A study published by researchers from the Radiation Oncology Department, Samson Assuta Ashdod University Hospital, the Faculty of Medicine at the Hebrew University of Jerusalem, and the School of Behavioral Sciences at the Academic College of Tel-Aviv Yaffo revealed how the attack by Hamas on Israeli civilians on October 7, 2023 and ongoing war could be detrimental to cancer care in general, and to radiation therapy in particular. Radiation therapy requires rigorous adherence to a fixed daily schedule of sessions at major medical centers. This presented unique and serious challenges for cancer patients. Travel was limited (or even forbidden in certain areas), patients were evacuated far from their primary care centers, spouses and caregivers were often unavailable because they were drafted into the reserves. All this caused unprecedented fear and anxiety that could result in non-compliance to treatment protocols.
Considerable attention was immediately focused on the medical system. Only 2 tertiary facilities in southwestern Israel provide radiotherapeutic services: Soroka Medical Center in Beer Sheva and Assuta Ashdod, located less than 25 miles from the Gaza strip.As Assuta, the researchers document the efforts taken to assure continuity of care during this period despite incessant missile attack and the relationship between these actions and the willingness of patients to continue their treatments.
They found that forty-seven patients enrolled in this study reported a significantly lower feeling of personal safety during wartime in comparison with the confidence in the professionalism of the staff. But patients also perceived that the impact of the national situation on their health was very low and analysis revealed that the desire to continue treatment in general and to continue treatment at the same department were significantly related to trust in the staff’s professionalism. They concluded that creating deep, trusting relationships between the patients and the medical staff have the potential to override the obstacle of fear of war poses to providing daily radiation therapy.
Encouraging research indeed. The empirical evidence to strengthen training and methods in other medical centers.
Aligned with these findings, the Israel Lemonade Fund redoubled efforts in partnership with frontline medical centers to be part of building that trust and confidence. Logistic concerns were very real, with serious consequences like costly transport to hospitals for daily radiation treatments. In just three short weeks, the Lemonade Fund distributed 133 Wartime Emergency Grants totaling NIS 239,400 ($61,845) for transportation for evacuees, childcare for families with drafted soldiers and immediate supplemental income. What we learned from this is that an emergency financial safety net can significantly reduce fear and anxiety. Thanks to this research, we have the empirical evidence that this can help facilitate better compliance and continuity of care.
It is difficult to imagine “the day after” in the war against Hamas and Hezbollah when over 100 hostages remain in captivity and our towns, villages and cities are subject to missile, rocket and drone attacks on a daily basis. But we promise to use our experience to effect changes needed to provide ongoing oncology care and the financial crises that come in its wake.