How cancer can be treated with radiotherapy
Britain is in the grip of a cancer crisis. Wait times for 2022 were the worst on record with more than 50,000 patients a month waiting two weeks to see a specialist. Some 25,000 patients in England were forced to wait more than a month for treatment last year – five times as many as a decade before.
Although record numbers eventually started treatment, every national cancer target was missed at least once for the first time ever.
The damning figures have piled pressure on the Government not to scrap its ten-year cancer plan – a long-term strategy dedicated to fighting the disease and investing in future services.
The plan was unveiled by then-health secretary, Sajid Javid, who declared a “national war on cancer” to recover services hit by the pandemic.
But it was recently announced that the scheme would be axed in favour of a “major conditions strategy” – part of a new multi-disease plan.
The decision leaves England as one of only a handful of countries without a dedicated national cancer plan.
Estimates suggest cancer cases will rise from 384,000 cases per year now to 506,000 in 2040 if current trends continue, with deaths set to rise by almost a quarter over the same period.
One of the “unsung heroes” in fighting cancer is Radiotherapy.
The treatment is needed in four out of ten cancer cures and used in half of all cancer patients.
Radiotherapy is needed for half of cancer patients (Image: Getty)
But Radiotherapy cancer care is in crisis too – at breaking point due to a lack of investment and thousands of lives will be lost without urgent action.
Of all the treatments for cancer, it is the one most overlooked for investment.
It’s never had the profile that surgery and chemotherapy have despite the fact that it is incredibly cost effective.
A typical cure by radiotherapy can be as little as £3,000 to £7,000.
By comparison, some chemotherapy drugs can cost up to £100,000 per year per patient.
The hi-tech treatment, which is delivered by a relatively small team (less than 6500) specialists nationwide, has been transformed during the past decade.
But the UK does not have enough radiotherapy machines and the ones we have are getting old and many can’t deliver modern treatment.
A typical cure by radiotherapy can be as little as £3,000 to £7,000 (Image: Getty)
France has 8.5 machines per million population, England has only 4.8 machines per million population.
And there are radiotherapy “desert areas” in the UK, in which patients have to take long journeys to get to a centre with a machine.
Currently, 3.5 million people live outside the recommended travel time of 45 minutes.
New radiotherapy machines – which cost around £2.4 million each – can treat more patients even more quickly.Over the next five years, we will need 200 new machines to catch up and keep up.
Campaigners say that if a new machine is efficiently used over its lifespan, the cost of treatment per patient is £400.This is why the Daily Express is on Monday launching a crusade to get a commitment from the government to ramp up investment in radiotherapy.
Our campaign has three simple demands;
1. A rolling programme of new radiotherapy machines to replace the old ones and secure more to keep up with the rising incidence of cancer.
2. A commitment to open new satellite radiotherapy centres in areas without treatment facilities to drastically reduce journey times.
3. A boost to the radiotherapy workforce to make sure the radiotherapy sector can play its full part in busting the cancer backlog and help get the UK back to the top of the survival league tables.
To achieve this, it will require a £1 billion boost over 5 years.
Our crusade is backed by Radiotherapy UK and the #CatchUpWithCancer campaign.
Manchester United and England legend Bryan Robson OBE, who survived cancer himself and received lifesaving radiotherapy in Thailand, has also thrown his weight behind our crusade.
He said: “This vital treatment needs more investment and priority. But without Government action little will change. That’s why I’m urging Daily Express readers to get behind this vital campaign.”
Crucially, the desire to boost funding for radiotherapy has cross-party support in parliament.
Lib Dem MP, Tim Farron, the Chair of the All-Party Parliamentary Group for Radiotherapy, said: “In the midst of a total cancer crisis, the Government has added fuel to the fire by quietly scrapping its long-promised 10-Year Cancer Plan. Frontline clinicians have the right recommendations for the Government, but Ministers aren’t listening.
