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Only 1 in 4 patients access radiation therapy, even though 50% of cancer patients would benefit from it for management of their disease. Radiation therapy (RT) is often misunderstood, possibly resulting in poor perceptions due to lack of knowledge. The primary aim of this study was to explore the cancer community perceptions of radiation therapy (RT) before and after completion of an educational intervention. The secondary aim was to evaluate the impact of an educational intervention on participants knowledge and possible change in perceptions.

A Massive Open Online Course (MOOC) was used to examine the cancer community perceptions of radiation therapy. Participants were asked a series of questions before and after the course to determine their perceptions and knowledge of radiation as a cancer treatment and evaluate the role and impact of an educational intervention. Braun and Clarke’s 6 step framework for thematic analysis was conducted on 3,053 anonymised comments from consenting participants. 

Six main themes were identified: 1) motivation for taking the course; 2) positive perceptions of RT; 3) negative perceptions of RT; 4) perceived impact of health services on RT patients; 5) coping with the RT journey from diagnosis to survivorship; 6) the value and purpose of an educational intervention. Overall, the participants valued an educational intervention to improve their knowledge of RT and even those with good knowledge commented on how the course increased their understanding and reduced their anxiety. Many of the participants identified themselves as health professionals who worked routinely worked with cancer patients and stated that they did not understand the RT treatment process. Professional participants commented that they would adapt their practice based on the insight gained from taking the course. Despite the key motivations for the course being lack of knowledge and lack of understanding – perceptions were in general positive towards RT. Positive perceptions and experiences could be linked to having a shared community with other patients and professionals who understood the RT treatment process. Negative perceptions were mostly associated with health service factors such as cost of treatment, financial burden, travel burden and a perceived lack of knowledge of health professionals about RT, in particular the family doctor.

In this study, participants reported a change in perceptions, increased knowledge, reduced anxiety, and greater understanding of the treatment process. A concerning result, is the lack of knowledge and understanding about RT among the ‘other’ health professionals that mange cancer patients, in particular the family doctor. Patients require their family doctor and other health professionals to be knowledgeable about RT to ensure patient centred care. An important next step to increase the patient access to RT may be to further explore the education of other health professionals about RT and promotion of the service.