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The times: Coronavirus: Cancer patients at risk as radiotherapy machines stand idle

30th April 2020 Featured on The Times online - https://www.thetimes.co.uk/edition/news/coronavirus-cancer-patients-at-risk-as-radiotherapy-machines-stand-idle-f5smbjmmr

Cancer patients are facing up to six months in treatment delays as vital radiotherapy is cancelled despite some hospital machines sitting unused for hours each day.

Results from a rapid inquiry into radiotherapy cancer treatment during the Covid-19 pandemic reveals that half of all clinicians have had to delay treatment but have the capacity to carry out vital care.

It is predicted that the outbreak could result in 18,000 extra cancer deaths due to treatment delays and experts argue that an opportunity is being missed to avoid “collateral cancer deaths” by not prioritising radiotherapy.

 

Results of the inquiry will be presented to ministers tomorrow.

Radiotherapy treatment is needed in half of all cancer cases and is used in a quarter of cases where cancer is cured. It leaves patients less vulnerable to Covid-19 than chemotherapy and surgery. However, it is often seen as a Cinderella service and was suffering from financial and technological underinvestment before the pandemic.

A survey of clinicians carried out by the all-party parliamentary group (APPG) of MPs for radiotherapy and the charity Action Radiotherapy found that 50 per cent reported that two thirds of patients had had their radiotherapy treatment disrupted because of the coronavirus crisis.

Unused machine capacity has increased five fold with some centres now reporting six hours of spare machine time a day. Prostate cancer treatment makes up about a third of the workload of most radiotherapy departments. Now 56 per cent of these patients have seen their treatment delayed by up to six months.

The survey of 341 radiotherapy professionals also uncovered huge concerns in the lack of personal protective equipment for frontline staff and 76 per cent felt they would contract or pass on Covid-19 because of this.

An anonymous clinician said: “We are a highly at-risk group. Our faces are super close to the patient’s. We have to lean our entire body into them to move them contaminating our uniform, yet we’ve been told we are not allowed long-sleeve gowns."

Another added: “The street cleaners in China, who are spraying the streets with disinfectant have better PPE than I do.”

On March 28 the National Institute of Clinical Excellence issued rapid guidelines on how radiotherapy should be delivered during the pandemic. It ranked patients in a priority of 1 to 5 and many treatments were stopped, leaving radiotherapy departments empty and machines unused.

Tim Farron, the Liberal Democrat MP and chairman of the APPG, said, “A double disaster is looming in which we stand to lose as many to cancer as we save from Covid and I fear the secretary of state does not realise there is something he can do about it.

“By boosting radiotherapy, we can massively reduce the number of patients experiencing cancelled, delayed and deferred treatments, and ultimately save lives that would otherwise be lost unnecessarily. The evidence submitted by ourselves to the [health and social care] select committee clearly sets out the problem, and crucially, the solution. I urge him to meet with us to discuss how we can prevent this double tragedy.”

Pat Price, chairwoman of Action Radiotherapy, said: “There are going to be so many extra deaths from conditions other than Covid-19. But it doesn’t have to be as bad as it is on track to be. We need to boost radiotherapy as it can treat patients where other methods are currently high risk.”

Press release: UK charity leads the charge on global response to COVID-19 with launch of international radiotherapy treatment resource

Date : Immediate Release 21st April 2020

 

Contacts :

Action Radiotherapy

0203 051 5671

info@actionradiotherapy.org

A new international cancer fighting resource has been launched by a UK charity to ensure cancer treatments can continue amid the COVID-19 pandemic. Whilst healthcare services wrestle with the possibility of deferring, delaying or cancelling cancer treatments, the tool provides a valuable source of short and long term solutions. Action Radiotherapy, who are playing a key role in the Coalition for Global Radiotherapy’s response to the global emergency, have published the tool which will allow international radiotherapy teams to develop the best and most life-saving approaches to keeping cancer treatments going during the pandemic.

