Incidence and severity of acute radiation induced toxicities among breast cancer patients treated with adjuvant radiotherapy at a major cancer treatment center in Ghana.

BACKGROUND: Adjuvant radiotherapy after mastectomy or breast conserving surgery (BCS) is the standard of care for majority of patients with breast cancer. This is however associated with mucosal and epidermal toxicity of organs at risk (OARs). Breast cancer patients are exposed to a plethora of wrong perceptions, misinformation and myths concerning the usefulness and adverse effects of radiotherapy. There is paucity of literature on the incidence and severity of radiation-induced acute toxicities experienced by patients with breast cancer in Ghana. AIM: To assess the occurrence and severity of four main acute radiation-induced toxicities among female breast cancer patients treated with external beam radiotherapy at a major cancer treatment centre in Ghana. METHODS: Data on the occurrence of acute toxicities among patients was collected from patients' medical records, through a semi-structured questionnaire and via weekly clinical assessments. The Common Terminology Criteria for Adverse Events (CTCAE) grading scale (version 4.0) was used to grade the severity of these toxicities. Descriptive and inferential statistics using an independent two-sampled t-test (two-tailed), one-way analysis of variance (ANOVA), Pearson's Chi-square and Fisher's exact tests were performed. RESULTS: Dermatitis, fatigue, pharyngitis, and breast (chest) pain were the radiation toxicities found among the breast cancer patients undergoing treatment on the two machines. The mean predominant radiation doses associated with the onset of dermatitis, fatigue, pharyngitis, and chest pain in the breast cancer patients were 22.32 Gy, 22.48 Gy, 13.59 Gy, and 19.27 Gy respectively for treatment with a statistically significant (p = 0.0173). Radiation dermatitis was the most dominant acute radiation toxicity recorded, and its incidence and severity. The range of Fisher's p-values (0.689-0.999) between the acute radiation toxicities with both machines revealed no statistical significance. CONCLUSION: Radiation dermatitis was the dominant acute toxicity, both in incidence and severity for patients treated. There was no statistical significance in the incidence and severity of acute radiation side effects.

Radiation-induced dermatitis among breast cancer patients undergoing adjuvant radiotherapy in Ghana.

The aim of the study was to investigate radiation-induced epidermal desquamation among breast cancer patients undergoing radiotherapy with 6MV linac and Co-60 teletherapy units. METHOD: Quantitative data was collected using self-administered closed ended questionnaires addressing the desquamation in relation to some patient-and treatment-related factors. The Radiation Therapy Oncology Group (RTOG) criteria for acute skin toxicity was used to grade the toxicity. Chi square and logistic regression analyses were respectively used to test statistical significance and evaluate the effects of the various factors on radiation induced epidermal desquamation RESULTS: Majority of the participants had high BMIs (overweight: 39.5 %; obese: 50 %). Patients with BMI ≥ 25 kg/m2 presented with wet desquamation (RTOG grade 2). A chi-square analysis showed a significant difference (p = 0.02) between BMI and severity of desquamation. There was no significant difference between type of treatment machine and cumulative incidence dose of desquamation (p= 0.251). The logistic regression analysis showed that patients who had undergone mastectomy (OR = 0.562) were less likely to develop wet desquamation (RTOG grade 2) on the Co-60 machine within the 20-30 Gy threshold (OR=0.981) compared to those on the linear accelerator. Patients with lower BMI (OR = 0.412,[ < 25 vs ≥30]; OR = 0.286, [25-29.9 vs ≥30]) were also less likely to develop wet desquamation compared to those with higher BMI. CONCLUSION: Radiation-induced epidermal desquamation is a common side effect of breast cancer patients undergoing radiotherapy. BMI has an effect on the severity of desquamation experienced during breast irradiation.

The sexuality of women with cervical cancer undergoing definitive radiotherapy in Ghana.

INTRODUCTION: The purpose of this study was to assess the sexuality of cervical cancer patients undergoing radiotherapy at a major cancer treatment center in Ghana. This is an area of interest as globally; cervical cancer kills approximately 342,000 people per annum with an estimated number of 604,000 new cases in 2020. Acknowledging the World Health Organization's definition of sexual health as a state of physical, mental and social well-being in relation to sexuality, this paper sheds light on how these dimensions affect the quality of life of cervical cancer patients. METHODS: This was a longitudinal study, which assessed the impact of radiotherapy on the sexuality of both premenopausal and postmenopausal cervical cancer patients presenting for primary treatment with chemoradiation from April to July, 2021 at a major cancer treatment centre in Ghana. The Female Sexual Function Index and Body Image Scale questionnaires were respectively used to evaluate the sexual functions scores among the cervical cancer patients, and to assess the impact of the treatment on their body image. MATLAB software was used for data analysis. RESULTS: Most of the cervical cancer patients sampled were postmenopausal (57 %). About 79 % premenopausal and 96 % postmenopausal cervical cancer patients were sexually inactive during radiotherapy (day 15). Also, 48 % premenopausal and 24 % postmenopausal patients were very dissatisfied with their bodies at the onset of treatment. The frequency of orgasm in cervical cancer patients declined after treatment causing a deterioration in their sexual function. The patients' sexuality was influenced by age and menopausal status. The decreased sexual desire of the patients resulted in emotional distancing from their partners, which invariably induced changes in their partners' level of sexual interest. This study established significant differences between premenopausal and postmenopausal cervical cancer patients who were generally very dissatisfied with their sexual relationships with their partners on day 1 (p = 0.02) and on day 15 (p = 0.00) of treatment. CONCLUSION: The majority of patients who presented for treatment for cervical cancer in this study were postmenopausal. Their interest in sexual activity was more influenced by their menopausal status than their antineoplastic treatment. This study indicates that cervical cancer patients are more likely to develop sexual health problems which could substantially worsen over the course of their treatment and beyond. IMPLICATION FOR PRACTICE: The study will contribute within the oncology team by assisting personnel in putting in place measures that will guide the treatment of cervical cancer patients and improve quality of care.

