NHS rolls out 'multi-beam' precision radiotherapy for prostate cancer

Thousands of men with prostate cancer in England are to be offered a high-powered, precision form of radiotherapy that can be completed in just five sessions, NHS England announced on 10 June. The treatment, known as stereotactic ablative radiotherapy or SABR, targets tumours with pinpoint accuracy from many different directions, sparing more of the surrounding healthy tissue.

NHS chiefs said the approach would spare eligible men around 15 courses of treatment compared with conventional radiotherapy, which typically requires at least 20 separate doses spread over several weeks. SABR can instead be delivered in five doses within a fortnight, cutting the number of hospital visits and the disruption to patients' lives.

Around 17,500 men are diagnosed with low or intermediate risk prostate cancer in England each year, and the NHS expects roughly 3,500 of them to choose SABR. The rollout has been supported by a £70 million government investment in new linear accelerator machines, and the treatment is being made available at radiotherapy centres across the country.

How the treatment works

SABR delivers a higher dose of radiation to the tumour than conventional treatment but does so with far greater precision, using beams from multiple angles that converge on the cancer. By concentrating the dose on the target and limiting exposure to nearby organs, clinicians hope to reduce the risk of certain side effects associated with longer courses of radiotherapy.

Because the technique is so precise, it can be effective at far fewer doses than older methods. For suitable patients that means a course completed in days rather than weeks, with fewer trips to hospital and less time away from work and family.

“This technology lets us focus a powerful and precise beam of radiotherapy directly onto the cancer, limiting the damage to healthy cells.”

— Professor Peter Johnson, NHS National Clinical Director for Cancer

Who will be eligible

The treatment is aimed at men with low or intermediate risk localised prostate cancer, meaning the disease has not spread beyond the prostate. SABR is not suitable for everyone, and decisions about treatment will be made by clinical teams in discussion with each patient, weighing the benefits against individual circumstances.

• Around 17,500 men diagnosed with low or intermediate risk prostate cancer each year in England
• Approximately 3,500 expected to opt for SABR annually
• Five sessions over roughly two weeks, against at least 20 with conventional radiotherapy
• Backed by £70 million of government investment in new machines

Reaction

Senior NHS figures welcomed the rollout as a significant advance in convenience and effectiveness for men facing one of the most common cancers in the country.

“This cutting-edge approach will transform treatment for thousands of men with prostate cancer, helping the NHS provide far more powerful and convenient care to stop their cancer spreading.”

— Sir Jim Mackey, NHS Chief Executive

Background

Prostate cancer is the most common cancer in men in the UK. Radiotherapy has long been a mainstay of treatment for localised disease, but the standard approach has required patients to attend hospital repeatedly over several weeks, a burden that can be especially difficult for older men or those who live far from a treatment centre. Advances in imaging and machine technology have made it possible to deliver higher, more accurately targeted doses safely, opening the door to much shorter courses.

The investment in new linear accelerators is part of a wider effort to modernise the NHS cancer estate, much of which relies on ageing equipment. Charities have long argued that the UK has lagged behind comparable countries in radiotherapy capacity, and that replacing out-of-date machines is essential if the NHS is to offer the most advanced techniques to all patients who could benefit.

Shortening treatment courses also has benefits for the wider system. Each course of conventional radiotherapy ties up a machine and a clinical team for many appointments, so delivering effective treatment in fewer sessions can help departments treat more patients overall and reduce waiting times for radiotherapy.

The NHS expects SABR for localised prostate cancer to become available across radiotherapy providers in England, with the first centres beginning to treat patients within days of the announcement. Officials say the longer-term aim is for the technique to become a standard option for suitable men, freeing up appointment slots and improving the patient experience.