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Advances in radiotherapy at N&N

PUBLISHED: 06:17 25 February 2009 | UPDATED: 22:35 05 July 2010

More cancer patients in Norfolk are set to benefit from the latest advances in radiotherapy.

The Norfolk and Norwich University Hospital was one of the first places in the country to use intensity-modulated radiotherapy, or IMRT, which uses computers to give a specific dose of radiation more targeted at the exact size and shape of the tumour than conventional radiotherapy.

More cancer patients in Norfolk are set to benefit from the latest advances in radiotherapy.

The Norfolk and Norwich University Hospital was one of the first places in the country to use intensity-modulated radiotherapy, or IMRT, which uses computers to give a specific dose of radiation more targeted at the exact size and shape of the tumour than conventional radiotherapy.

The highly-advanced treatment means there are fewer side-effects and could ultimately increase survival rates. At the moment it is used for some head and neck cancer patients - about 30 a year - but later this year it will be expanded to some men with prostate cancer, expected to be 50 to 100 people a year. In future there are plans to expand it to gynaecological cancers such as cervical cancer. But not all patients will benefit any more than from conventional radiotherapy, and because it is more labour-intensive, some hospitals do not use it at all. It is thought it could be beneficial for about a third of people who have radiotherapy.

The side-effects of radiation for head and neck cancers include difficulty swallowing and a dry mouth, which can be long-term if the salivary glands are damaged. In prostate cancer, side-effects can be damage to the bowels, causing incontinence, and rectal bleeding. The more precise targeting used in IMRT means that side-effects are reduced. In future this could mean that a higher dose can be given, resulting in better survival rates.

The N&N has four of the linear accelerators used to give radio-therapy, each costing £1.5m and paid for through a PFI deal. All can be used for IMRT or conventional radiotherapy. The N&N was the first place in the country and the second in the world to use portal dosimetry, a way of checking in advance that the right dose is being given.

Consultant oncologist Tom Roques said: “It is to cure more patients and reduce side-effects. At the end of the day it is about being able to say we have given patients the best treatment they can possibly get. If it was a member of your family you would want them to be treated in that way in your centre.

“Even though we are not the largest centre in the world, we see no reason why patients shouldn't get state-of-the-art radiotherapy for whatever cancer they have got. I think we can provide that.”

Jenny Tomes, head of radiotherapy, said: “We have always worked innovatively and we have got a very keen workforce. This is moving forward to reduce side-effects - and with radiation, side-effects are a big issue to the patient.”

Richard Gundry, 59, from Gillingham, near Beccles, was treated with IMRT for neck cancer. He had radiotherapy for six weeks in March 2008 following chemotherapy for a tumour the size of a ping-pong ball. The company director is doing well and has been told that all traces of the cancer have gone. He said: “After about the fourth week my throat was quite sore, but I had drugs prescribed and it was manageable.

“Everyone was incredibly helpful and the radiographers were really good. All I can do is speak highly of the level of service.”

Dr Roques and his team are planning to publish the results of their research in a scientific journal later this year, and he is in Barcelona this week to talk about the work that has been done at the N&N.

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