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What's the future for radiotherapy?

Advanced radiotherapy can be highly effective and can also cost less than some cancer drugs. But many people continue to question if it's getting the funding and resources it deserves.

In October 2012, Prime Minster David Cameron announced a £23 million Radiotherapy Innovation Fund to improve access to advanced radiotherapy services in England. Not surprisingly, the move was generally applauded by everyone from oncologists, radiographers and radiologists to cancer charities. Just a few months later, a congratulatory letter was winging its way to the PM from a group of organisations, including the College of Radiographers and the Royal College of Radiologists. Their conclusion was that the fund had 'given a significant boost to the radiotherapy service in England' and 'significantly increased the radiotherapy service's ability to deliver advanced radiotherapy.'

So, what went wrong? In March this year several newspapers reported the contents of a leaked letter to NHS England from several leading neurosurgeons, which claimed that 'radiotherapy has descended into chaos in just one year... machines worth millions are sitting idle in hospitals...'

In April, the Daily Mail reported that thousands of cancer patients were missing out on advanced radiotherapy treatments such as Intensity Modulated Radiotherapy (IMRT) and Stereotactic Ablative Radiotherapy (SABR). The Breast Cancer Campaign echoed the concerns raised in the article, pointing out that IMRT can be particularly important for women with breast cancer because it delivers better cosmetic outcomes than standard radiotherapy.

In July, charity Action Radiotherapy said that NHS England's funding for SABR had virtually dried up and launched a petition calling on them to stop the cuts to radiotherapy funding.

It seemed the problem was not only a matter of cash. Advanced technology requires advanced skills and in some parts of the country there seems to be a shortage of trained radiotherapists who can operate the new machines. According to the Daily Mail's research, 'the NHS needs 39 per cent more radiographers by 2016 to meet demand'.

The Radiotherapy Board, a UK-wide collaborative of clinical oncologists, therapy radiographers and medical physicists, sees things a little differently. In March they wrote to the Sunday Times to point out that 'radiotherapy services are in a much better place today compared to March 2013'. Their contention was that the problem with the Radiotherapy Innovation Fund was not one of funding, but of an unrealistic time frame, and that the Vision for Radiotherapy strategy issued by NHS England and Cancer Research UK is a 'major opportunity to address what still needs to be done'.

One thing everyone seems to agree on is that advanced radiotherapy can improve outcomes for patients. Let's hope that, where it's an appropriate treatment, all cancer sufferers across the UK have the opportunity to benefit from this life-saving technology.

Are you a therapy radiographer or radiologist working in the NHS? If so, what's your experience of advanced radiotherapy services - positive or negative? Comment on this article or email us.

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