April 2026 • PharmaTimes Magazine • 32-34
// CANCER //
Radiotherapy’s capacity is holding cancer care back – a modernised approach must be embraced
Cancer services in the UK stand at a turning point. Over the past decade the NHS has made meaningful progress in improving diagnostic pathways and identifying cancer earlier.
I began my career as a diagnostic radiographer. Like many clinicians working in imaging, I spent years focused on the importance of early detection.
For a long time, I believed that the biggest challenge was diagnosis. If we could simply detect cancers earlier, the rest of the system would be able to respond.
Over time I realised that is not the case.
Earlier diagnosis is an essential part of the cancer pathway, but it is not enough on its own. Patients must be able to move quickly from diagnosis into treatment.
Across the UK, too many people with cancer still wait too long to begin care. That gap between diagnosis and treatment is becoming one of the most pressing challenges facing our health system.
Radiotherapy and the treatment gaps
Recent discussions around the National Cancer Plan have rightly focused on earlier diagnosis.
But early intervention does not stop at identifying cancer sooner, it depends on patients being able to access timely, high-quality treatment without delay.
Radiotherapy is central to that effort. It has one of the highest curative contributions in cancer care and is highly targeted, delivering treatment directly to the tumour site.
Around 60% of patients who have radiotherapy do so with curative intent, often alongside surgery and chemotherapy. This means improvements in access to radiotherapy could significantly increase cancer cure rates in the UK.
However, radiotherapy only achieves its full benefit when patients can attend treatment consistently. Courses of treatment are typically delivered daily over several weeks, which means access and geography matter enormously.
Across the UK there are significant regional disparities in the availability of radiotherapy services. Something as simple as where patients live can directly affect how easily and how quickly they receive treatment.
Long travel times, disruption to work and family life and the practical challenge of repeated hospital visits all shape patient experience and potentially clinical outcomes.
If we are serious about proactive early intervention, diagnostic ambition must be matched with treatment capacity. Expanding modern radiotherapy infrastructure, particularly closer to communities, is a critical part of that challenge.
Workforce challenges
Radiotherapy is one of the most effective tools we have to treat cancer. More than half of all cancer patients will need it at some point during their care.
Yet in the UK, only around 35% of patients who could benefit from radiotherapy currently receive it.
Recent Government investment, such as funding for new LINACs, is an important and welcome step. But machines alone will not close this gap.
The challenge is fundamentally about people.
Across the country, oncology services face intense workforce pressures, particularly among therapeutic radiographers, medical physicists and specialist clinicians. These professionals are essential to delivering safe and effective radiotherapy. Without them even the most advanced equipment cannot be fully utilised.
At the same time, demand is growing rapidly. As diagnostics improve and more cancers are identified earlier, more patients require timely access to treatment.
The NHS has made real progress on diagnostics, yet the 62-day referral to treatment standard continues to lag behind.
Earlier diagnosis is a positive step, but it inevitably increases pressure on treatment services.
Radiotherapy is usually delivered in tightly scheduled courses with little room for delay. When patients cannot access treatment quickly and consistently, whether due to staffing shortages or capacity constraints, outcomes suffer.
Conversations with patients and families make these pressures clear. Many describe the anxiety of waiting to begin treatment or the practical challenges of travelling long distances for radiotherapy several times a week.
These conversations are a powerful reminder that improving treatment capacity is not simply a policy issue. It directly shapes how patients experience some of the most difficult weeks of their lives.
Addressing these pressures requires new thinking about how services are organised, how professionals are supported and trained and how capacity is shared across the system.
