The ongoing pandemic has had a profound impact on routine screening tests and treatment appointments. Many people prefer to avoid hospitals and clinics, delaying potential life-saving exams and therapies. The fear of contracting Covid added to the intrinsic anxiety of a possible negative outcome or beginning a new treatment plays a major role in the decision to delay such appointments.
The development of digitized tools could help patients decrease the psychosocial distress that can have negative effects on treatment compliance and quality of life. One such promising tool is Digi-Do. Developed in Sweden, its aim is to support breast cancer patients before, during, and after radiotherapy.
Radiation therapy (RT) is received by 75-80% of breast cancer patients after surgery, and is important in reducing the risk of local recurrence. Most patients are unfamiliar with it and their lack of knowledge can result in high levels of anxiety and enhanced feelings of being unprepared for the treatment.
How Digi-Do works
Digi-Do is divided into two applications for mobile devices: one (information app) containing information obtained through the pre-treatment phase, and one employing virtual reality (VR-app), making the experience even more immersive, thanks to the feeling of “being there” produced by the technology. The VR-app provides a guided tour of the RT department with a voice-over describing the 360° images, leading to the sensation of actually having visited the department before RT treatment begins. Patients can complete the simulated study-visit on their mobile or tablet even without the VR effect. Apart from the RT department tour, Digi-Do has a Q&A section presented both in written and recorded voice methods, practical information such as maps and public transport, and also some short, animated movies about cancer and physical activity during RT.
Digi-Do’s ability to decrease RT-related distress will be evaluated with a clinical trial set to begin recruiting patients soon. This study will involve 160 breast cancer patients (80 will receive standard care and oral and written information about RT, plus the digital information tool, while the other 80 patients will be the control group, receiving standard care and oral and written information only). The psychosocial distress will be evaluated with a “distress thermometer” – a screening tool for cancer patients including 34 dichotomous items on the presence of physical, emotional, family, practical, and spiritual problems, and follow-up interviews up to six months after treatment is completed.
Results
Results are expected to be available in 2023, but the Digi-Do mechanism of action looks promising. Furthermore, some pilot studies with a small number of participants have already demonstrated that VR interventions can decrease anxiety about the process and improve RT knowledge, providing patients with useful content. Such digital tools offer an added value not only to patients, who become more informed and better prepared, but also to their loved ones, who can better understand what the patients are experiencing. This enhanced knowledge will in turn increase the psychosocial support provided to patients by people around them, defeating the concept of cancer being a lonely fight.
Bibliography: Fristedt S et al. BMC Med Inform Decis Mak. 2021 Gao J et al. J Cancer Educ. 2020 Aug 22. Jimenez YA et al. Support Care Cancer. 2018 www.clinicaltrials.gov
