44 Health Care Provider Experience in the Referral of Canadian Paediatric Oncology Patients for Proton Beam Radiation: A Survey-Based Analysis

Proton beam therapy is becoming more widely utilized in paediatric cancer treatment due to its ability to deliver highly targeted radiation, reducing damage to surrounding healthy tissues. Countries that do not have proton beam therapy facilities, such as Canada, face major logistical challenges to facilitate access to this treatment abroad. The objective of this study was to gain a better understanding of the health care provider (HCP) experience and perspective in the referral and treatment process of children who were prescribed proton radiation. Methods: We conducted a cross-sectional survey study on HCPs involved in caring for paediatric oncology patients across Canada. After obtaining individual consent, HCPs completed a survey of up to 11 questions that explored the provider’s involvement in the referral process, treatment, or follow-up care of patients who received proton beam radiation. Results: We received 47 survey responses: 27 physicians, 4 trainees, 13 nurses, and 3 allied health staff. Proton beam therapy recommendations were driven by its therapeutic benefits, including precise tumour targeting and reduced late effects. Patient and family factors, such as travel, time away from home, and costs, were also considered. Barriers included disruption to continuity of care across teams and challenges with provincial health authority approval for out-of-province medical and supportive care. Conclusion: Medical and patient factors play a significant role in the HCP decision to pursue proton beam therapy. Further studies are required to explore strategies to improve referral pathways, streamline care coordination, and enhance communication among providers to ensure equitable access and optimal patient outcomes.