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Side effects of radiotherapy in breast cancer patients

The Internet as an information source

Nebenwirkungen der Strahlentherapie bei Brustkrebspatienten

Das Internet als Informationsquelle

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Abstract

Aim

Breast cancer is the most common cancer type among women necessitating adjuvant radiotherapy. As the Internet has become a major source of information for cancer patients, this study aimed to evaluate the quality of websites giving information on side effects of radiotherapy for breast cancer patients.

Methods

A patients’ search for the English terms “breast cancer – radiotherapy – side effects” and the corresponding German terms “Brustkrebs – Strahlentherapie – Nebenwirkungen” was carried out twice (5 months apart) using the search engine Google. The first 30 search results each were evaluated using the validated 16-question DISCERN Plus instrument, the Health on the Net Code of Conduct (HONcode) certification and the Journal of the American Medical Association (JAMA) benchmark criteria. The overall quality (DISCERN score) of the retrieved websites was further compared to queries via Bing and Yahoo search engines.

Results

The DISCERN score showed a great range, with the majority of websites ranking fair to poor. Significantly superior results were found for English websites, particularly for webpages run by hospitals/universities and nongovernmental organizations (NGO), when compared to the respective German categories. In general, only a minority of websites met all JAMA benchmarks and was HONcode certified (both languages). We did not determine a relevant temporal change in website ranking among the top ten search hits, while significant variation occurred thereafter. Mean overall DISCERN score was similar between the various search engines.

Conclusion

The Internet can give breast cancer patients seeking information on side effects of radiotherapy an overview. However, based on the currently low overall quality of websites and the lack of transparency for the average layperson, we emphasize the value of personal contact with the treating radio-oncologist in order to integrate and interpret the information found online.

Zusammenfassung

Hintergrund

Brustkrebs ist der häufigste Tumor bei Frauen, der eine adjuvante Strahlentherapie notwendig macht. Da das Internet eine wesentliche Informationsquelle für Krebspatienten geworden ist, hat diese Untersuchung das Ziel, die Qualität der Webseiten mit Informationen zu Nebenwirkungen einer Strahlentherapie bei Brustkrebs zu evaluieren.

Methoden

Mit Hilfe der Suchmaschine Google wurde eine patientenorientierte Suche englisch- und deutschsprachiger Webseiten mit den Suchbegriffen „Brustkrebs-Strahlentherapie – Nebenwirkungen“ und „Breast cancer – radiotherapy – side effects“ an zwei verschiedenen Zeitpunkten durchgeführt. Die ersten 30 Treffer wurden anhand des validierten 16-Fragen DISCERN-Plus-Scores, der HON-Code-Zertifizierung („Health on the Net Code of Conduct“) und den JAMA-Kriterien („Journal of the American Medical Association“) untersucht. Die Gesamtqualität der untersuchten Seiten (DISCERN-Score) wurde im Weiteren mit einer separaten Analyse der Suchmaschinen Bing und Yahoo verglichen.

Ergebnisse

Während die allgemeine Qualität der Internetseiten (DISCERN-Score) eine große Bandbreite zeigte, waren die Ergebnisse mehrheitlich von mäßiger bis schlechter Qualität. Englischsprachige Webseiten zeigten signifikant bessere Ergebnisse, insbesondere Seiten von Krankenhäusern, Universitäten sowie Nicht-Regierungs-Organisationen. Nur eine Minderheit erfüllte alle 4 JAMA-Kriterien und war HON-Code-zertifiziert (beide Sprachen). Die Google-Suche zu unterschiedlichen Zeitpunkten zeigte unter den ersten zehn Treffern keine wesentlichen Unterschiede. Signifikante Variationen traten erst bei hinteren Treffern auf. Der Vergleich unterschiedlicher Suchmaschinen ergab ähnliche DISCERN-Score-Ergebnisse.

Schlussfolgerung

Durch das Internet können sich Patienten auf der Suche nach Informationen zur Strahlentherapie einen Überblick verschaffen. Basierend auf der aktuell geringen Qualität der Internetseiten und der fehlenden Transparenz, tritt der persönliche Kontakt mit dem behandelnden Strahlentherapeuten in den Vordergrund, der zur Einordnung und Interpretation beitragen kann.

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Authors and Affiliations

  1. Medical Practice for Radiotherapy and Radiation Oncology, Rundestr. 10, 30161, Hannover, Germany

    S. Janssen

  2. Department of Radiation Oncology, University of Luebeck, Luebeck, Germany

    S. Janssen, L. Käsmann & D. Rades

  3. Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander-University of Erlangen-Nuernberg, Erlangen, Germany

    F. B. Fahlbusch

  4. Department of Radiation Oncology, University Hospital Halle (Saale), Halle (Saale), Germany

    D. Vordermark

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  1. S. Janssen
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  2. L. Käsmann
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  4. D. Rades
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  5. D. Vordermark
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Correspondence to S. Janssen.

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Conflict of interest

S. Janssen, L. Käsmann, F.B. Fahlbusch, D. Rades and D. Vordermark declare that they have no competing interests.

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Janssen, S., Käsmann, L., Fahlbusch, F.B. et al. Side effects of radiotherapy in breast cancer patients. Strahlenther Onkol 194, 136–142 (2018). https://doi.org/10.1007/s00066-017-1197-7

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  • DOI: https://doi.org/10.1007/s00066-017-1197-7

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