Clinic offering affordable radiation therapy to increase access to care for patients enrolled in hospice

Jessica M. Schuster, Thomas J. Smith, Patrick J. Coyne, Stephen Lutz, Mitchell S. Anscher, Drew Moghanaki

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Purpose: A majority of patients enrolled in hospice have advanced cancer. Most of them are burdened by symptoms related to uncontrolled tumor growth. Although palliative radiation therapy (RT) is highly effective, only 1% of hospice patients are ever referred. Commonly cited concerns include high treatment cost, burden of travel for multiple visits, and a perceived reluctance of radiation oncologists to deliver single-fraction RT. Methods: A clinic offering affordable RT to patients in hospice was developed to simplify the intake, reduce cost, and minimize travel to a single visit. The goal was to evaluate, simulate and plan treatment, and treat patients with a single fraction of palliative RT within a 4-hour period. Results: The initial 18-month experience is reported in this Health Information Portability and Accountability Act- compliant report that was approved by the Viriginia Commonwealth University Institutional Review Board. Eight referrals were received from local hospice agencies that had not referred any patients in previous years. A telephone screening process avoided unnecessary travel for two patients who were not candidates for RT. Two additional patients who were evaluated with a same-day computed tomography simulation were not good candidates for RT. Ultimately, four patients were successfully treated with single-fraction palliative RT of 8 Gy. None had to disenroll from hospice. Conclusion: This novel program increased access to palliative RT for patients in hospice who would otherwise not have been referred. The main challenge identified was a need for ongoing educational activities at hospice agencies where staff turnover may be high and understanding about palliative RT can be limited.

Original languageEnglish (US)
Pages (from-to)e390-e395
JournalJournal of oncology practice
Issue number6
StatePublished - Nov 1 2014

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)
  • Health Policy


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