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Feature Radiotherapy

How NHS investment in proton beam therapy is coming to fruition

BMJ 2019; 364 doi: (Published 11 February 2019) Cite this as: BMJ 2019;364:l313
  1. Matthew Limb, freelance journalist, London, UK
  1. limb{at}

As the first national centres start to provide this developing radiotherapy technology in the UK, Matthew Limb reports on the hopes and expectations of doctors, policy makers, and patients

Advocates view this winter’s opening of the NHS’s first high energy proton beam therapy unit, at the Christie NHS Foundation Trust in Manchester, as a landmark for the National Health Service. “It is a confirmation that radiation oncology is absolutely a key part of modern cancer treatment,” says Adrian Crellin, NHS England clinical lead for proton beam therapy.

Stuart Green, director of medical physics at University Hospitals Birmingham NHS Foundation Trust, also sees a “milestone for our NHS radiotherapy community” being reached. When the NHS’s second planned proton beam unit opens at University College Hospital (UCH), London, in 2020, he says, “Whatever we can do with protons we’ll be doing as well as anyone can possibly do in the UK.”

What is proton beam therapy?

Proton beam therapy is an advanced form of radiotherapy. It uses a high energy beam of protons, rather than the high energy x rays in conventional or standard radiotherapy.

A particle accelerator (cyclotron) is used to speed up the protons. Protons are aimed at the tumour using a gantry that rotates through 360°. The beam of protons stops once it “hits” the cancer cells, rather than carrying on through the body so there is little or no dose to surrounding tissues.

Proton therapy for rare eye tumours has been available on the NHS at the Clatterbridge Cancer Centre on the Wirral since 1989. But for other cancers, patients requiring high energy proton beam therapy have had to go abroad for treatment. Since 2008, some 1400 patients have been referred to hospitals in the US and Europe under an NHS overseas treatment programme that funds treatment, transport, and accommodation.

When fully up …

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