Radiotherapy: our vision for the next ten years

Where will you be in ten years’ time?

It’s a tricky one – almost anything could happen. But this is the question we set ourselves to answer about radiotherapy: what will radiotherapy look like in 2024? How will the technology have developed; how will we treat patients; and, most importantly, who will we be able to save then who we can’t save now?

It’s a challenge to look that far into the future, but it’s also very exciting. We have a long history of championing radiotherapy and we’re proud to have taken on this new project. Working with NHS England we’ve produced our Vision for Radiotherapy, which lays out the progress we want to make over the next 10 years.

We’d like to describe just a few of the most interesting developments we want to see in radiotherapy in the coming years.

Imaging – seeing what we’re doing

When a patient receives radiotherapy the aim is to hit the tumour but avoid the healthy surrounding cells. To do this, the people giving the treatment need to be able to know what they’re targeting – they need imaging technology that allows them to see the tumour.

This already happens and is called Image Guided Radiotherapy (IGRT), but there are still big improvements to be made.

Some of the most exciting developments in radiotherapy technology in the next 10 years will come from improvements in imaging.

In particular, combination technologies, where imaging equipment is combined with the machines used to give radiotherapy (linear accelerators), will mean that radiographers will be able to see the parts of the body they are treating as they are treating them.

This means that they will be able to more accurately target a lung cancer tumour that moves as a patient breathes, and even see how a tumour reacts to treatment in real time.

This opens up possibilities for more sophisticated and personalised treatments.

Data – using what we already know

Radiotherapy centres generate a huge range of information about the people they’re treating and what results they’re getting. We need to make better use of this data to answer some of the key questions we still have about radiotherapy.

Before a patient is treated, we have certain pieces of information about them – for example their general health and the kind of tumour they have. Then they’re given radiotherapy and we record how they respond to this, whether they recover well, what kind of side effects they have.

If we link these sets of information together we can start to observe patterns and make predictions.

If we use the data we already have properly, when a patient is diagnosed they are not approached as an isolated case. The medical team treating them will have access to information about the people who came before them. They will compare and contrast new patients with old and so will be able to make more informed decisions about how they should treat each individual.

We already have vast amounts of data – it’s time we started working out what it’s telling us.

Research – looking into the future

The progress that’s been made over recent years in radiotherapy has been fantastic. We want to make sure that the next 10 years are even better. And there’s only one way to ensure that we are continually improving: research.

Our report looks at a range of ways we can encourage research in radiotherapy from better collaboration between centres to ensuring that staff have the training and resources that they need. Crucially, we need to make sure that when we get results from research, the NHS is in a position to adopt these quickly.

Historically, this hasn’t always happened.

The NHS has been slow to make the most of intensity modulated radiotherapy (IMRT) a type of radiotherapy that targets the tumour more accurately, sparing the healthy tissue, meaning that, for some time, not enough patients were benefiting from this treatment. Since then, the Radiotherapy Innovation Fund has had a big impact on patient access IMRT, which we are really pleased to see.

This is the first time there has been a vision for 10 years into the future. If something similar had existed 10 years ago then maybe we might have predicted the arrival of IMRT and been able to plan for it. With the NHS ready for the change more patients could have benefited more quickly.

Now we have an opportunity to do things differently. By thinking about the future now, we can invest properly in research and plan for how we’re going to adopt innovations within the NHS.

When the next big breakthrough arrives, we’re going to be ready.

How does the vision become a reality?

We’re pleased to have a vision for the future of radiotherapy, but, of course, this is only the first step. Next, the NHS needs to establish exactly how they’re going to deliver the big ambitions we’ve laid out.

The timing is perfect because NHS England is now working on its five year strategy for radiotherapy.

While writing this report we spoke to a wide range of experts from doctors to researchers, manufacturers to patients and they all talked to us about their inspiring visions for the future. We’ve set our goals high and it will be a challenge to deliver them, but we see every reason for optimism.

Radiotherapy will save many lives in 2014 and we look forward to seeing what it can achieve in 2024.