One in three people develop cancer some time in their lives. Treatment - surgery, radiotherapy, and chemotherapy - cures between a third and a half of them. Most of the restneed some form of palliative care, commonly entailing radiotherapy or chemotherapy. Whenfaced with the unsettling reports of overdosage of radiation in Exeter1 and underdosage in North Staffordshire2 and the severe late complications of radiotherapy alleged by Radiotherapy Action Group Exposure (RAGE, p 188)3 the public isjustifiably alarmed. Moreover, doctors who have made errors in administering chemotherapy have faced charges of criminal negligence.4 Howcanthese problems be avoided or detected before many patients have been affected?

The royal colleges are responsible for ensuring the highest standards of clinical practice, and for the past two years the Faculty of Clinical Oncology of the Royal College of Radiotherapists has been addressing this issue. The proposed solutions include a programme of quality assurance in radiotherapy for all clinical oncology departments based on the experience of two pilot sites in Bristol and Manchester.5 Among the other proposals …