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Radiotherapy uses high-energy radiation to destroy cancer cells. It works by damaging the DNA inside tumour cells so they can no longer grow or divide, while healthy cells are better able to repair themselves
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Around half of all cancer patients will receive radiotherapy during their treatment. It is used across many cancer types, including breast, prostate, lung, head and neck, and brain cancers
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Radiotherapy contributes to around 40% of cancer cures. Although surgery and chemotherapy are widely recognised, radiotherapy remains one of the most effective curative treatments available
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There are two main forms of radiotherapy: external beam radiotherapy, delivered from outside the body using a machine such as a linear accelerator; and brachytherapy, where a radiation source is placed inside or next to the tumour
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Modern radiotherapy is highly precise. Techniques such as intensity-modulated radiotherapy and stereotactic radiosurgery allow clinicians to shape radiation beams to the tumour, reducing exposure to surrounding healthy tissue
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Treatment is usually delivered over several sessions, known as fractions. This phased approach helps protect normal cells while maintaining continuous pressure on cancer cells
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Radiotherapy is often combined with other treatments. It may be used before surgery to shrink tumours, after surgery to reduce the risk of recurrence or alongside chemotherapy to increase effectiveness
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Side effects vary depending on the part of the body being treated. Advances in imaging, planning and delivery have significantly reduced long-term complications for many patients
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Access to radiotherapy is uneven across the UK. Geography, workforce shortages and ageing equipment can affect how quickly patients begin treatment, contributing to regional disparities in outcomes
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Investment in modern technology, training and new treatment centres is helping expand capacity. As earlier diagnosis improves and cancer incidence rises, radiotherapy will play an increasingly central role in delivering timely, effective care for patients across the country.
Role of partnerships
One part of the solution may lie in how we think about collaboration across the healthcare system.
Public–private collaborations can play a constructive role in strengthening radiotherapy services in the UK. By combining private investment, modern infrastructure and specialist expertise with the clinical leadership of NHS teams, these partnerships can help expand treatment capacity and improve patient access.
In practice, this can take different forms depending on the needs of each local system. It may involve modernising existing radiotherapy units, developing satellite centres that bring treatment closer to patients or supporting the upgrade of LINACs and planning technology.
The UK does not need to start from scratch in designing these collaborations. International experience offers useful examples of what this can achieve.
In Troyes, France, a partnership between Amethyst and the local hospital revitalised an underperforming radiotherapy centre.
Within a year, investment in new linear accelerators, imaging systems and AI-driven contouring software helped reduce waiting times for treatment after multidisciplinary team decision from four to five weeks to just 10–15 days.
In Portugal, a satellite centre model supports public hospitals by transferring patients based on case complexity and local capacity. By bringing radiotherapy services closer to regional populations, this approach has helped public providers meet growing demand while maintaining consistent clinical standards.
Similar partnerships in Poland, France and Italy have enabled significant capital investment in modern equipment and facilities while expanding treatment capacity.
Germany offers another example of how care can be delivered closer to where patients live. Large university hospitals typically manage the most complex cancer cases, but they are supported by a wide network of smaller radiotherapy centres connected to community hospitals.
Many of these centres are independently run while being based on public hospital sites. This model allows patients to receive treatment closer to home while maintaining strong clinical links with major specialist centres.
The lesson is clear: when investment, workforce planning and clinical teams work together, services can expand more quickly without compromising quality.
Supporting NHS capacity
In the UK, partnership models are already supporting NHS cancer services.
As part of Stingray Healthcare Group, Amethyst already works alongside NHS teams at Queen Square Radiosurgery Centre in partnership with UCLH NHS Foundation Trust, and at Thornbury Radiosurgery Centre with Sheffield Teaching Hospitals NHS Foundation Trust.
Since 2020, the number of patients treated at these centres has grown by 84%, including a 70% increase in NHS patients.
These examples demonstrate what collaboration can achieve when the goal is clear: expanding access to high-quality cancer care.
They also align with wider ambitions set out in the Government’s National Cancer Plan and 10-Year Health Plan. Both emphasise improving productivity, meeting the cancer waiting times targets and tackling inequalities in access to treatment.
Radiotherapy sits at the intersection of all these priorities.
Path to better outcomes
If earlier diagnosis is to translate into better patient outcomes, treatment capacity must keep pace.
Expanding modern radiotherapy services, investing in the specialist workforce and supporting collaborative models that increase capacity will all be essential.
Partnerships that combine NHS clinical leadership with external investment and expertise can help relieve pressure on overstretched teams while maintaining the standards of governance and accountability that patients rightly expect.
Cancer care in the UK has never been stronger in terms of expertise, commitment and innovation. But progress in diagnosis must now be matched by progress in treatment access.
Radiotherapy already saves lives across the NHS every day. With the right investment, workforce support and collaboration, it has the potential to save many more.
Sasha Burns is CEO at Amethyst Radiotherapy UK