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Childhood cancer and proton beam therapy

BMJ 2014; 349 doi: (Published 16 September 2014) Cite this as: BMJ 2014;349:g5654
  1. Adam Glaser, consultant in paediatric oncology and the late effects of cancer1, honorary clinical associate professor2,
  2. James Nicholson, consultant paediatric oncologist3, chairman, children’s cancer and leukaemia group4,
  3. Roger Taylor, professor of clinical oncology5,
  4. David Walker, professor in paediatric oncology6
  1. 1Leeds Teaching Hospitals NHS Trust
  2. 2Leeds Institute of Cancer and Pathology, University of Leeds
  3. 3Cambridge University Hospitals NHS Foundation Trust
  4. 4Department of Paediatric Oncology and Haematology, Addenbrooke’s Hospital, Cambridge
  5. 5Swansea University and South West Wales Cancer Centre, Singleton Hospital, Swansea
  6. 6Children’s Brain Tumour Research Centre (, University of Nottingham, Queen’s Medical Centre Campus, Nottingham University Hospitals NHS Trust
  1. Correspondence to: A Glaser adam.glaser{at}

Promising new treatments need a strong evidence base

Survival of UK children with cancer is showing sustained improvement, with the proportion of under 15s living five years after diagnosis now at 82%.1 With more young people facing the prospect of long term cure, focus has moved from “cure at all cost” to “the cost of cure.” This is particularly important in brain tumours, as they account for nearly a quarter of all cancers in this age group. Although cure rates have improved, these cancers are the commonest cause of deaths from cancer in children, and 60% of survivors are moderately or severely disabled.2 Novel therapeutic strategies are being introduced in the hope of increasing survival rates while maximising the quality of resultant long term survival. Proton beam therapy, the focus of much recent discussion, is one such strategy.

The case of Ashya King has highlighted the immense pressure that develops for children, their parents, and their treating teams when dealing with the complex clinical management of brain tumours.3 Working closely and effectively with parents in the best interests of the ill child is an overwhelming priority for clinical teams. When communication breaks down, the consequences can be profound, as noted by the medical director of Southampton General Hospital.4 This underlines the importance …

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