Professor Manjit Dosanjh is a member of the Lancet Oncology Commission on Radiotherapy and Theranostics; here she comments on how physics has a key role to play in tackling the disparity in access to essential radiotherapy treatment and how advances will transform treatment in the future.
Without physics, many aspects of modern life that we take for granted from transport and telecommunications to construction, simply wouldn’t be possible. But a particularly vital contribution of physics is to healthcare, specifically in developing tools and technologies for cancer treatment. Radiotherapy, a cornerstone of cancer care, relies heavily on advances in physics – but not just for the underpinning science. Physics also has a role to play in increasing access to this life-saving treatment.
Access to radiotherapy is far from universal and in a paper published today in The Lancet Oncology, we have observed significant disparities in radiotherapy access that result from insufficient equipment, infrastructure, and expertise across the Baltic countries, eastern Europe, central Asia and the Caucasus. Our work has observed a similar picture across Sub-Saharan Africa: ‘Tackling the radiotherapy shortage in Sub-Saharan Africa by gathering data from lower-middle-income and high-income countries’ facilities for designing a future robust radiotherapy facility’.
Both papers are part of an Access to Radiotherapy Technologies (ART) study and crucially, we are looking at what we can do to address these challenges. We have been looking at how data from different economic contexts can help find strategies to solve this shortage. By using examples from both high-income and lower-middle-income countries, the research identifies scalable and practical solutions that can be adapted to the specific needs of resource-limited regions. The work demonstrates how physics, combined with data science, can create impactful solutions, particularly in places where access to advanced healthcare is limited.
By applying cutting-edge physics-based innovations such as the development of cost-effective linear accelerators or more efficient treatment protocols, it is possible to improve access to cancer care globally. As researchers at Oxford’s John Adams Institute for Accelerator Science (JAI), we are currently studying patterns in faults in radiotherapy linear accelerators and looking at how machine learning and AI can be deployed for early fault prediction; this would limit or even prevent machine downtime and result in more treatment for more people. We are also investigating an alternative, more robust multi-leaf collimator design to still deliver conformal dose distributions while again, still minimising the likelihood of faults. Interestingly, our advanced accelerator technology research that feeds into experiments at CERN is also being used to develop a novel robust and reliable radiotherapy machine.
Looking to the future, innovations in radiotherapy treatment will improve patient outcomes through advanced treatment planning and delivery technologies. Alongside numerous collaborators, we have been heavily involved in such innovations. One of these is the so-called FLASH effect: a new horizon which could utilise ultra-high dose rates to improve patient outcomes and reduce treatment times. JAI researchers have contributed to studies on scattering systems for high intensity beam delivery, as well as silica fibre detectors for rapidly and accurately determining the received dose.
For Oxford’s Department of Physics, these studies are a reminder that the applications of physics are not confined to laboratories or theoretical work. Real-world healthcare challenges demand interdisciplinary collaborations where physics plays a central role in creating life-saving technologies. Through innovative research and global partnerships, we can ensure that cancer treatment technologies, powered by physics, are made accessible to all.
Access to diagnostic imaging and radiotherapy technologies for patients with cancer in the Baltic countries, eastern Europe, central Asia, and the Caucasus: a comprehensive analysis, Dosanjh et al, The Lancet Oncology