Insight

Richard Sullivan reflects on major issues cancer care faces in radiotherapy

Richard Sullivan/LinkedIn

Jan 20, 2025, 14:03

Richard Sullivan reflects on major issues cancer care faces in radiotherapy

Richard Sullivan, Director of the Institute of Cancer Policy, shared a post on LinkedIn:

“Radiotherapy is one of the core modalities for cure and palliation in cancer care with a proven return on investment. But a new study led by Fabio Moraes at Queen’s University and colleagues found that to meet global radiotherapy demands up to 2045 between 16,000 and 20,000 new LINACs will be needed.

‘Global linear accelerator requirements and personalised country recommendations: a cross-sectional, population-based study’

Authors: Fabio Moraes et al.

Whilst the investment per country for upper middle and above will be within reach of domestic budgets, for most countries below this group, especially those with significant debt and liquidity issues, the capital and recurrent costs will be unaffordable.

The 2015 Lancet Oncology Commission on Radiotherapy estimated that scale up radiotherapy costs just to 2035 would require up to US$14·1 billion for low-income countries, and US$33·3 billion for lower middle-income countries. And this is a conservative estimate. It does not consider advances in technology, nor the expansion in workforce that will be required, irrespective of whether more radiotherapy planning can be augmented using artificial intelligence.

The radiotherapy community has some of the best comparative intelligence on the scale of the global challenges, but sustainable economic solutions (domestic and external) continue to allude. Part of the problem, and this is a truism not just for radiotherapy, is that the focus is technological innovation rather than national implementation and scale-up.

‘Balancing Equity and Advancement: The Role of Health Technology Assessment in Radiotherapy Resource Allocation”

Authors: D. Rodin et al.

Richard Sullivan reflects on major issues cancer care faces in radiotherapy

We know from previous King’s-Queens studies of Brazil that national radiotherapy plans become severely delayed, have huge cost overruns and capacity is maldistributed.

‘Challenges in building radiotherapy capacity: A longitudinal study evaluating eight years of the Brazilian radiotherapy expansion plan’

Authors: Andre Gouveia et al.

Richard Sullivan reflects on major issues cancer care faces in radiotherapy

Add to this the considerable barriers to building a capable workforce and the inevitable conclusion is that a lot more effort needs to go towards implementation and operational science to support domestic and donor planning.”

‘Strengthening Capacity in Radiotherapy Skills to Deliver High-Quality Treatments in Low- and Middle-Income Countries: A Qualitative Study’

Authors: Thea Hope-Johnson et al.

Richard Sullivan reflects on major issues cancer care faces in radiotherapy