Current Alberta radiation therapy care practices for patients with obesity and recommendations for improvement

Introduction: Obesity has been associated with increased incidence of cancer thereby impacting the number of patients with obesity who may require radiation therapy (RT) treatment. Previous studies have detailed the impacts of obesity on RT treatment delivery including considerations when positioning, imaging, and communicating with patients. However, there is limited literature regarding best clinical practices used by Canadian RT departments when treating patients with obesity. This study aimed to answer the following question: How can the current standards of care (SOC) used by Alberta RT departments be improved to ensure safe and quality care of patients with obesity? Methods: Semi-structured interviews were conducted with 19 practitioners including three RT managers, two medical physicists, two clinical educators, two radiation oncologists, a senior practice lead, and nine radiation therapists from five cancer centers across Alberta. Interviews were transcribed and analyzed independently by two researchers and used to inform recommendations for improvement to existing care practices. Results: Four themes emerged as unique considerations for patients with obesity undergoing RT, which included technical factors, interpersonal interactions, patient care factors, and education and training. Recommendations to improve the current SOC in Alberta RT departments included the need for longer appointment times, sufficient staff, accessible mobility equipment, and additional education and training for HCPs tailored towards patients with obesity. Conclusion: SOC in Alberta could be improved for patients with obesity with modified appointment time, increased staff and resources, and more in depth and tailored education. Implementation of these considerations and recommendations for improvement to the current SOC used by Alberta RT departments has the potential to ensure safe and quality care of patients with obesity.