 

The resource provides an opportunity for international healthcare professionals to learn from one another, rapidly share data, disseminate best practise and provide valuable global learning opportunities for healthcare professionals and governments.

 

Professor Pat Price, Chair of Action Radiotherapy said: “The resource is a call to action from the radiotherapy community to produce a multidisciplinary voice and demonstrate what a global coalition can achieve in advocating for best practice in radiotherapy services, which at this difficult time, will ultimately, save lives.”

 

“Unfortunately, the information we have so far does show that the UK is lagging behind in its response and there is a very real risk that the lives saved from COVID-19 will be outstripped by those we lose to cancer. It is therefore vital we learn from our global colleagues. And most importantly, act immediately.”

 

“The Coalition for Global Radiotherapy creates an international stakeholder network bringing together healthcare professionals, charities and industry. The resource provides the go-to information source that will help healthcare providers and policy makers ensure the best treatments for cancer patients during the current situation”.

 

Radiotherapy is one of the most important cancer treatments needed by 1 in 4 people and is vital in 40 percent of cancer cures. The treatment has quickly become the most important and safest cancer treatment option during COVID-19, largely because it does not require an ICU (Intensive Care Unit) facility like surgery and does not supress the immune system like chemotherapy.

 

Ends

 

Notes to the editor

Global Coalition For Radiotherapy COVID-19 response website: (https://www.actionradiotherapy.org/global-coalition)

The site was launched on the 8th of April 2020. Action Radiotherapy are continuing to populate the page on a daily basis with the latest information.

 

The international tool provides opportunities for professionals taking responsibility for finding short and long term solutions for cancer patients during this Covid-19 emergency. It will achieve this by:

 

  • Leveraging all organisations work and experiences – a global Radiotherapy (RT) stakeholder coalition for all parties

  • Rapid collection and dissemination of data from international experience to be shared in one place

  • Learning from Global experience through sharing what is or is not working in various countries

  • Linking with industry to find technical solutions

  • Thinking at an advocacy and policy level for what is needed for RT in short, medium and long term

 

The Coalition initially comprises of the following groups, others are of course welcome to join:

  • Action Radiotherapy

  • Union for International Cancer Control (UICC)

  • International Atomic Energy Agency (IAEA)

  • The Radiation Therapy Advisory Group (RTAG)

  • The Independent Clinical Oncology Network (ICON)

  • European Coordination Committee of the Radiological Electromedical and Healthcare IT Industry (COCIR)

  • The American Association of Physicists in Medicine (AAPM)

  • Targeting Cancer

  • City Cancer Challenge

  • Breastcare International

  • The Civic Group

  • Gamma Gurus

  • AIIMS Rishikesh

  • Zhongnan Hospital of Wuhan University

  • National Cancer Centre Singapore

  • King's College London

  • Advamed

  • Varian

  • Elekta

  • Accuray

  • Viewray

  • GenesisCare

 

This piece first appeared in the Times Red Box of 16th April 2020. Click here to download the original article in.pdf

The response to the coronavirus is already having a severe impact on patients with a range of other health issues as operations are deferred and treatments reprioritised. And in particular for cancer patients, this impact will be an issue long after the imminent expected “peak virus” has passed.

Until a vaccine is generally available special measures will continue to be needed for cancer patients as their condition often reduces immunity and so increases the risk of coronavirus complications. The inescapable consequence of the recent NHS guidelines on cancer prioritisation is that some cancer patients who would have survived without the pandemic will be lost.

Despite the heroic efforts of all concerned, these disruptions to treatment pathways mean that this is perhaps the most worrying period in our lifetimes to be given a cancer diagnosis. It’s vital that the NHS reconfiguration of all cancer treatments, but particularly radiotherapy, is supported, well funded, and flexible and innovative enough to save as many lives as possible.

