Fears and misperceptions of radiation therapy: sources and impact on decision-making and anxiety

Recent media attention about radiation has led to heightened public awareness and concern about radiation therapy (RT). An understanding of concerns and their potential role in patient decision-making can inform education efforts. A multiphase needs assessment survey was designed to ascertain broad public perceptions of radiation (phase I) and the more in-depth cancer patient perceptions of RT (phase II). One hundred forty-six phase I and 111 phase II surveys were completed. Data suggested a prevalence of negative connotations of the word "radiation," often associated with information from the media or secondhand experience. Side effects during and after RT were reported as concerns, including misperceptions about becoming radioactive and impact on fertility. Rankings of quality and safety perceptions suggested confidence in staff training and equipment, though concerns regarding overdoses and protection of healthy tissue were higher amongst those who refused RT. In deciding whether or not to undergo RT, high value was placed on the reputation of the cancer centre and the expected effectiveness of RT. The importance of understanding RT was more highly regarded by those who underwent RT than those who refused it. Perceptions of RT should thus be addressed amongst those in a position to consider RT, to maximize RT utilization where appropriate.