| Sumario: | Background: This case study discusses a 37-year-old man who presented with stage IV (cT3N1M1a) sigmoid colon cancer that had metastasized to the liver. The patient underwent stereotactic body radiation therapy using real-time, fiducial-based, triggered-imaging guidance and amplitude-based respiratory gating at exhalation. In addition to the cancer diagnosis, the patient was deaf and had a substantial medical and surgical history for other comorbidities. Discussion: Although deaf patients account for a small percentage of those undergoing radiation therapy, this treatment has the potential to be more inclusive to this group, which the authors accomplished using a novel approach. Providing instructions to enable the patient to breathe in a consistent, periodic, and reproducible manner via sign-language interpretation and visual setup was key to providing equitable care. Conclusion: The multidisciplinary team must work to ensure that deaf patients are not excluded from gating treatment protocols typically achieved through verbal coaching. With appropriate visual setup, sign-language interpretation, and coaching through translation, culturally competent care can be provided successfully and seamlessly.
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