Background: Humour has long been considered an important coping tool for patients with cancer, but published quantitative data about its significance are limited. The purpose of our study was to survey patients with cancer undergoing radiotherapy regarding their opinions about the use of humour in their care. Methods: An anonymous 35-item questionnaire evaluating the patient experience, including the value of humour, was developed by an interdisciplinary team of health care providers (HCPS) working within the Radiation Medicine program. This anonymous, voluntary, paper-based survey for self-completion required approximately 10 minutes to finish and was administered during the fall of 2018 and the spring of 2019. Results: For the 199 patients who completed the survey [108 women, 89 men (2 respondents did not specify)], median age was 68 years. That group represents approximately 30%–35% of the patients on treatment during the study period. Almost all respondents (86%) indicated that, during their visits to the cancer centre, it was “somewhat important” or “very important” for health care providers (HCPS) to use appropriate humour, and 61% of respondents indicated using humour “frequently” or “always” when dealing with their individual cancers. Most respondents (79%) said that humour decreased anxiety, and 86% indicated that laughing was considered “somewhat important” or “very important.” Approximately 4% of respondents even listed “sense of humour” as being the most important quality that they looked for in their interactions with their HCPS. Conclusions: Cancer patients undergoing radiotherapy clearly view humour as being important for coping and dealing with their disease, and oncology HCPS should routinely consider incorporating the use of appropriate humour into the care that they provide.

The patient-provider relationship is a key driver of patient satisfaction as it relates to overall healthcare experience. We surveyed patients undergoing radiation therapy to determine what they consider to be the most valued qualities in their interactions with the healthcare team. An ethics-approved 35-item patient satisfaction survey was developed in-house to gain insights on patients’ perception of their relationship with the healthcare team throughout their cancer journey. There were 199 completed survey, median age 68 years, 54% women and 45% men. Almost all (95%) “agreed” or “strongly agreed” that their physicians had been sensitive and compassionate. Over 90% felt that they received adequate explanations about their treatment, and had their questions answered. The vast majority (93%) felt included in the decision-making process. Patients reported the 5 most highly rated qualities among their healthcare providers (HCPs) as knowledge, kindness, honesty, good communication, and a cheerful attitude. Overall satisfaction was high but areas for improvement were identified including being offered future appointments for further discussion, more information about clinical trials, other treatments, and community resources. Patients noted their HCPs tended to focus on the physical and emotional needs of patients, but spiritual and cultural needs were rarely addressed. Patients receiving radiotherapy reported high rates of satisfaction across many aspects of their care. These findings also reinforce the different aspects of holistic care that can be improved, and serve as a reminder to clinicians that patients perceive their role as more than just that of a medical expert.

Smoking tobacco is a known risk factor for both incidence and mortality in a variety of genitourinary cancers, likely due to accumulation and concentration of carcinogens in urine. However, in prostate cancer (PC) there are conflicting results from several meta-analyses. We sought to test the association between current smoking (CS) and past smoking (PS) with the development of prostate cancer-specific mortality (PCSM) in the Veterans Health Administration, a comprehensive medical system with high smoking prevalence. Materials/Methods: We used the Department of Veterans Affairs (VA) Informatics and Computing Infrastructure (VINCI) to assemble a cohort of patients diagnosed with prostate cancer between 2000 and 2015. We collected tumor, treatment, comorbidity, and sociodemographic data using the VINCI cancer registry; coded laboratory, vital sign, and drug databases; and manual chart review, and cross linked these data to the social security death index. PCSM was evaluated using Fine-Gray regression and cumulative incidence function plots.

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e19249 Background: Healthcare providers (HCPs) strive to maximize the experience for cancer patients. Published reports suggest a variety of characteristics that are considered important. We decided to survey our patients undergoing radiotherapy to determine what they considered desirable traits and characteristics. Methods: An ethics approved 35-item patient satisfaction survey evaluating respondent experience was developed by an interdisciplinary team of HCPs working in the radiation medicine program. It was an anonymous, voluntary, paper-based survey for self-completion. It evaluated a variety of domains with respect to the quality of care patients received, and was administered to patients undergoing radiotherapy. Results: A total of 199 patients completed the survey. The median age was 68, with approximately 54% women and 45% men (1% unreported). Most patients (85%) had been diagnosed with their cancer within the previous year, and the commonly reported malignancies (61%) were breast, prostate and lung cancers. Almost all (95%) “agreed" or "strongly agreed" about the importance of physicians being sensitive and compassionate. Over 90% felt they received adequate explanations about their treatment, and had their questions answered. The vast majority (93%) felt included in the decision-making process. They reported the 5 most important qualities among the HCPs as follows (in descending order): knowledge, kindness, honesty (answering questions/giving information), good communicator and cheerful attitude. Most (>70%) reported feeling connected with their HCPs. Although overall satisfaction was high, there were areas for improvement identified. These included patients being offered future appointments to discuss their diagnosis and treatment, receiving information about clinical trials and other treatment options, and being given contact information for psychosocial and community resources. Also, HCPs tended to focus mainly on the physical needs of patients and to a lesser degree on their emotional needs, but spiritual and cultural needs were not routinely addressed (<10%). Conclusions: Reassuringly, cancer patients receiving radiation report high rates of satisfaction across many aspects of their care. The qualities most appreciated serve as a reminder to clinicians that their role is more than just that of a medical expert. These findings also reinforce the different aspects of holistic care that can be improved.

Purpose: To characterize the distributions of setup corrections for radical IMRT lung patients treated on a couchtop with six degrees of freedom (6DOF). Methods: Translational and rotational setup corrections were retrospectively analyzed for patients treated on the HexaPODTM 6DOF couchtop. Conventional and hypo‐fractioned radical IMRT lung treatments were included, for a total of 152 patients and 2,042 fractions. The distribution of setup corrections was analyzed for each DOF. Potential correlations between pairs of corrections were examined and possible causes identified. Intra‐patient variability of setup corrections was characterized. Results: For lateral, longitudinal and vertical setup corrections, the mean ± 1 S.D. (in mm) were: −0.6 ± 3.8, 2.8 ± 5.1, and 1.1 ± 3.9. Each of the three means is statistically significant from the theoretical population mean of zero (p<0.01). For rotations, the means were within 0.1° from zero, with a standard deviation of 1.3°. Moderate correlation (r = −0.45) was observed between longitudinal and pitch corrections, which can be caused by changes in the spinal column position, to which registration is mostly done. The standard deviation for intra‐patient corrections varies among patients: 2 – 10 mm for translations and 0.5 – 3° for rotations. Intra‐patient variability in translations has a positive correlation with that in rotations. Conclusions: In 6DOF setup corrections for lung patients, systematic translational corrections were observed, with moderate correlation between longitudinal and pitch corrections. Careful setups and custom immobilization may help reduce such offsets, correlations, and intra‐patient setup variability.