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Training and role expansion for the Radiotherapy workforce
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This project is based around the Radiotherapy workforce and online Adaptive Radiotherapy (oART). It aims to make oART available to more patients in more departments by expanding training and job roles for staff.
In Radiotherapy we now have a new generation of treatment machines to further personalise a patient's radiotherapy treatment at each treatment session with a process known as online Adaptive Radiotherapy (oART). Online Adaptive Radiotherapy requires a new scan at each radiotherapy session and if the patient's anatomy has changed since the previous sessions, we can update the treatment whilst the patient is on the couch. This is now possible with the help of artificial intelligence (AI). The benefits of personalising radiotherapy treatment are more precise treatments with better disease control and fewer side effects.
In the UK, the people who usually design patient specific radiotherapy treatments are often known as Dosimetrists and hold specialist radiotherapy treatment planning knowledge. The people who usually deliver radiotherapy treatments are known as Therapeutic Radiographers. Often Dosimetrists do not deliver treatment on the radiotherapy machines and treatment Therapeutic Radiographers feel they do not have enough treatment planning knowledge to design the patient treatments or understand what the AI is doing.
We would like to propose a study to develop a training plan to expand the roles of Therapeutic Radiographers and Dosimetrists so that Therapeutic Radiographers undertake more planning training and Dosimetrists can deliver more treatments, therefore increasing the number of staff who can plan and deliver oART.
How can you get involved?
Based on your experiences of radiotherapy (as a patient or a carer) do you have any thoughts or ideas to share (below) that could inform or support this project?
- What are your thoughts about AI automating adaptive radiotherapy?
- How do you feel about role expansions for Therapeutic Radiographers and Dosimetrists?
This project is based around the Radiotherapy workforce and online Adaptive Radiotherapy (oART). It aims to make oART available to more patients in more departments by expanding training and job roles for staff.
In Radiotherapy we now have a new generation of treatment machines to further personalise a patient's radiotherapy treatment at each treatment session with a process known as online Adaptive Radiotherapy (oART). Online Adaptive Radiotherapy requires a new scan at each radiotherapy session and if the patient's anatomy has changed since the previous sessions, we can update the treatment whilst the patient is on the couch. This is now possible with the help of artificial intelligence (AI). The benefits of personalising radiotherapy treatment are more precise treatments with better disease control and fewer side effects.
In the UK, the people who usually design patient specific radiotherapy treatments are often known as Dosimetrists and hold specialist radiotherapy treatment planning knowledge. The people who usually deliver radiotherapy treatments are known as Therapeutic Radiographers. Often Dosimetrists do not deliver treatment on the radiotherapy machines and treatment Therapeutic Radiographers feel they do not have enough treatment planning knowledge to design the patient treatments or understand what the AI is doing.
We would like to propose a study to develop a training plan to expand the roles of Therapeutic Radiographers and Dosimetrists so that Therapeutic Radiographers undertake more planning training and Dosimetrists can deliver more treatments, therefore increasing the number of staff who can plan and deliver oART.
How can you get involved?
Based on your experiences of radiotherapy (as a patient or a carer) do you have any thoughts or ideas to share (below) that could inform or support this project?
- What are your thoughts about AI automating adaptive radiotherapy?
- How do you feel about role expansions for Therapeutic Radiographers and Dosimetrists?
Based on your experiences of radiotherapy (as a patient or a carer) do you have any thoughts or ideas to share that could inform or support this project?
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I do think that the proposal potentially will be very beneficial for patients. As a patient who underwent a course of radiation treatment post breast cancer surgery I felt that the staff involved knew their role and gave me confidence whilst in their care. Therefore if the proposal becomes future treatment policy it Will be important that all levels of staff involved in delivery should feel appropriately confident to carry out their roles and they should be actively engaged in the development of their learning and development programme. Supporting staff through this process will , I feel , ensure their full engagement with the future enhanced role changes.
Cusa
6 days ago
Thank you for your comments, they are extremely useful understanding what is important to patients.
CS24
3 months ago
I have had radiotherapy twice, both for breast cancer. If cross training and using AI will increase the number of people treated, tailor the treatment for each patient and help staff expand their knowledge, that can only be a good thing for all concerned
Jeanette
3 months ago
I received two weeks of radiotherapy for a BCC on my nose. I was surprised at how tired I felt. I was not sure whether it was due to the treatment or the journey to get there everyday. I did work throughout. I was unprepared for the skin reaction which was alarming and painful and took some time to heal.
If AI automating adaptive radiotherapy can assist with the reduction of side effects and personalise treatments for patients I feel that this is a development that will benefit the patient. However, the introduction of the AI model must be rigorously tested and conform to quality assurance.
The expansion of the roles of staff is an excellent move forward as it increases the number of patients able to access radiotherapy quickly. It will also help the recruitment and retention of staff as it gives a clear pathway of development.
Shona56
3 months ago
Thank you all for sharing your experiences so far. Your comments are extremely valuable and much appreciated in this project proposal.
