Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Empowering Diversity: Mobile App Improves Accessibility and Training for Multilingual Radiation Therapy Patients in Breath-Hold Techniques (#310)

Rory Hartley 1 , Toby Lowe 1 , Alexander Podreka 1 , Maiko Crispin 1 , John Atyeo 1 , Susan Carroll 1 , Gillian Lamoury 1 , Marita Morgia 1 , Brian Porter 1
  1. Radiation Oncology, Northern Sydney Cancer Centre, Sydney, NSW, Australia

Introduction:

The Deep Inspiration Breath Hold (DIBH) technique is a leading method in radiotherapy for breast cancer treatment due to its efficacy in reducing radiation exposure to critical organs like the heart, LAD, and lungs. At the Northern Sydney Cancer Centre (NSCC), DIBH has become the standard protocol for breast cancer treatment, with notable challenges. Analysis between January 2021 to August 2022 revealed a 20% failure rate among 355 patients. While half of these failures were attributed to pre-existing co-morbidities, the remaining patients, notably those regarded culturally and linguistically diverse (CALD), faced language-related barriers, with the six most common languages at NSCC being Korean, Japanese, Cantonese, Mandarin, Vietnamese, and Arabic.

Methods:

An initiative was launched to develop a mobile application to enhance training and accessibility to breath-hold techniques for patients. The application offers patient education in the six languages spoken at the centre, focusing on gated radiotherapy. Recognising the significant proportion of patients (91%) desiring more education before their CT simulation, the app provides early access to familiarise themselves with breath-hold exercises before their scan. Secondly, the application offers pre-recorded verbal instructions for Radiation Therapists in each language, ensuring the safe and effective breath holds during treatment sessions.

Results:

The development of the application concluded in March 2024, and its integration into clinical workflow commenced. Initial data indicates a notable improvement in patient-reported confidence in their breath-holding technique before CT scans, alongside an increase in access for CALD patients to the service.

Conclusion:

The introduction of a mobile application to address language barriers and improve patient education in breath-hold techniques represents a promising approach in enhancing the effectiveness and accessibility of DIBH in breast cancer radiation therapy. Ongoing evaluation will be crucial to further refine the application and ensure its continued effectiveness in addressing the needs of diverse patient populations.

  1. Sixel KE, Aznar MC, Ung YC. Deep inspiration breath hold to reduce irradiated heart volume in breast cancer patients. Int J Radiat Oncol Biol Phys. 2001;49:199–204.
  2. Lai J, Hu S, Luo Y, Zheng R, Zhu Q, Chen P, Chi B, Zhang Y, Zhong F, Long X. Meta-analysis of deep inspiration breath hold (DIBH) versus free breathing (FB) in postoperative radiotherapy for left-side breast cancer. Breast Cancer. 2020;27:299–307.
  3. Latty D, Stuart KE, Wang W, Ahern V. Review of deep inspiration breath-hold techniques for the treatment of breast cancer. J Med Radiat Sci. 2015;62:74–81.