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Proton therapy

Proton beam therapy is coming to the NHS (image from Wikimedia Commons)

New radiotherapy techniques have hit the headlines in recent weeks, both for the right and the wrong reasons. Let’s take a closer look.

A boost for proton beam therapy

On the plus side, we were pleased to hear the Government announce last week that proton beam therapy will be introduced in England on the NHS.

At the moment, patients requiring proton beam therapy have to go abroad to receive it (paid for by the NHS). Up to 1,500 patients a year could benefit from this investment in radiotherapy technology – especially those with spinal cord tumours, sarcomas near the spine or brain, and some children’s cancers – which comes with a £150 million price tag.

Radiotherapy by any other name…

The Sunday Times recently ran a story (behind paywall) claiming that Health Secretary Andrew Lansley is putting cancer patients at risk by refusing to bring in Cyberknife radiotherapy machines into the NHS.

On the surface, this story seems alarming. We’re all too aware that radiotherapy services in the UK could do with improvement, and believe that thousands of cancer patients could be missing out on this potentially lifesaving treatment.

Throughout this Year of Radiotherapy we’ve been trying to raise awareness of the treatment, and our Voice For Radiotherapy petition gathered over 36,000 signatures from people demanding world-class radiotherapy here in the UK.

But we also believe it’s important to talk about technology rather than brand names.

Cyberknife and Gammaknife are brand names for a technique known as stereotactic radiotherapy which allows doctors to treat cancers that are too difficult to remove with surgery – especially brain tumours. It’s also known as radiosurgery, stereotactic ablative surgery (SABR) and stereotactic body radiotherapy (SBRT).

Although there are several Cyberknife and Gammaknife centres in the UK – including within the NHS – stereotactic radiotherapy technology is available more widely at many NHS radiotherapy units.  So although a cancer centre may not provide named Cyberknife or Gammaknife treatment, it could still have the same (unbranded) technology.

We feel it is important to make this point clear, particularly in the light of articles such as the one in The Sunday Times.

In response to that particular article (behind paywall), the UK “Cancer Czar” Professor Sir Mike Richards pointed out that the piece

“gives the impression that the Health Secretary is standing in the way of this treatment, which is not the case at all. Stereotactic Body Radiotherapy (SBRT), of which Cyberknife is one brand, is already available to patients on the NHS in over a quarter of all radiotherapy centres in England, and the number of centres providing this treatment is increasing.”

There’s more information about Cyberknife, stereotactic body radiotherapy and stereotactic radiotherapy specifically for brain tumours on our CancerHelp UK website.

Radiotherapy is a lifesaving cancer treatment, and we welcome any advances in research and service provision. But it’s important that we focus on the technology itself and the benefits for patients, not just the name of a particular company.

Kat

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Comments

Kat Arney December 22, 2011

Hi Mark,
Thanks for your comment. As we point out in our post and on our CancerHelp UK page about Cyberknife, this is a brand name for a highly targeted type of radiotherapy known as stereotactic radiotherapy, also called radiosurgery. All types of stereotactic radiotherapy – Cyberknife, Gammaknife and unbranded radiosurgery treatment – use highly focussed beams of radiation to treat tumours as precisely as possible, while reducing the chances of damaging surrounding tissue.

As we and Professor Sir Mike Richards explain in our post, Cyberknife is just one brand of stereotactic radiotherapy/radiosurgery. Please take a look at the information about Cyberknife on our CancerHelp UK website, which should help to clear up any confusion: http://cancerhelp.cancerresearchuk.org/about-cancer/cancer-questions/treatment-with-cyberknife

Best wishes,
Kat
Science Information Manager

Mark December 22, 2011

The author of this article is confused about the difference between radioTHERAPY and radioSURGERY. The former (radiotherapy – eg Tomotherapy) involves fairly unfocussed radiation which badly damages healthy tissue as well as cancerous tissue and typically requires a month or more of therapy. It is most suitable for large, diffuse tumors. The latter (radiosurgery – Cyberknife) employs extremely focussed radiation via a multitude of very narrow beams which all intersect at the tumor, providing an extremely high dose of radiation at the tumor and very little elsewhere. Radiosurgery is most suitable for a limited number of small tumors, and requires only 1-5 days of treatment. The Gamma Knife lies somewhere in between radiotherapy and radiosurgery, but has nowhere near the resolution of the Cyberknife.

The point is that radiotherapy does not provide anywhere near the optimum treatment for patients with small tumors, particularly when they are situated close to critical body structures. That is why the Cyberknife is needed in the UK.

The article by Kat Arney is scandalously misleading and should be immediately retracted.

Kat Arney December 21, 2011

Hi Andrew,
As you may know, TomoTherapy is a brand name for a type of image-guided radiotherapy (IGRT) – a more accurate way of giving radiotherapy taking into account the three-dimensional shape of a tumour. There’s more about this technique on our CancerHelp UK website:
http://cancerhelp.cancerresearchuk.org/about-cancer/treatment/radiotherapy/external/about-external-radiotherapy#tomo
and more about the latest 3-D radiotherapy techniques here:
http://cancerhelp.cancerresearchuk.org/about-cancer/cancer-questions/conformal-radiotherapy-3d-conformal-radiotherapy

Thanks for your comment, and we hope your treatment has been successful.

Best wishes,
Kat
Science Information Manager

Andrew Harmsworth December 21, 2011

This is good to hear, although it’s just typical of the level of scientific understanding in the UK media – that a paper such as the Sunday Times can care more about brands than technologies is mind-boggling. Unfortunately, even with comments from the likes of Sir Mike Richards, the damage is already done – how many people will have read the article compared to his response? As someone who received “Tomotherapy” treatment earlier this year, I find myself wondering whether this approach is available from other companies?