Distance to Radiation Facility Affects Compliance with Treatment for Elderly

Distance to Radiation Facility Affects Compliance with Treatment for Elderly Women with Early Breast Cancer

According to an article recently published in the International Journal of Radiation Oncology, Biology and Physics, elderly women who are to receive radiation therapy following surgery for early breast cancer are less likely to comply with follow-up radiation treatment if they live at a distance from the radiation facility.

Early breast cancer refers to cancer that has not spread outside the breast or axillary (under the arm) lymph nodes to distant sites in the body. A common treatment for patients with early breast cancer is the surgical removal of the cancer or the entire breast, followed by radiation therapy. The radiation therapy is used to kill any cancer cells that may remain in the body following surgery. The additional radiation therapy significantly reduces the risk of a cancer recurrence.

Researchers from the Dana-Farber Cancer Institute recently evaluated data to determine if the distance to radiation facilities affects compliance with radiation schedules for women with breast cancer. The data included 2,075 patients from the Surveillance, Epidemiology, and End Results-Medicare (SEER-Medicare) database who had undergone the complete removal of their breast (mastectomy) followed by radiation therapy between 1991 and 1999.

  • An increased distance to a radiation facility was associated with a decreased likelihood that a patient would comply with their radiation schedule.
  • A radiation facility distance of greater than 25 miles from a patients home was associated with a decreased likelihood the patient would receive radiation therapy; this became particularly pronounced if the facility was more than 75 miles away.
  • Patients over the age of 75 years appeared to be less likely than younger patients to not receive radiation therapy if the radiation facility was at least 25 miles away.

The researchers concluded that a greater distance from the radiation facility to a patients home decreases the likelihood that patients with early breast cancer will receive radiation therapy, particularly among more elderly patients. The authors suggest that Oncologists must be cognizant of the potential barrier to quality care that is posed by travel distance, especially for elderly patients; and policy makers should consider this fact in resource allocation decisions about radiation treatment centers.

Reference: Punglia R, Weeks J, Neville B, Earle C, et al. Effect of Distance to Radiation Treatment Facility on use of Radiation Therapy after Mastectomy in Elderly Women. International Journal of Radiation Oncology, Biology and Physics. 2006;66:56-63.

Related News:Accessibility of Radiation Therapy Facilities Influences Breast Cancer Treatment (12/21/2005)

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