Poster Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Marked by trauma, resigned to accuracy: the dual impact of tattoos in radiation therapy   (126497)

Felicity Hudson 1 2 3 , Kylie Dundas 1 2 3 , Rachael Beldham-Collins 4 5 , Kathy Andrews 1 , Triet Dang 4 5 , Michelle Roach 1 , Liam O'Brien 4 5 , Shalini Vinod 1 2 3
  1. Liverpool and Macarthur Cancer Therapy Centres, Liverpool, NSW, Australia
  2. Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
  3. South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
  4. Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
  5. Blacktown Cancer and Haematology Centre, Blacktown Hospital, Blacktown, NSW, Australia

OBJECTIVES/PURPOSE

Permanent tattoos are used to improve reproducibility of patient setups for daily radiotherapy treatment. Previous studies investigating the impact of tattoos after the completion of radiotherapy reported issues relating to cultural/religious beliefs, physical discomfort and a negative psychological impact associated with the permanent reminders that tattoos bring.  Previous studies focussed on female patients with a breast cancer diagnosis well after treatment conclusion. This study aimed to understand the wider perception of tattoos in patients during radiotherapy treatment in an Australian multi-cultural setting.

SAMPLE AND SETTING

Four Sydney hospitals in Western and South Western Sydney distributed a questionnaire on situational unease due to modesty concerns in radiotherapy to 312 patients undergoing radiotherapy to the chest (C-female only) or pelvic (P) regions. Three selected responses and one free text response assessed patient attitudes towards tattoos.

PROCEDURES

306 patients responded to these questions. Descriptive and summative content analysis of responses was conducted.

RESULTS

11% of patients agreed/strongly agreed with the statement “the permanent treatment marks upset me” (13%C; 6%P); 25% would have preferred an alternative to tattoos (29%C; 15%P). 22% (26%C; 12%P) disagreed that a tattoo was better than a longer time lying uncovered during treatment. Among 98 free text responses, 46% revealed negative feelings, including pain and/or needle phobia, uniformed/unexpected, religious/cultural objections, preference for alternatives, and the concern over permanent reminders.  The most prominent positive/neutral sub-themes related to the small size of tattoos, followed by resignation to the situation and perceived accuracy.

CONCLUSION AND CLINICAL IMPLICATIONS

Patients continue to accept tattoos as part of their radiotherapy treatment, while also struggling with the negative impact imposed. This study demonstrates that discomfort with tattoos is not exclusive to female patients with a breast cancer diagnosis. Given the technological advances in radiotherapy, a future without permanent tattoos should be prioritised.