Evaluating the Psychological and Physical Impact of Long Waiting Times in Cancer Patients Receiving Radiotherapy

In low- and middle-income countries (LMICs), delayed access to radiotherapy can mean the difference between survival and suffering. In Bangladesh, where oncology resources are limited and underfunded, these delays not only enable cancer progression but also impose severe emotional tolls on patients. Drawing on the observations of an experienced medical physicist, this mixed-methods study investigates how delayed care affects both the body and mind. The research includes 72 patient interviews, clinical data analysis, and evaluations of departmental workflows. Findings reveal a stark reality: patients who waited more than four weeks for treatment experienced an average tumor volume increase of 18%. Additionally, 62% reported significant anxiety, and nearly half met clinical criteria for depression based on HADS. Underlying these delays were systemic issues, like outdated equipment, poor scheduling, and understaffed departments which disproportionately affected economically disadvantaged patients, 71% of whom lacked private care alternatives. The study calls for immediate policy intervention. Recommendations include investing in radiotherapy infrastructure, adopting scheduling optimization tools, and integrating medical physicists into both clinical and operational roles. By addressing these gaps, Bangladesh and similar LMICs can move toward more timely, equitable, and humane cancer care.