Sparking the radiotherapy revival

Last year was a breakthrough year for radiotherapy. We have been talking about radiotherapy’s importance, and the need for better awareness and investment, for a number of years, including through our Voice for Radiotherapy campaign, which called on Government to tackle inequalities in access.

“We already have a guarantee for drugs – that if they’re safe, cost-effective and doctors say you need them, you will get them.

From April 2013, for the first time ever, we’re extending that guarantee to radiotherapy too.

This is going to help thousands of people at one of the hardest times of their lives.”

– David Cameron, September 2012

But in September 2012, this culminated in the Government launching the Radiotherapy Innovation Fund – initially £15 million but later boosted to £23 million – to help NHS Trusts in England provide more patients with access to advanced radiotherapy.

Today, Cancer Research UK, the Institute of Physics and Engineering in Medicine, The Royal College of Radiologists and The Society and College of Radiographers have published a report evaluating its impact.

It’s easy to see why the Fund has been such a good news story in England. It was set up to help the country’s 50 radiotherapy centres deliver more of an advanced form of treatment called Intensity Modulated Radiotherapy (IMRT) to suitable patients.

This allows the radiotherapy beam to be more targeted to a patient’s cancer and therefore cause less damage to surrounding healthy issue, and can help reduce the side effects – as the images below demonstrates.

Intensity-modulated radiotherapy, or IMRT, delivers a lower dose to a patient’s tissues

This particular form of radiotherapy has been around for a while, but many of the radiotherapy services in England just haven’t had the capacity to give it to their patients.

At the time of the Prime Minister’s announcement, on average fewer than 14 per cent of patients were receiving IMRT, well below the recommended 24 per cent.

Our report shows that, following the delivery of the Fund, the average delivery of IMRT in April 2013 was up to over 22 per cent – a fantastic achievement in such a short space of time.

This means that around 5,800 more patients across England will now be in line to benefit from IMRT than last year. We expect that this figure will keep on rising.

IMRT also can avoid damaging organs like the salivary glands, reducing side-effects

So how did this come about?

Each Trust used their allocation to buy specialist equipment and to train staff to perform IMRT. This sort of investment means that hospitals across England are in a better position to give advanced radiotherapy.

Before last year, the radiotherapy service in England had been underfunded and neglected, despite the crucial role it plays in cancer treatment.

Now that Government, the NHS and hospitals are becoming more aware of its importance we must maintain the momentum and continue to push for improvements.

Not the end of the story

But the work doesn’t stop here – as well as IMRT, there are still other types of radiotherapy that some patients are missing out on, which we think the NHS should be doing more to provide. These involve using imaging in real time to track the treatment (so-called ‘image-guided’ radiotherapy, or IGRT), and using smaller, more accurate beams.

But much more importantly, we have some serious concerns about the long-term capabilities of the NHS to cater to the increasing need for radiotherapy.

As cancer rates increase, and we get better at diagnosing the disease earlier – which gives us more opportunity to treat the tumour with radiotherapy – the demand on radiotherapy services will increase. But many of the machines currently in use are getting older and need replacing.

As we discussed last year,  the Department of Health estimates that funding needs to be found for 254 new machines in the next three years to keep up with demand.

Today’s report helps to show the NHS and Government how a comparatively small investment into radiotherapy services in England can deliver a significant benefit to cancer patients. We think that the Fund should be the foundations for more sustained investment into radiotherapy in order to give England the world class service that it needs.

A final note – it’s worth pointing out that because the different nations of the UK have devolved healthcare systems, these announcements are related to England. We are continuing to work with the governments of Wales, Scotland and Northern Ireland to make sure that patients in these countries have access to the radiotherapy and the most recent techniques.

We’ll be covering these issues in future blog posts.

Dan Bridge