“We desperately need investment to replace out-of-date radiotherapy machines, solve workforce shortages, and to fund timesaving auto-contouring technology if we’re to beat this almighty cancer backlog. We’re not asking to put man on mars. The solutions are simple, and they’ll prevent lives being lost unnecessarily.”
APPG vice-chair, Conservative MP Henry Smith, said: “Radiotherapy machines can and should play a key role in treating cancer patients, especially as we look to overcome the Covid backlog.
“Many radiotherapy equipment is manufactured in the UK – including my Crawley constituency – and so it’s deployment is not only vital to help those with cancer hopefully recover but represents a high-tech investment in British employment and economic growth.”
Fellow vice-chair, Labour MP Graham Morris, said: “There is no doubt, in this country, there is an unresolved cancer treatment backlog and we have some of the worst cancer outcomes of any comparable western country.
“Ministers need to address the lack of adequate NHS cancer treatment capacity and recognise that investment in modern radiotherapy treatment will help to dramatically improve cancer survival rates in this country.
“Radiotherapy is one of our most important cancer treatments, yet it is treated as a Cinderella service and denied the vital investment it needs.
“Millions of people live outside the recommended travel time to access radiotherapy treatment and there is no national plan to replace old machines with the most modern and effective precision radiotherapy machines.
“If ever there was a time to invest in high-tech modern radiotherapy, that can treat more patients faster and more effectively, it is now.”
Between 2016 and 2022 at least £162 million was invested to make sure NHS trusts have access to cutting edge equipment, including the replacement or upgrade of more than 100 radiotherapy treatment machines.
In the same period, there have been increases in the cancer workforce, according to the department for health and social care.
A spokesperson said: “We are laser-focused on fighting cancer on all fronts which is why we’ve invested £162m into modern, cutting-edge radiotherapy equipment to replace or upgrade more than 100 radiotherapy treatment machines so we can deliver the best possible outcomes for patients.
“According to the latest figures 91% of people began treatment within 31 days where the subsequent treatment was a course of radiotherapy in December 2022 which was up on the previous month.
“We have increased the cancer workforce by 4,300 additional staff between 2016 and 2021 and are investing an additional £50 million this year to increase this further.”
What is Radiotherapy?
Radiotherapy is Britain’s secret lifesaver, one of the “unsung heroes” in fighting cancer.
The treatment is needed in four out of ten cancer cures and used in half of all cancer patients.
The treatment works by using high-energy ionising radiation to destroy cancerous cells in the early stages of cancer or after it has started to spread.
It can also be used to help relieve symptoms.
It’s not just cancer either as one in four of us will need radiotherapy at some point in our lives.
It is also sometimes used to treat benign (non-cancerous) tumours and other conditions, such as thyroid disease and some blood disorders.
Patients might have the treatment from inside the body, called internal radiotherapy, or external radiotherapy, which is from outside the body.
You might have it by itself or with other treatments, such as chemotherapy or surgery.
It is generally considered the most effective cancer treatment after surgery, but how well it works varies from person to person.
Radiotherapy is usually given in hospital. Most people have several treatment sessions, which are typically spread over the course of a few weeks.
Bryan Robson (Image: Getty)
Comment by Bryan Robson – Former Manchester United and England Captain/Radiotherapy UK Patron
My world was rocked when I received the diagnosis. Cancer, the disease that so many of us think happens to someone else, had finally happened to me.
I thank God that my wife chivvied me on to get the irritating cough investigated. We were far from home at the time, due to my job coaching in Thailand. The ear nose and throat clinic was literally across the road from our apartment, the shortest of walks. But it’s fair to say that the walk back home felt a lot longer than the walk there.
I was in a shocked daze. Mercifully, the doctors and radiotherapy professionals acted so quickly.
Within days they had started to tackle the tumour. I owe my life to radiotherapy. That’s why I offered on my return to the UK to help the charities and campaigners that are crying out for more resources for radiotherapy here.
