In September 2023, I had the opportunity to attend an Open Day at St Luke’s Cancer centre (within the Royal Surrey County Hospital, Guildford, Surrey). The focus was a tour of the radiotherapy department which, alongside a satellite centre at East Surrey Hospital, covers a population of 1.2 – 1.4 million, with over 3000 new referrals each year. On average 200-250 patients are receiving radiotherapy at any one time.
The tour began with the Kingfisher machine which costs over £4 million and has AI (Artificial Intelligence) technology. Royal Surrey County Hospital is first hospital in the UK to have this type of AI machine. On walking through the corridor to view the machine, I was struck by the calming photos of the local landscape surrounding Guildford. I expected a very clinical experience with plain white walls. Once in the room there are calming images on screens in the ceiling for patients to watch, they can choose between floating jellyfish, star lit sky or flowers, to name a few options. Patients can also listen to podcasts or music during their treatment.
The Kingfisher machine is more like a CT scanner where the patient travels through the hole in the middle to receive treatment. Treatment is much quicker than using other machines but set up takes longer because of the ability to adapt the treatment beam depending on size etc of the tumour, thus reducing exposure to surrounding tissue to minimise the risk of side effects.
It was evident that the radiotherapy staff have a wealth of knowledge and enthusiasm for this state-of-the-art machine which they operate. It was explained that there’s lots of communication with the patient before they arrive for treatment, during and after, ensuring the patient is as relaxed as possible and fully understands the procedure.
The treatment itself is pain free, like having an x-ray, but the patient would expect some side effects, such as fatigue, as the body works to repair the damaged cells.
Moving on, we were shown the Goldcrest machine which is used for superficial treatment like skin cancers. This was a much less visually impressive machine but with the cone shaped attachments, also very specialised.
I was surprised at the extent of the technology we saw in the next room. Desks topped with computer screens which is where the doctors, medical physicists (who provide radiation dose information) and radiology staff look at each slice of a CT scan and overlay the images to ensure the tumour is targeted and minimal damage is done to nearby organs. Much of this work is done by hand which explains why there’s a delay between having a planning scan and receiving the first treatment. As you would expect, everything is checked by a minimum of two staff members and often the teams are much bigger, to ensure the patient’s treatment plan will be programmed as per the Doctor’s instructions.
The CT scanner is usually where the treatment pathway begins. The patient needs to keep as still as possible during treatment to reduce the side effects. Preparation and/or immobilisation is done to help with this. Tiny tattoos are used to line up for treatment that’s below the head and neck. Above the shoulders, a head mould is used which looks a bit scary, but is necessary to ensure the treatment is targeted and to minimise/prevent patient movement during the procedure.
In the mould room the procedure for producing the head mould was explained, as it would be for a patient to alleviate unnecessary stress. Moulds are also made for other parts of the body too, like hands.
As in many cases the anticipation is often worse than the procedure - I feel that the Radiotherapy department is very aware of this and explains everything. A cancer diagnosis is a very scary time for anyone and a patient can feel out of control, so knowing what to expect can help to reduce this anxiety a little.
As you can imagine, with all this incredible science fiction looking equipment, there needs to be a team of engineers on hand to check the machines are all calibrated correctly and to rectify any faults that should occur. One engineer said there could be over 5000 faults that could crop up, so the knowledge that these people have is immense. This is an aspect I hadn’t even thought about. There’s so much that goes on behind the scenes which makes the open day really important because it allows the public into areas they’d not usually get access to and to speak with highly skilled staff members who are an integral part of the functioning of the department.
The final department of the tour took us to Brachytherapy. There are only four Brachytherapy centres in the entire UK and the one in Guildford is the only one in the South so patients attend from all over including Wales, the Isle of Wight and Jersey for treatment. We are so fortunate to have these amazing facilities on our doorstep. Brachytherapy is the insertion of radioactive implants into a tumour. Obviously, this area of treatment has strict access and usage protocols so we couldn’t see the theatres and the radioactive source is very securely housed, but we saw some of the machines used and questioned the radiographer.
If, in the future, I was to require the services of the radiotherapy department, I feel confident that I’ll have access to the best technology available to deliver treatment, and I’ll receive care and compassion from all the wonderful staff.
The open day was a valuable insight into the pathway that a cancer patient has to travel. As a volunteer therapist at the Fountain Centre, I now feel I have the knowledge to reassure patients and better understand their experiences and concerns. I also offer Oncology massage at Tranquil Tea House Therapies, so this knowledge and understanding will benefit those clients too.
More information can be found here
https://www.royalsurrey.nhs.uk/radiotherapy-