Radiotherapy is already one of the major weapons against cancer. One in four of us will need it at some point in our lives and it is already needed in four out of ten cancer cures. The number of people receiving radiotherapy is as high as the number receiving chemotherapy. It is delivered by a community of around 5,000 dedicated, highly trained professionals. They are already performing heroically in the face of the Covid-19 challenge.

But its role is about to become even more crucial as clinicians judge it to be most appropriate treatment option in even more cancer cases for two main reasons. First, surgery as a treatment option will become more difficult as surgical resource (and the associated intensive care resource) is redeployed to combat Covid-19. Second, clinicians are aware that chemotherapy tends to reduce immunity so will judge radiotherapy to be, on balance, the better and safer option for more patients.

In this most concerning of times, the need to take every possible step to unleash the full capability and capacity of the radiotherapy service, to play its part in making sure that as many cancer patients are saved as possible, has never been greater. And some of those steps are eminently achievable at pace. First, the radiotherapy professionals need to be a priority case for the supply of PPE. It is outrageous that some centres appear to have no PPE at all, and many others limited supplies of only partially effective items.

Secondly, the bureaucratic restriction that only half of the centres in England can offer the more advanced and faster radiotherapy techniques, even though their machines are capable of delivering it, needs to be swept aside. Thirdly, there is an urgent need to boost IT connectivity between and within radiotherapy centres to maximise treatment capacity, and fourthly, the government should harness the significant spare radiotherapy capacity that exists in the private sector.

These are eminently achievable steps that can, and should, be taken. Cancer patients, and not just those of today, but of the next many months deserve the very best we can do despite the unavoidable pressures of this pandemic.

Professor Pat Price is a visiting professor in surgery at Imperial College, London, and chairwoman of the charity Action Radiotherapy

 

Press release: Henry Smith supports global manufacturer of innovative cancer technologies in Crawley

Date : Immediate Release 13th March 2020

Contacts :

Peter Carroll 07866 800 755

Daniel Laing 07983 472 541

Henry Smith MP visited Varian Medical Systems today, Friday 13th March 2020, to see the world-leading cancer care technologies manufactured in Crawley. As a supporter of the Radiotherapy4Life campaign, Action Radiotherapy and an active member of the All-Party Parliamentary Group for Radiotherapy (APPG RT), Henry met with representatives and local constituents who contribute to these innovative cancer care technologies.

 

Henry said:

 

“I was proud to visit Varian Medical Systems who have been creating jobs and opportunities in Crawley for over 35 years. Having access to the most advanced radiotherapy treatments is vital for fighting cancer and a staggering 1 in 4 of us will need it at some point in our lives.”

 

“On my visit I was delighted to see the work of local manufacturers in Crawley contributing to innovative technologies driving new wins in cancer care. As a member of the APPG for Radiotherapy, I know the life-saving impacts of radiotherapy and was grateful for the chance to see these innovations being produced first hand”.

 

Adele Lyons, Head Sales and Service UK and Ireland for Varian Medical Systems, said:

 

“We are very pleased to welcome Henry Smith, Crawley MP, to our UK and Ireland headquarters. We are particularly excited to share with him the manufacture of our latest technology platform, Halcyon. At Varian, we are committed to supporting the UK economy for more than 35 years, as well as the APPG RT, to enable the right access to radiotherapy for all patients who need it, by focusing on innovation through a strong investment in R&D.”

 

With 250 employees in the UK and Ireland and 10,000 worldwide, Varian Medical Systems hold a shared vision of a world without fear of cancer. Providing important tools for fighting cancer used across private, NHS, and veterinary sectors, Varian has the stated aim of providing simpler, more efficient, and more effective technologies to power new victories in cancer care.

 

Varian provides comprehensive solutions for radiotherapy, radiosurgery, proton therapy, and brachytherapy, as well as software systems for planning treatments, managing cancer clinics, sharing knowledge, coordinating care, and using data to deliver evidence-based medicine. With an Intelligent Cancer Care approach, the company is harnessing advanced technologies like artificial intelligence, machine learning and data analytics to enhance cancer treatment and expand access to care.

