Mastectomy is a treatment option for patients diagnosed with breast cancer. There is very limited research into the psychosocial impact of mastectomy on female breast cancer patients, especially in the sub-Saharan African setting which has unique cultural norms. The study aimed at assessing the psychosocial impact of mastectomy on female breast cancer patients attending a radiotherapy/oncology centre in Ghana.

A cross-sectional design was used to undertake this study. A total of 80 female mastectomy breast cancer patients participated in this study. A semi-structured questionnaire was used for data collection over a 5-month period, January to May 2018. The data collected were analysed with Statistical Package for Social Science (SPSS) version 22.

Most of the participants were adversely affected psychologically and emotionally by mastectomy. In particular, many (56·7%) agreed that they felt less feminine, and 71% reported they experienced psychological distress as a result of their mastectomy, while 63% of them reported loss of self-confidence. A large proportion of them (51, 63·8%) agreed that their lifestyles had changed following mastectomy, while 58% of them admitted that they felt treated as outcasts by society, and 75% resorted to the use of breast prostheses to reduce attention.

The study revealed that mastectomy for breast cancer patients had a negative impact on their psychological, emotional and social well-being. The availability of affordable breast prostheses, involvement of clinical psychologists in the care of post-mastectomy women, provision of emotional, psychological and even financial support could alleviate the psychosocial impact of affected women.

To evaluate the dosimetric parameters of level II lymph nodes in chest wall three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) of mastectomy patients using dual-isocentric (DIT) and mono-isocentric techniques (MIT).

Computed tomography (CT) images of 20 mastectomy patients undergoing chest wall external radiotherapy were used as the input data for the abovementioned techniques. Selected dosimetric parameters were calculated for the axillary level I–III lymph nodes, chest wall, heart and lung. Paired t-test statistical analysis was used for comparing the results of MIT and DIT in both 3D-CRT and IMRT methods.

There were significant differences in Dmin (minimum dose), Dmax (maximum dose) and maximum–minimum dose between MIT and DIT techniques (13, −8·6, −52·2% differences for Dmin, Dmax and maximum–minimum, respectively) in IMRT. There were also significant differences for Dmean (mean dose), Dmax and maximum–minimum dose (7·8, −11·4, −44·6% differences in Dmean, Dmax and maximum–minimum, respectively) in 3D-CRT (p < 0·05). In addition, there were not any differences in the dosimetric parameters for heart, lung and level I and III lymph nodes.

In both 3D-CRT and IMRT methods, level II lymph node dose distribution in MIT was closer to the prescribed dose compared with DIT due to the position of these nodes in the field junction area. To achieve a better dose homogeneity, it could be recommended to use MIT instead of DIT in 3D-CRT and IMRT for mastectomy patients.

Lung tumours, especially those in the lower lobes, can move a lot during respiration; this motion needs to be accounted for during radiotherapy. In cases where 4D CT simulation scans are not performed, the current protocol at our centre is to apply a generic (internal motion + setup) margin of 0·70 cm in the axial plane and 1·20 cm in the longitudinal plane to all lung tumours, regardless of location. We analyse the tumour motions of a cohort of our local patients and categorise them into different locations in the lung. We seek to assess the adequacy of the current margins and to derive a more accurate set of standard margins which are specific for lung tumour locations.

All cases of lung tumours treated with stereotactic ablative radiotherapy between 2012 and 2016 were identified retrospectively and 4D CT scan data analysed. These tumours were grouped into the following locations: upper zone (UZ), middle zone (MZ) and lower zone (LZ). The treatment planning system was used to generate the displacements of the centre of mass of the tumours in the right–left, anterior–posterior and superior–inferior axes; these were compared with the current generic margins. Median displacements were calculated for each axis in each location. New planning target volume (PTV) margins were derived by summing the median displacement, median absolute deviation (MAD) and 0·5 cm (for setup error).

Sixty-three cases were eligible for analyses. Motion in the superior–inferior direction was the greatest for all tumour locations, ranging from a median of 0·17 cm (MAD 0·12 cm) in UZ to 0·77 cm (MAD 0·27 cm) in LZ. Median tumour displacements in the anterior–posterior and right–left axes were similar for all locations, <0·30 and 0·20 cm, respectively. The current generic margins were adequate for only one-third of the cases in this study. A new PTV margin of 2·10 cm in the superior–inferior axis may be required for LZ tumours, while an additional 1–2 mm should be added to the current radial margins.

The current generic margins are inadequate for the majority of cases. Tumour motion is the greatest in LZ in the superior–inferior axis. Motion mitigation strategies are essential for large LZ tumours.

Current literature suggests the information and support needs of oncology patients undergoing radical radiotherapy to the prostate often remain unmet and can impact quality of life. We aimed to explore the effectiveness of delivery and opportunities for service improvement, including a group-based treatment review.

A total of 60 prostate patients completing radical radiotherapy (mean age 70, range 47–79) in a UK cancer-centre completed a self-designed questionnaire assessing information and support. To explore views on a group-based treatment review, 11% took part in a semi-structured interview. Descriptive data were computed and interviews transcribed and analysed thematically.

In all, 87% were satisfied with information and support when delivered by radiographers. However, 26% were only ‘sometimes’ able to complete bladder-filling, suggesting information regarding treatment delays would improve this. In total, 49% preferred both Doctor and Urology nurse reviews whereas 26% preferred nurse only; 70% stated their ‘concerns were always addressed’ by a nurse and 49% by a Doctor. Interviews revealed that a group review was generally acceptable with peer support an influencing factor.

Overall patients felt their needs were being met. Suggestions for improvement (more information on preparation, side effects and delays) will be implemented locally. Future work will explore the feasibility of group reviews in patients undergoing radical radiotherapy to the prostate.

