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Background: Utilisation of radiation therapy for regional Australia and around the world has been the focus of much health policy the last decade. Radiation therapy centres have been built in Australian regional and rural areas to improve access to radiation therapy and reduce the tyranny of distance as a barrier to access. After this the enablers, barriers and perceptions of patients has been evaluated to determine utilisation once centres have been built. Thisreview looks the impact of rural radiation services in the developed world, barriers and enablers of establishing a rural radiation centre, and patients' and service providers' perspectives and preferences around the uptake of rural radiation therapy., Methods: Online search of peer reviewed literature was undertaken using MeSH terms relating to the topic. Inclusion criteria were regional radiation therapy centres in developing countries, any year of publication, in English, and qualitative or quantitative methodologies. Articles were reviewed by two authors with conflicts discussed with a third., Results: Twenty three studies addressed the theme directly. Distance barriers have been overcome by building regional centres and health economic burden was lower for government service providers with this strategy. However distance still plays an important role in influencing uptake of radiation therapy. Cultural expectations, influence of the family doctor and perception of care was influential. Carer support, duration of displacement from home, financial impact of the required care and seasonal weather were practical factors on a patient's decision., Conclusions: Regional radiation therapy centres have improved access to radiation therapy in developing countries. However the complex nuances between socio-economic, cultural and health system factors that influence regional patient's decision making bears further consideration, as distance is not the only issue.

Abstract: Aim: The aim of this study was to examine stakeholders' views of how the establishment of the South West Radiation Oncology Service in Bunbury, Western Australia, has affected treatment decision‐making, and the extent to which patients are involved in the decision‐making process. Methods: Semi‐structured in‐depth interviews were undertaken with 21 service providers involved in the treatment and care of people with cancer, and 17 adults diagnosed with cancer who opted to undergo radiotherapy (RT) treatment at the Service. Data were subject to thematic analysis using the qualitative data analysis software NVivo 10. Results: Patients were overwhelmingly positive about their experiences at the Service, praising the quality of the care provided and noting the convenience associated with receiving treatment locally. Most patients reported feeling involved in decision‐making, but tended to rely on and generally adopt advice from medical professionals regarding type and location of treatment. Although service providers in the region had become more aware of the regional RT service and referrals had increased, some patients continued to travel to the metropolitan area for treatment. Reasons identified for this included the need for more specialized RT treatment and the more extensive range of allied health services offered. Conclusion: Increased convenience and a lower financial burden are key reasons why rural cancer patients prefer treatment at a regional RT service rather than travelling to metropolitan centers. These factors highlight the need for ongoing improvement in access to local RT services so that disparities in cancer outcomes between rural and metropolitan patients are reduced. [ABSTRACT FROM AUTHOR]

This paper examines the supportive care in place to meet the needs of patients receiving radiotherapy at a regional oncology service in Bunbury, Western Australia. Semi‐structured in‐depth interviews with 21 service providers and 17 adults diagnosed with cancer who underwent radiotherapy at the Service were recorded, transcribed and analysed thematically. Key themes relevant were co‐operation and collaboration of interdisciplinary team members; support from organisations to assist with accommodation, transport, emotional support and provision of practical assistance, as well as barriers to accessing support. Most participants were positive about the support available, recognising the needs of rural radiotherapy patients for assistance with travel, accommodation and psychosocial support to help deal with the stressors they face. Collaboration between the various service providers maximised the support available to patients but the drop off in psychosocial support once the intensity of treatment was completed was identified as a weakness in the support available. The support system, established around a regional radiotherapy service, was enhanced by the collaborative professional relationships developed among service providers. The service extends beyond clinical service delivery by recognising financial, logistical and psychosocial support needs, factors to be considered to ensure rural radiotherapy patients are provided with holistic care. [ABSTRACT FROM AUTHOR]