficulty is where it gets out of hand. Where patients check themselves too often, or they might request additional checks or scans at the hospital which are probably unnecessary.

"But it's very difficult for a patient to assess this, which is why they need to speak about it openly with staff rather than keeping it to themselves.

"What our training will aim to do encourage staff to give sufficient space to patients - even with a busy service - to express those concerns and make it feel like 'we're listening, and we can provide you with help and support'."

The FORECAST2 trial, funded with more than £110,000 from charity Breast Cancer Now and the Scottish Government’s Chief Scientist Office, will first develop training materials to enable radiographers to understand and manage emotional communications more effectively.

The training package will enable staff to encourage patients to express their concerns and fears, and to understand how best to communicate with their patients as they near the end of their treatment.

The team will then trial the training course with staff at the Edinburgh Cancer Centre, to find out how easily it is adopted by staff and whether it will benefit patients.

The researchers hope this could lead to wider trials across the UK.

Ashleigh Simpson, policy and campaigns manager for Scotland at Breast Cancer Care and Breast Cancer Now, which is co-funding the trial, said: "It’s very common for people who have had breast cancer to fear that the disease will return after treatment.

"For some people this fear can have a significant long-term effect on their life and mental health."

"Professor Humphris’ study is incredibly important as it will help clinicians to understand how they can better support breast cancer patients who may be getting anxious about their cancer returning after treatment.

"This training package could ultimately help radiographers and other healthcare professionals to adopt the best methods at the most appropriate time to help reduce this fear, which will allow people to achieve the best possible quality of life during and after treatment.”

Health Secretary Jeane Freeman said: “Being diagnosed with cancer is an anxious time for all those affected.

"It’s important that patients can be reassured when receiving treatment.

“I am pleased that, with funding from the Scottish Government’s Chief Scientist Office and Breast Cancer Now, researchers will be looking at how communications between patients and radiographers can help support patients feel more reassured following treatment.”