Perception of professionalism in clinical practice among clinical year radiography students in a tertiary institution in Ghana.

INTRODUCTION: Professionalism describes the positive attitudes, conduct, aims, values, skills, and behaviours that characterize a profession or a group of professionals. The steady professional growth of radiographers, which begins during undergraduate training, continues to be significantly influenced by education. As professional traits are ingrained in radiography students through official clinical instruction and observations, research on professionalism is necessary to monitor the perception of the subject matter. However, no study on Ghanaian radiography students on professionalism has been conducted. The goal of this study was to determine how clinical radiography students at a higher education facility in Ghana viewed the professionalism of radiography practice. METHODS: Sixty-four consenting Level 300 (3rd year) and Level 400 (4th year) students in the University of Ghana School of Biomedical and Allied Health Sciences' BSc Diagnostic Radiography and BSc Therapy programmes completed the Pennsylvania State College of Medicine Professionalism Questionnaire (PSCOM-PQ) which was used to determine the impacts and challenges to professionalism. Version 23.0 of the Statistical Package for Social Science program (SPSS 23.0) was used to analyze the collected data. RESULTS: A good sense of professionalism in clinical practice was held by the majority of clinical radiography students. More than 56% of them observed professional practice among the majority of radiographers, contrary to 40.6% of them who witnessed it among only a few radiographers. The students observed both positive and negative effects on the professionalism of radiography practice. As a result, 77.9% of the students said that it was difficult to exhibit professionalism in radiography during their clinical training. CONCLUSION: The students agreed that professionalism impacted positively and negatively on radiography practice, and consequently identified to need to address the mitigating challenges to improve the level of professionalism. By this, most of the clinical year students had a better understanding of perceptions of the professionalism of radiography practice. IMPLICATION FOR PRACTICE: According to the study's findings, clinical students' radiography practice is affected either positively or negatively by their conceptions of professionalism and their adherence to them during the entire training period.

Assessment of diagnostic radiographers' knowledge of work-related health problems and associated effects: A multicentre study in Ghana.

INTRODUCTION: Work-related health problems (WRHPs) are health conditions peculiar to a group of people or occupations including radiography in a specific work setting. These WRHPs occur as a result of prevailing work conditions which predispose workers to risks of physical or psychological distress. AIM: This study assessed the knowledge of WRHPs among practicing radiographers in Ghana and evaluated the sources, causes, effects and preventive measures of WRHPs. METHODS: A prospective cross-sectional design incorporating a quantitative data collection approach was used. A questionnaire was used to assess the knowledge and evaluate the effects of WRHPs among two cohorts of 31 practicing radiographers at a regional hospital (RH) and a teaching hospital (TH). RESULTS: An average score of 4.2 (SD = 0.4) out of 5 (84.8%) obtained on the knowledge scale indicated very good knowledge of WRHPs among the radiographers. Physical work demands, ergonomic issues, increased workload and stress levels on on-duty radiographers due to sick absence by colleagues, large numbers of daily cases, and extra work without incentives were reported as WRHPs effects mostly experienced by the radiographers. The study also showed no significant difference between gender groups (p = 0.313), years of professional practice experience level (p = 0.319), and academic qualifications (p = 0.287) on knowledge of WRHPs. CONCLUSION: Radiographers working in some referral and teaching hospitals in Ghana demonstrated very good knowledge of WRHPs and identified several effects of WRHPs on professional practice. IMPLICATION FOR PRACTICE: The study concludes that WRHPs predispose radiographers to adverse health conditions, and administrative protocols are required to prevent or mitigate the burden.

Thermal neutron reflection method for measurement of total hydrogen contents in Ghanaian petroleum products.

A fast and non-destructive technique based on thermal neutron reflection was used to determine total hydrogen contents in petroleum products available in Ghana. A source holder consisting of an 241Am-Be neutron source and 3He neutron probe designed for detection of liquid levels was used to measure reflection parameter as a function of hydrogen contents in liquid hydrocarbons which served as standards. The measured data were fitted to two linear equations for two different geometrical arrangements. The trend of data was found to be consistent with theoretical analysis based on neutron moderation. The calibration lines were used to determine hydrogen contents in 10 petroleum products. The results agree favourably with those obtained using different experimental set-ups with other neutron sources and probes. The technique was also used to determine the quality of diluted petrol with aviation fuel.

Geometrical effects on thermal neutron reflection of hydrogenous moderators using 241Am-Be source.

The variation of thermal reflection parameter with thicknesses of water and paraffin moderators was measured using an instrument consisting of 1 Ci 241Am-Be isotopic neutron source and 3He neutron detector. Based on experimental data obtained from two different source-detector-sample geometries, analytical expressions were derived for calculation of reflection parameters for various moderator thicknesses. The measured data for the two geometries exhibit saturation curves with saturation achieved at about 8 and 16 cm when sample container was placed at top and side of the source holder, respectively. By locating the source holder along the vertical axis of the sample container, measurements showed that the reflection parameter was very sensitive with the axial location and was strongly dependent on the moderator and its thickness.