In this article, our goal is to compare the TMR10 and convolution dose calculation algorithm in GammaPlan used in stereotactic radiosurgery (SRS) treatments with Gamma Knife and to assess if the algorithms produce clinically significant differences.

Treatment plans were analysed from ten patients who have undergone Gamma Knife SRS treatments. Patient plans were retrospectively recalculated using Lesksell GammaPlan 10 treatment software utilising the TMR10 and convolution dose calculation algorithms in order to create a paired dataset for comparison. Evaluation was based on the dose volume histogram (parameters of minimum, mean, maximum and integral doses.

The ratios of average integral doses calculated by the convolution dose calculation algorithm to the average integral doses calculated by the TMR10 algorithm are 0·997 for the target (p=0·028), 1·048 (p=0·48) for the skull and 1·005 (p=0·68) for the brainstem.

Although doses calculated with the convolution algorithm resulted in slightly higher mean integral doses for the brainstem and skull critical structures when compared to that of TMR10 doses, these results were not statistically or clinically significant. Thus we continue to use the TMR10 algorithm at our clinic.

Service user involvement has been demonstrated as an important aspect of cancer professionals’ education. There is some understanding of service users’ incentive to be involved, but little insight into what motivates them. This study explores this concept more fully.

To explore the motivations and experience of service users’ involvement in radiotherapy and oncology education.

One-to-one interviews were conducted with service users who have been involved in education at the university. Thematic analysis was conducted. Five participants were asked about their motivations and experience of taking part in a variety of educational activities.

The experience of being involved gave the participants a sense of wellbeing and purpose. Three sub-themes were identified that related to service users’ motivation for being involved in educational activities with undergraduate students. These were to promote awareness by sharing their experiences of cancer; improve patient care through learning from negative experience; and personal reward skills for survivorship.

This study has highlighted the importance of hearing the voice of the service users; a two-way engagement for which there are benefits for both the students and service users. The involvement of service users in education becomes part of their personal journey.

Delays in the diagnosis of cancer were found to be a worldwide matter, and the early cancer detection has been targeted as a way to improve survival. Quantitative studies from Saudi Arabia reported a high number of cancer cases presenting at cancer centres for the first time with more advanced stages of the disease progression compared to Western countries without exploring the reasons for this phenomenon. Worldwide research identified several factors that contribute to delay in the diagnosis and treatment of cancer which were attributed to both patient and healthcare system. However, it was argued that variation in the operation of health systems and the socio-cultural context across countries makes it difficult to generalise findings beyond individuals’ countries. This necessitates country specific research to investigate why patients in Saudi Arabia present to cancer centres with late/advanced stages of their diseases.

The aim of this study is to identify and explore the factors that contribute to late-stage presentation of common cancers in Saudi Arabia. The main objective of this study is to understand the help seeking journey taken by patients with cancer from the time they discovered or felt their symptoms until the time they have their treatment initiated.

Qualitative interviewing was used to collect data from 20 patients and 15 health professionals. The interviews were transcribed and then were subjected to the thematic analysis using a framework approach developed by Ritchie and Spencer (1994).

While some findings support what previous studies found as contributing factors responsible for delayed presentation of common cancers, this study identified several factors, which are believed to be country-specific. The ‘role of General Practitioner (GP)’, ‘challenges facing GPs’ and ‘ambiguity of the referral system’ were found to be factors that contribute to delay in the diagnosis and treatment of cancer in Saudi Arabia.

This research identified several factors that need to be investigated in the future using quantitative methods. There is a need to investigate the extent of using alternative medicine and its possible association with late presentation of cancer.

Stereotactic-fractionated radiotherapy and radiosurgery (RS) for benign and malignant intracranial lesions relies on a very high degree of accuracy in dose alignment due to the ablative dose delivered, and therefore requires a high-precision image guidance modality. The aim of this review is to investigate the localisation and verification accuracy performance of ExacTrac (ET) and Novalis Tx System.

A systematic review of the database Science Direct was carried out using search terms ‘stereotactic radiotherapy (SRT)’ and ‘ET’. All articles before 2000 were excluded. Only articles that involved intracranial lesions, with the exception of one article, were included in the final review.

Results from gold standard Hidden Target Tests and patient data show that patient position can be reproduced within 1·0 mm with the use of ET imaging. In addition, the 6 degrees of freedom algorithm function of ET allows for better translational accuracy as well optimal positioning when rotations are corrected for. Studies showed excellent correlation (p<0·01) between bony ET images and cone beam computed tomography (CBCT) soft tissue registration, evidencing the safe reliance of bony anatomy for image guidance via ET. Shifts were found to be comparable between CBCT and ET.

There is the need for regular calibration to prevent systematic errors and potential geographic miss. However, due to ET’s additional benefits, including reduced concomitant dose and faster imaging time, ET is the superior image guidance modality for RS/SRT in the treatment of intracranial lesions.

Studies have investigated the prevalence of compassion satisfaction and compassion fatigue in various healthcare professions. However, the majority of evidence is linked to the nursing profession and little is known about paramedical professions such as radiography and even less is known about its prevalence in students. The purpose of this study was to describe the levels of compassion satisfaction and compassion fatigue in the student population and how they varied in time.

Students undertaking radiotherapy training at the researcher’s host sites were surveyed using the Professional Quality of Life questionnaire at the end of each final clinical block in each year of their training.

During the 3 years of training compassion satisfaction falls and burnout increases in the student population, although the change is not significant. Secondary traumatic stress increases significantly during the 3 years of training, F=5·725, p=0·005. Considerable variation also exists in the three scores dependent on the student’s clinical training site. Relationships are also observed between some personality traits, particularly conscientiousness and neuroticism and compassion scores.