While meta-analysis reports a statistically significant association between cancer patient's FoR and the receipt of RT, these results should be interpreted with caution owing to significant variability between studies. Further longitudinal studies should be conducted to address the trajectory of FoR over RT in greater detail.

Acute skin reactions are expected in patients receiving radical radiotherapy to the breast. Side effects of other adjuvant treatments such as chemotherapy and hormonal therapy can further impact upon patients' well being. As a result these patients are routinely monitored throughout their radiotherapy treatment at a review clinic. Previously the domain of doctors, radiographers are expanding their existing role and becoming more involved in review clinics.This paper highlights the key side effects reported by actual patients from their adjuvant treatment and strategies to alleviate these side effects. It also reflects upon the experience, both positive and negative, of undertaking clinical review and role expansion in general.

BackgroundFear of cancer recurrence (FCR) has been shown to be higher in patients treated with external beam radiotherapy (RT) compared to those untreated. However, little is known about the dynamics of patient’s FCR during and after RT. The aim of this study was to examine FCR levels in a longitudinal panel design with breast cancer patients receiving RT.MethodsConsecutive newly-diagnosed breast cancer patients (n = 94) attending a single cancer centre were invited to complete a 7-item FCR scale (FCR7) that was collected weekly by paper instrument and at a follow-up phone call 6–8 weeks after completion of RT. Descriptive statistics, and Latent Growth Curve Modelling (LGCM) were utilised to analyse the data.ResultsWomen who were younger, single/separated, had chemotherapy, had extra boost radiation treatment, taking Herceptin and treated by 4-field technique reported higher recurrence fear at baseline. There was strong evidence of substantial variation in the trajectory of FCR (z = − 3.54, p < .0001). The average trajectory of FCR over RT was negative (unstandardized estimate = − 0.59) and associated with FCR follow-up level (standardised estimate = 0.36, z = 3.05, p < .002), independent of baseline recurrence fears.ConclusionPatients vary in their trajectory of recurrence fears over RT which predicts FCR approximately 2 months following treatment. Review appointments by therapy radiographers presents an opportunity to intervene in FCR trajectories.Trial registrationClinicalTrials.gov: NCT02599506. Prospectively registered on 11th March 2015.