CS24
3 months ago
I have had two courses of RT over the past 6 years. I found the process relatively straightforward and easy to comply with (the radiography team were very helpful and supportive), although following treatment there was a period of tiredness. AI is being increasingly used in all walks of life as a productivity aid, including for clinical purposes, so it would be logical to do so in automating adaptive radiotherapy. However, AI Machine Learning needs to be rigorously validated before 'Machine Reasoning' can be trusted. The validation bar needs to be set higher for medical purposes such as this, in comparison with other commercial or industrial use-cases (e.g financial, voice/face recognition etc). The proposed role expansions for Therapeutic Radiographers and Dosimetrists sounds like a good idea, at least from a layman's perspective. It could improve productivity and enhance job satisfaction for the staff.
Gerry
3 months ago
Anything that helps to reduce the time and dose can only be good. I had 28 sessions over 6 weeks for my bowel cancer and a couple of years later had 3 sessions of SABR for a liver met. Both very very tiring and left me feeling drained.
Jcrouchley
3 months ago
I had 28 weekday sessions of radiotherapy and then SABR a couple of years later. I would support the use of AI and role expansion to help increase the number of staff who could administer radiotherapy.
Jcrouchley
3 months ago
I had 7 weeks of daily radiotherapy to treat cancer in my right tonsil and lymph nodes.
Given that the side-effects and ultimate damage caused by RT to the head and neck are so severe, if using AI to help improve precision of the beams so that there is less collateral damage, then that can only be a good thing.
With regard to expanding the roles of Therapeutic Radiographers and Dosimetrists, if this was welcome by both sets of professions, and it also reduced cancellations for patients, then again this would be brilliant.
AnsonMackay
3 months ago
I had daily radiotherapy for 7 weeks to tackle cancer in my right tonsil and lymph nodes.
I think that using AI to help give greater precision and accuracy of where the radiation beams will be targeted can only be a good thing, especially if this helps mitigate potential damage from RT down the line. It would also be good to know if this extra step will impact if new masks would need to be made and fitted as treatment progressed.
Regarding the role expansions, I'm not sure how technical the respective roles were. If it was possible that an overlap could occur, then that would be great, as having deeper knowledge of each others roles means that there is deeper understanding of why decisions are being made. And if there is more personnel in the long run to do the RT, then that would be excellent news for the patient
AnsonMackay
3 months ago
Speaking as a patient that received radiotherapy to my backside for 6 weeks, anything that can be done to improve the patient experience will be gratefuly received. It is highly embarrassing to lie down with your bottom in the air. I think the idea of personalising the treatment based on progress has got to be good. I beleive i received more than required as there was no real check in - i was treated in 2014. The pain I went thru was excrutiating so better pain management might follow if you dont need quite as much treatment. TBH a specialist on hand to help with pain management would be good anyway, to help deal with the brutal effects. Its a dificult one as the treatment obviusly works, but 10 years on i am still smarting.
Regards Paul Finch
Redtrouserday
3 months ago
Would this mean loosing the distinct separate professions? My worry would be more from a workforce perspective, but if it means patients receive less intense radiotherapy sparing them from short and long term effects, sounds a good idea
Loz
3 months ago
Thank you for your feedback. I can gladly report that breast radiotherapy is now a lot shorter, between 1 and 3 weeks.
CS24
3 months ago
My experience with radiotherapy was a 35 doses for prostate cancer treatment 12 years ago and was successful. Obviously treatment and equipment have changed in that period. I had to be tattooed so that the radiologist could find the same area to treat. This new oART system would remove that and provide optimum treatment. The proposals in this project are positive in improving the treatment for the reasons given for starting the expansion of the system. I can see only positive outcomes to this project. The use of AI is becoming increasingly used in medicine and is even improving the results by highly trained operatives. It improves efficiency and waiting times for results and in terms of cancer treatment, time reduction for treatment can be lifesaving.
Harry101
3 months ago
I'm not sure of the role that AI will play in this context. If it is comparing one scan with another and highlighting the differences then that should be a good thing. I had radiotherapy for breast cancer in 2000 - 30 zaps over 6 weeks. It was draining and if anything can be done to reduce the amount of radiotherapy needed I think it would be a benefit to the patient.
Find out how much treatment planning knowledge is required to plan and treat oART.
Develop a training plan to expand the roles of Therapeutic Radiographers and Dosimetrists. This would increase the number of staff who can plan and deliver oART.
Develop guidance for other hospitals and professional bodies on how to implement the training program and new ways of working with the newly created/modified Therapeutic Radiographer and Dosimetrists job roles.
I do think that the proposal potentially will be very beneficial for patients. As a patient who underwent a course of radiation treatment post breast cancer surgery I felt that the staff involved knew their role and gave me confidence whilst in their care. Therefore if the proposal becomes future treatment policy it Will be important that all levels of staff involved in delivery should feel appropriately confident to carry out their roles and they should be actively engaged in the development of their learning and development programme. Supporting staff through this process will , I feel , ensure their full engagement with the future enhanced role changes.
