Radiotherapy continuity for cancer treatment: Lessons learned from natural disasters

This study examines the impact of natural disasters on the continuity of radiotherapy services, a critical component of cancer treatment responsible for managing one of the world's leading causes of death. As climate change intensifies the frequency and severity of natural disasters, healthcare systems — particularly oncology departments — face growing risks of treatment disruption. The authors conducted a Structured Literature Review complemented by a global online survey of radiotherapy professionals to systematically assess how events such as hurricanes, floods, and earthquakes affect radiotherapy practice worldwide, and to identify strategies that can strengthen resilience and ensure uninterrupted care for cancer patients.

The findings reveal that hurricanes, floods, and earthquakes are the principal natural disaster types disrupting radiotherapy services, with the review identifying twelve key academic publications on the subject. Through this analysis, nine overarching themes emerged, forming the basis for a taxonomy of 36 distinct risk mitigation groups — findings that were subsequently validated through the global survey. Building on these results, the authors developed a conceptual framework for natural disaster-resilient radiotherapy along with a practical checklist for clinicians and administrators. The study ultimately calls for the establishment of robust business continuity programs and evidence-based disaster preparedness plans, positioning the research as both a clinical resource and a foundation for policy initiatives aimed at safeguarding cancer treatment in the face of future natural hazards.