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Timely administration of palliative radiation therapy (PRT) to manage symptoms derived from advanced prostate cancer is necessary to help alleviate discomfort and improve quality of life. Despite PRT being an effective treatment, analyzing utilization rates in British Columbia (BC), Canada for palliative purposes implies it is an under-utilized medical resource. Access to and utilization of radiation therapy (RT) is lower in remote geographical regions and higher in urban regions where a cancer care facility is close in proximity suggesting the presence of geographical barrier affecting access to health care and services. Equitable access to PRT can be achieved by reducing barriers such as geographical distance. This retrospective cohort study describes accessibility of PRT in the management of prostate cancer and the impact of an additional facility on improving access to PRT.

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BackgroundThe primary objective of this research was to assess the relationship between FPs’ knowledge of palliative radiotherapy (RT) and referral for palliative RT.Methods1001 surveys were sent to FPs who work in urban, suburban, and rural practices. Respondents were tested on their knowledge of palliative radiotherapy effectiveness and asked to report their self-assessed knowledge.ResultsThe response rate was 33%. FPs mean score testing their knowledge of palliative radiotherapy effectiveness was 68% (SD = 26%). The majority of FPs correctly identified that painful bone metastases (91%), airway obstruction (77%), painful local disease (85%), brain metastases (76%) and spinal cord compression (79%) can be effectively treated with RT, though few were aware that hemoptysis (42%) and hematuria (31%) can be effectively treated. There was a linear relationship between increasing involvement in palliative care and both self-assessed (p < 0.001) and tested (p = 0.02) knowledge. FPs had higher mean knowledge scores if they received post-MD training in palliative care (12% higher; p < 0.001) or radiotherapy (15% higher; p = 0.002). There was a strong relationship between FPs referral for palliative radiotherapy and both self-assessed knowledge (p < 0.001) and tested knowledge (p = 0.01).ConclusionsSelf-assessed and tested knowledge of palliative RT is positively associated with referral for palliative RT. Since palliative RT is underutilized, further research is needed to assess whether family physician educational interventions improve palliative RT referrals. The current study suggests that studies could target family physicians already in practice, with educational interventions focusing on hemostatic and other less commonly known indications for palliative RT.

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