Researchers have found that for many kids, “zoning out” to their favorite videos is a better option. Especially given that a child may need up to 35 radiation treatments, usually her five days a week, over several weeks.
“I think that a few weeks of therapeutic experience is really important for the child and their family,” Hiniker said.
Maximum benefit for small children
To receive radiation therapy, the patient lies on a treatment table and a beam of radiation is directed at the tumor. Depending on the location of the tumor, the patient may be fitted with a table-mounted device to keep the patient from moving the body part being treated.
Researchers tested a video viewing setup developed at Stanford Medicine Children’s Health. It consists of a wireless projector mounted on a table behind the child and a thin, radiation-transparent plastic screen mounted where the child can see it during treatment. The display screen does not significantly affect radiation dose.
Using video distraction instead of anesthesia eliminated the need for children to fast overnight before radiation therapy. Each patient chose the video they wanted to watch. Usually children’s shows available on streaming services. Parents can bring their child into the treatment room and stay until the child is placed on a table and begins watching a video of their choice.
With video distraction, 78% of the children in the study were able to remain still through one radiotherapy session of at least 10 to 30 minutes without anesthesia. Fewer than half of all children were found to tolerate radiotherapy without anesthesia. Children participating in this study received a median of 28 treatment sessions and avoided anesthesia for a median of 20 sessions each. All 10 cancer treatment centers successfully delivered video distractions. This means that at least half of the patients were able to avoid anesthesia.
The success of video distraction was partially dependent on the child’s age. In children aged 3 or 4 years, 55% avoided anesthesia, whereas from age 5 to age 7 and from age 8 to age 10, the rate was 81%. 85% each.
The distraction effect of video was greatest for 3- and 4-year-olds, Hiniker said. Without distraction, other studies found that less than 10% of children in this age group were able to avoid anesthesia.
“For the smallest patients, it can make the biggest difference,” she said.
If you can get them occupied with something to focus their attention on, such as a video they enjoy, that really helps.
The researchers also measured quality of life with standardized questionnaires given to all patients’ parents and to patients aged 5 to 10 years. Both reported that their patients’ overall quality of life and physical appearance improved and their anxiety about treatment decreased during the course of radiation therapy. Anxiety about treatment was also significantly reduced at ages 8-10. Anxiety scores decreased more in children who successfully video distracted than in those who required anesthesia.
Avoiding anesthesia has also reduced treatment costs for children. A previous study estimated the typical anesthesia fee for her six-week course of pediatric radiotherapy to be his $50,000, or about $1,667 per treatment session. Researchers estimate the cost savings from avoiding anesthesia in the current study to be about $2.3 million. Hiniker said his one-time cost to install a video distraction system in a medical facility is about $500.