Radiotherapy4life world cancer day event 4th february 2020

Yesterday, the Radiotherapy4Life campaign, in association with Action Radiotherapy and the All-Party Parliamentary Group for Radiotherapy (APPGRT), hosted an event for MPs and Peers in the House of Commons for World Cancer Day to raise awareness about the need for improved radiotherapy provision in the NHS. We were supported by the UK Radiotherapy Board (SOR, IPEM and RCR) as well as industry and individual professionals. We had a great turn out of MPs interested to hear about radiotherapy. We discussed our recent report, covered this week by the Daily Express, showing that 3.5 million people in England live further than the 45 minute recommended travel time to their nearest radiotherapy centre. Investment in infrastructure, workforce and IT is desperately needed - half of NHS Trusts have machines that need replacing and advanced treatments are being restricted. Following this, a signed letter was delivered to No 10 Downing Street. The next step is for MPs to visit their local radiotherapy department and learn what a fantastic job the professionals do. To see more, please visit the Radiotherapy4Life website or the Twitter page, and follow the hashtag #Radiotherapy4Life
 

petition and government response

On the 26th of November 2018 Action Radiotherapy lodged a petition on the Governments petition website.

The petition was titled "We want a world class radiotherapy service accessible for all cancer patients"

Action Radiotherapy want the best radiotherapy treatment for cancer as close to home as possible. 1 in 2 of us will at some point develop cancer, meaning 1 in 4 of us need radiotherapy at some point in our lifetime. More investment is critical; despite the need, radiotherapy only receives 5% of the UK cancer budget.

The petition asked for an increase the NHS Cancer budget dedicated to radiotherapy from 5% to 6.5%, and a one-off £250 million investment to modernise existing machines and build satellite radiotherapy centres to ensure accessible service nationwide. UK cancer survival rates are well below European average.

 

If the UK achieved best European levels, 10k more patients would survive per year. Radiotherapy has a huge part to play in giving the people of the UK the cancer treatment service they deserve.

Reaction

The petition achieved 10,610 signatures within the 3 month window prompting a response from The Government.

Response

The response from The Government can be read HERE

Launch of APPGRT

On the 22nd of May 2018, in Westminster Tim Farron MP launched the APPG (All Party Parliamentary Group) on Radiotherapy with cross party support with an aim to develop a new patient manifesto for radiotherapy treatment in the UK. Action Radiotherapy was confirmed as the secretariat. With adequate resources we have the capability of providing a world leading high quality cost effective nationally consistent innovative radiotherapy service. 

Parliamentary Reception: Radiotherapy

On Tuesday, November 14, Tim Farron MP in partnership with AdvaMed, the United States Trade Association for Advanced Medical Technologies, held a briefing to shine a light on radiotherapy and the benefits that it can bring to patients and in improving cancer outcomes. The event took place in the Strangers’ Dining Room, House of Commons, and featured Steve Brine, Parliamentary Under Secretary of State for Health, the lead Minister for cancer services.

In addition to Mr. Brine, the event brought together stakeholders from the local and national NHS, patient and professional groups, MPs and Peers to consider the benefits of radiotherapy and next steps across the UK. Participants recognised the welcome progress made to improve the provision of radiotherapy in the UK, raised awareness of the benefits of radiotherapy and considered how we can ensure equal access for all patients to the latest techniques.

Action Radiotherapy worked with Map Medtech in highlighting the parliamentary event to patients and professionals in the UK. Map Medtech confirmed that in large part to us, we have been successful in generating a large interest by both patients and professionals, enabling the event to be fully registered.

Action Radiotherapy was well represented at the event with attendance by Professor Pat Price, Chairman, Judith Potts, Trustee, Dr Christy Goldsmith, Trustee and Peter Zarko-Flynn, Trustee. We were also pleased to attain a new friend of Action Radiotherapy at the event, Rachel Bland, who presented her patient experience at the event with a round of applause from the audience.

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