2406 - Do Patients with Head and Neck Cancer Feel Anxious about Mask Use during Radiotherapy? Importance of Medical Support and Coping Strategies

Purpose/Objective(s): A thermoformed radiation therapy mask applied to the face and secured to the treatment table is used to ensure safe and accurate delivery of the radiation dose, by limiting the patient's movement, particularly in case of treatment of head and neck tumors. Nevertheless, the mask's restrictive design can exacerbate anxiety in many patients, with some describing the experience as "feeling like being buried alive". The purpose of this study was to assess anxiety related to the mask and the coping strategies employed by patients with head and neck cancer.

Materials/Methods: Eighty five patients undergoing radiotherapy for head and neck cancer with use of an immobilization mask, in the radiotherapy department on the national institute of oncology in Rabat, Morocco, were included in this study. Semi-structured, qualitative interviews were conducted with these patients on the day of their simulation to explore their experiences of anxiety with mask use and gathering their suggestions for reducing it, using the State-Trait Anxiety Inventory (STAI-YB) and the Ways of Coping Checklist (WCC) were used.

Results: Eighty five patients treated for head and neck cancer provided consent to participate in our study. The median age was 46 years (range: 31–74). Anxiety scores related to wearing the radiotherapy mask were generally low, with an average of 30 at the time of mask fabrication. However, nine patients (10,6 %) exhibited phobia-like anxiety before or during the creation of the mask. The majority of these patients had a history of phobic disorders. These patients emphasized the restrictive and suffocating nature of the mask. Only two patients categorically refused to wear the immobilization mask and even exhibited states of agitation, preventing the completion of the dosimetric scan. Indeed, 99% of patients reported that the coping strategies were implemented on the day of the simulation. Thus, the presence and reassuring support of the team, the possibility of opening the mask, and occasionally the use of relaxants for anxious patients before the simulation may have played a decisive role in helping patients adjust to wearing the mask.

Conclusion: Mask-related anxiety appears to be low in most patients treated for head and neck cancer. Patients valued the support of the treatment team, some suggestions for improvement include enhancing communication about the mask-fitting procedure, informing patients that they might experience anxiety related to the mask, and providing guidance on how to manage it.