Thank you for your comments, they are extremely useful understanding what is important to patients.
I have had radiotherapy twice, both for breast cancer. If cross training and using AI will increase the number of people treated, tailor the treatment for each patient and help staff expand their knowledge, that can only be a good thing for all concerned
I received two weeks of radiotherapy for a BCC on my nose. I was surprised at how tired I felt. I was not sure whether it was due to the treatment or the journey to get there everyday. I did work throughout. I was unprepared for the skin reaction which was alarming and painful and took some time to heal.
If AI automating adaptive radiotherapy can assist with the reduction of side effects and personalise treatments for patients I feel that this is a development that will benefit the patient. However, the introduction of the AI model must be rigorously tested and conform to quality assurance.
The expansion of the roles of staff is an excellent move forward as it increases the number of patients able to access radiotherapy quickly. It will also help the recruitment and retention of staff as it gives a clear pathway of development.
Thank you all for sharing your experiences so far. Your comments are extremely valuable and much appreciated in this project proposal.
I have had two courses of RT over the past 6 years. I found the process relatively straightforward and easy to comply with (the radiography team were very helpful and supportive), although following treatment there was a period of tiredness.
AI is being increasingly used in all walks of life as a productivity aid, including for clinical purposes, so it would be logical to do so in automating adaptive radiotherapy. However, AI Machine Learning needs to be rigorously validated before 'Machine Reasoning' can be trusted. The validation bar needs to be set higher for medical purposes such as this, in comparison with other commercial or industrial use-cases (e.g financial, voice/face recognition etc).
The proposed role expansions for Therapeutic Radiographers and Dosimetrists sounds like a good idea, at least from a layman's perspective. It could improve productivity and enhance job satisfaction for the staff.
Anything that helps to reduce the time and dose can only be good. I had 28 sessions over 6 weeks for my bowel cancer and a couple of years later had 3 sessions of SABR for a liver met. Both very very tiring and left me feeling drained.
I had 28 weekday sessions of radiotherapy and then SABR a couple of years later. I would support the use of AI and role expansion to help increase the number of staff who could administer radiotherapy.
I had 7 weeks of daily radiotherapy to treat cancer in my right tonsil and lymph nodes.
Given that the side-effects and ultimate damage caused by RT to the head and neck are so severe, if using AI to help improve precision of the beams so that there is less collateral damage, then that can only be a good thing.
With regard to expanding the roles of Therapeutic Radiographers and Dosimetrists, if this was welcome by both sets of professions, and it also reduced cancellations for patients, then again this would be brilliant.
I had daily radiotherapy for 7 weeks to tackle cancer in my right tonsil and lymph nodes.
I think that using AI to help give greater precision and accuracy of where the radiation beams will be targeted can only be a good thing, especially if this helps mitigate potential damage from RT down the line. It would also be good to know if this extra step will impact if new masks would need to be made and fitted as treatment progressed.
Regarding the role expansions, I'm not sure how technical the respective roles were. If it was possible that an overlap could occur, then that would be great, as having deeper knowledge of each others roles means that there is deeper understanding of why decisions are being made. And if there is more personnel in the long run to do the RT, then that would be excellent news for the patient
Speaking as a patient that received radiotherapy to my backside for 6 weeks, anything that can be done to improve the patient experience will be gratefuly received. It is highly embarrassing to lie down with your bottom in the air. I think the idea of personalising the treatment based on progress has got to be good. I beleive i received more than required as there was no real check in - i was treated in 2014. The pain I went thru was excrutiating so better pain management might follow if you dont need quite as much treatment. TBH a specialist on hand to help with pain management would be good anyway, to help deal with the brutal effects. Its a dificult one as the treatment obviusly works, but 10 years on i am still smarting.
Regards
Paul Finch
Would this mean loosing the distinct separate professions? My worry would be more from a workforce perspective, but if it means patients receive less intense radiotherapy sparing them from short and long term effects, sounds a good idea
Thank you for your feedback. I can gladly report that breast radiotherapy is now a lot shorter, between 1 and 3 weeks.
My experience with radiotherapy was a 35 doses for prostate cancer treatment 12 years ago and was successful. Obviously treatment and equipment have changed in that period. I had to be tattooed so that the radiologist could find the same area to treat. This new oART system would remove that and provide optimum treatment. The proposals in this project are positive in improving the treatment for the reasons given for starting the expansion of the system. I can see only positive outcomes to this project. The use of AI is becoming increasingly used in medicine and is even improving the results by highly trained operatives. It improves efficiency and waiting times for results and in terms of cancer treatment, time reduction for treatment can be lifesaving.
I'm not sure of the role that AI will play in this context. If it is comparing one scan with another and highlighting the differences then that should be a good thing.
I had radiotherapy for breast cancer in 2000 - 30 zaps over 6 weeks. It was draining and if anything can be done to reduce the amount of radiotherapy needed I think it would be a benefit to the patient.