S2668
RTT - Patient experience and quality of life
ESTRO 2026
Innovating radiation oncology, together: Integrating social science for patient-centred cancer care Lisa A Ashmore, Hilary Stewart Lancaster Medical School, Lancaster University, Lancaster, United Kingdom Purpose/Objective: The recent Lancet Oncology Commission, the Human Crisis in Cancer (1) highlights that despite rapid advances in oncology, patients and families continue to experience fragmented, impersonal care systems where human, relational and psychosocial dimensions are undervalued. Social sciences can provide valuable insights into cancer care by examining how clinical systems operate within wider social and institutional contexts, highlighting that care processes depend on human relationships and collaboration.Drawing on multiple qualitative projects, this study assessed how integrating social science methods into radiotherapy research enhances understanding of patient experience, staff relationships and system innovation, aligning with the conference theme “Innovating Radiation Oncology, Together.” Material/Methods: This analysis synthesised findings from three studies: (1) the Gynae Cancer Narratives Project, which collected narrative accounts from people treated with radiotherapy for gynaecological cancers; (2) a sexual wellbeing project, which brought sexual wellbeing facilitators and therapeutic radiographers together to improve communication about sexual pleasure; and (3) The GRACE project, which explores how infrastructures for consent in gynae radiotherapy can be reimagined.All studies used feminist-informed, infrastructure-aware thematic analyses and co- designed participatory methods. A cross-study synthesis identified shared themes relating to patient experience, relational care, and system innovation in radiotherapy. Results: Across all studies, relational and emotional aspects of care were found to shape both individual experiences and broader system dynamics. Three overarching themes emerged:Relational labour: Everyday emotional and moral work by patients and professionals sustains care infrastructures but can obscure unmet needs;Dialogic space: Creating room for open dialogue about sensitive issues,Patient- centred infrastructures: Reimagining institutional processes, such as consent, enhances patient autonomy and shared decision making.In the Gynae Cancer Narratives Project, expressions of gratitude sustained relational infrastructures of care yet constrained critique and discussion of long-term effects. The sexual wellbeing project demonstrated that explicitly addressing sexual pleasure re-centres
Conclusion: Chest wall pain was recorded in half of patients but not captured by PROMs. EORTC QLQ-C30 and BR23/45/42, widely used in major trials [3-6], do not differentiate breast pain from chest wall pain. The distinct tissues of the breast and chest wall will have different radio-sensitivities resulting in a unique spectrum of potential late adverse events. Accurate pain reporting is therefore essential to ensue the correct identification of late effects for appropriate symptom management. Current PROMs under-report chest wall pain; improved tools and larger studies are needed to distinguish and address this issue to improve reporting and quality of life. References: [1] Durrant, L.A., et al. 2023. SWRLES. 10.1016/S0167-8140(23)08418-9[2] Batenburg, M.C.T., et al 2023. UMBRELLA cohort. RT10.1016/j.ijrobp.2022.11.008[3] Haviland, J.S., et al 2013. START Trial. 10.1016/S0140-6736(20)30932-6[4] Brunt, A.M., et al 2020. FAST-Forward Trial. 10.1016/S0140-6736(20)30932-6[5] Bhattacharya, I.S., et al 2019. IMPROT-Low Trial. 10.1200/JCO.18.00982[6] Velikova, G., et al 2018. SUPREMO Trial. 10.1016/S1470-2045(18)30515-1 Keywords: PROMs, pain, late effects
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