Impact of Extreme Weather Events on Radiation Oncology Practices in Puerto Rico

ObjectivesThis study aims to evaluate the perceived impact of extreme weather events from 2017 - 2024 on delivery of radiotherapy in Puerto Rico (PR), including effects on radiation oncologists, medical physicists, clinical staff, and patients. A secondary objective is to identify resources and strategies that may strengthen resiliency and support continuity of care in radiation oncology clinics located in weather-vulnerable regions.MethodsWe developed a comprehensive online cross-sectional survey to evaluate clinic emergency preparedness and the impact of extreme weather events on radiation oncology clinic stakeholders in PR. Potential participants were identified through the American Society for Radiation Oncology (ASTRO) membership directory and were invited to participate via email and direct outreach.ResultsFourteen radiation oncologists and four medical physicists were invited to participate, with a response rate of 56% (n = 10), representing 71.4% of radiation oncology clinics in PR. Among respondents, 90% reported clinical disruptions due to extreme weather events from 2017 to 2024. The most commonly reported impacts were property damage (90%), communication failures between providers, patients and staff (90%), power outages (80%), and school and/or childcare closures (80%). A majority (90%) supported developing comprehensive supportive resources, including professional society resources, to enhance disaster preparedness and operational resiliency.ConclusionRadiation oncology providers in PR reported significant disruptions in care delivery from extreme weather events and identified a need for strong resiliency measures. Institutional policy, coupled with targeted support from professional societies, may reduce lapses in treatment, safeguard vulnerable patients - particularly those with complex treatment plans - and improve continuity of care and outcomes in weather-prone regions.