title: 'If we get too close to your bones they'll go brittle': women's initial fears about radiotherapy for early breast cancer.
abstract: BACKGROUND
  Radiotherapy is a common treatment for breast cancer. However, previous studies have shown that women who present for radiotherapy fear its use and associated side effects. The aims of this study were to develop further understanding of breast cancer patients' fears of radiotherapy, ascertain how patients deal with these fears and determine the best time in the treatment planning trajectory for health professionals to address these concerns.
  
  
  METHODS
  Semi-structured interviews were conducted with early breast cancer patients at four time points during their experiences of radiotherapy. Grounded theory was used to analyse the data. Symbolic interactionism informed data interpretation.
  
  
  RESULTS
  Thirty-four participants were interviewed. The two main themes that emerged prior to treatment commencement were 'fears about receiving radiotherapy' and 'ways of coping with the fear of radiotherapy'. Sub-themes that emerged as components of the theme 'fears about receiving radiotherapy' were: 'fearing the unknown', 'getting burnt', 'damaging internal parts' and 'anticipating tiredness'. Patients were able to cope with their fears by trying not to worry about their fears and by seeking information. Many patients found that their fears about radiotherapy were much worse than their actual experiences of receiving treatment and the side effects they experienced.
  
  
  CONCLUSIONS
  In discussing radiotherapy with patients, health professionals have a window of opportunity at the planning appointment, prior to the commencement of radiotherapy, to assess patients' understanding and concerns about radiotherapy, listen to their fears, address meanings they assign to radiotherapy and provide reassurance about radiotherapy and the management of side effects.
authors.affiliation: WA Centre for Cancer and Palliative Care, Curtin University of Technology, Perth, WA, Australia. g.halkett@curtin.edu.au
authors.forename: Georgia K B
authors.initials: GK
authors.lastname: Halkett
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Kristjanson
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Lobb
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D015519:Bone Density / Q000528:radiation effects*; D001943:Breast Neoplasms / Q000523:psychology* / Q000532:radiotherapy*; D003469:Culture; D005221:Fatigue / Q000523:psychology; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007206:Individuality; D007406:Interview, Psychological; D008875:Middle Aged; D010025:Osteoradionecrosis / Q000523:psychology*; D010353:Patient Education as Topic; D011788:Quality of Life / Q000523:psychology; D011832:Radiation Injuries / Q000523:psychology*; D011855:Radiodermatitis / Q000523:psychology*; D011878:Radiotherapy / Q000009:adverse effects* / Q000523:psychology*; D012803:Sick Role