Until my own experience, I only had the haziest idea of what radiotherapy actually was. Like most people, I’d seen a lot of media coverage about the advances in cancer surgery and chemotherapy.
Radiotherapy simply didn’t seem to be in the media much. But the more I have learnt about radiotherapy in the UK, the more I think it needs to be in the spotlight. It is widely known that cancer affects one in two of us. But most people are surprised to learn just how important radiotherapy is. The health professionals that deliver radiotherapy in the UK tell me that they often feel like it is an overlooked service for investment and priority.
The workforce is crying out for support to help them help patients. They tell me that the country also simply doesn’t have enough radiotherapy machines and many of the ones they do have are past their recommended life of 10 years. They tell me that newer machines can treat patients in far fewer visits to hospital than the older ones.
There have been enormous advances in radiotherapy technology over recent years. What used to take 20 to 30 sessions of radiotherapy can now be achieved in less than a handful.
And I was amazed to learn that the most modern technology can keep the beam of cancer killing radiation focussed on the tumour even as it moves while a patient breathes. It might sound like the stuff of science fiction. But these machines are available right now. But despite all radiotherapy has to offer, the Government’s approach to it hasn’t kept up.
There is hope that we can turn this situation around. I was at a radiotherapy event in Parliament only a few weeks ago. Over 70 MPs came. I could sense that many of them shared my view that this vital treatment needs more investment and priority. But without Government action little will change. That’s why I’m urging Daily Express readers to get behind this vital campaign.
I’ve played with some great teams in my life and the team of great professionals that deliver radiotherapy in the UK are up there with the best of them. They, and the cancer patients they treat, deserve the best.
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Comment by Professor Pat Price – Chair and co-founder of #CatchUpWithCancer
The worst cancer crisis in my lifetime is laid bare by a huge unsolved cancer backlog and a deadly postcode lottery where waits for cancer treatment can be bad or terrible.
As an oncologist, it pains me to see the real and present danger that Government policy failures on cancer are posing to thousands of patients. Chief among these policy failures is the bafflingly low level of investment and priority put on radiotherapy, one of our most important cancer treatments and the closest thing we have to a silver bullet against the cancer backlog.
Radiotherapy is a high-tech cancer treatment that kills cancer cells using high-precision radiation. It is one of the most curative and most cost-effective of all cancer treatments, at £3-7k per cure, with few side effects. In many cases, it is the patient’s treatment of choice.
And is particularly well suited to clearing backlogs because it is COVID safe and where appropriate, it can substitute for surgery to bring down waiting lists. There has been a giant leap forward in technology in recent years which means smarter, faster machines and IT innovation are available that can dramatically increase survival and reduce treatment times. With that in mind, you might think that radiotherapy would be at the forefront of the Government’s plans for cancer.
But sadly, the opposite is true. Radiotherapy has been largely overlooked and desperately underfunded. In fact, it only receives 5% of the cancer budget. There is a major workforce crisis in radiotherapy.
Many of our treatment machines are out of date and we do not have as many machines per million as comparable countries. Worse still, the service is held back by red tape which means clinicians can’t use the existing machines to their full potential. It often feels like ministers and NHS leaders do not understand radiotherapy.
But we need them to get it and get it fast. International standards show that at least 53% of cancer patients need radiotherapy, but in the UK we are miles off this. Only 27% had access in 2019 and this got worse during the pandemic.
The demand for radiotherapy is only increasing as it is needed in 40% of cures. CRUK estimates the number of cancer patients per year will jump from 384,000 to over 500,000 by 2040. Half of these will need radiotherapy and at present levels that will not happen.
There is an overwhelming case for the Government to deliver a transformational boost to radiotherapy services. We will fail to tackle the cancer backlog without it and we will never produce truly world-class cancer outcomes.
I wholeheartedly support the Daily Express campaign for world-class radiotherapy in the UK. If ever there was a time for the Government to embrace radiotherapy it is now.
