Obstacle of Palliative Radiotherapy for Cancer Patients at Uttaradit Hospital

Abstract

The goals for treatment of advanced or metastatic cancers are to decrease suffering symptoms and to improve patients’ quality of life. Many patients at Uttaradit hospital cannot receive palliative radiotherapy (RT), leading to poor quality of life, family and financial problems. This research aimed to study the obstacles of reaching palliative radiotherapy service by reviewing medical records of cancer patients treated between January 2005 and December 2014. There were 579 consulted patients, 373 cases refused palliative RT (64.42 %). The majority of patients were old (mean 60.3 years) with low incomes. They had children, but lived separately, thus their children could not take care of them. Most of patients (86.86 percent) entered universal coverage program. They had no car. Many of them had 2-3 metastatic sites of cancer, especially bones (87.67 %), lungs, pleura and brain. The major problems were pain and obstructive symptoms. Patients usually listen the data about their illness and treatment from their cousins. But 76.35 % of them could not receive palliative RT due to poor support from their cousins. Striking obstacles were burdens of their cousin (98.66), financial problems (97.59), the living in another province and inconvenient referring system. So, they had frequently gone to Uttaradit hospital. The mean number of visits for out-patients and in-patient treatments were 14 and 5 times, respectively. Average cost was 20,664 baths for each admission and 7,298 baths for each out-patients visit.