In the Spring 2024 edition of SCOPE, published by the Institute of Physics and Engineering in Medicine (IPEM), Professor Andy Beavis, Head of Medical Physics for the Hull University Teaching Hospitals NHS Trust, Professor at the Hull York Medical School, Professor at University College London and CSO and Founder of Vertual Ltd, shares a reflective poem in relation to the early work of the National Radiotherapy Innovation Fund.
In the mid 2000’s, the National Cancer Action Team provided a funded infrastructure for the National Radiotherapy Advisory Group, to establish a series of committees to guide national strategy and make systematic operational changes to Radiotherapy in England. It is generally considered that the National Radiotherapy Innovation Fund was instrumental in bring IMRT into sustainable and mainstream practice in radiotherapy in England.
Andy's poem
Bentley and Milan taught us to compute
dose with simple PCs.
We used plaster of Paris bandages to trace
the shape of the body,
X-ray films on boxes of light, to find distances
between OARs and hidden tumour.
We limited the dose and statistical control,
fearing collateral damage.
We called this two Dimensional Radiotherapy.
We wanted to do more…
Godfrey – and his students – gave us the
CT scanner.
On an 8-inch floppy disk, Andy drove to
collect the image of the week for the
golden ticket winner. That one, central
prostate slice, was all we could afford.
We filled the body contour with water and
used our four-field box to great precision,
or so we believed.
We called this two and a half Dimensional
Radiotherapy.
We wanted to do more…
Sherouse and Kalet pioneered in three
dimensions, Mackie wrote his thesis; we
said to the beams “don’t be square –
daddio!”
Helax produced their commercial system,
but they expanded too rapidly and
floated away.
Computer memory grew and grew and
the networks brought us Moore and Moore
images.
We called this three Dimensional
Conformal Radiotherapy.
We wanted to do more…
Brahme and Webb showed us how to plan
backwards, with psychedelic results.
Convery and Bortfield modulated and
taught us their dance sequences.
Carol had his vision and his Carpenter
Dawson MiMic’d the dream.
Baylor began the long strange trip,
MSKCC followed and we got Truckin’.
We called this three Dimensional Intensity
Modulated Radiotherapy.
We wanted to do more…
Mackie, Holmes and Reckwerdt
understood the geometric limitations and
Guided us all. The rule book was torn up,
thrown away and rewritten. Marcel wrote
down his formula and challenged us to
embrace our uncertainties. We tightened
our margins and focused on Target to spare
our sensitivities.
We called this three Dimensional Image
Guided Intensity Modulated Radiotherapy.
We wanted to do more…
Professor Sir Mike Richards called the UK to
action, threw down his challenge to all. Tim
Cooper rallied his Urban Guerillas, and we
camped out near Victoria. We gathered
data, we lobbied hard, we wrote to David
Cameron to tell him what we could do.
Ministers promised a few quid.
Sir Mike said: “Please sir, can we
have more?”
We called this the Radiotherapy
Innovation fund.
We wanted to do more…
Every Oncologist, Radiographer,
Dosimetrist and Physicist was trained, so
they couldn’t say “we don’t know how.”
Richards and Cooper played Santa, the
Guerillas helped departments open their
presents and read the instructions.
We met Sir Mike’s challenge and 24% of our
patients got IMRT.
We called this World Class Radiotherapy
and we did it in the UK.
We always wanted to do more…
We need to refresh technology for today’s
Merry Pranksters to take us Furthur.
Tumour engineering drugs will sensitise the
resistant and prove their value.
The Learning Machines will find knowledge
we don’t yet know we need, at speeds we
can’t believe.
Well-trained, motivated staff will
push the possibilities beyond where
we ever imagined.
Please, politicians, please, don’t let it spiral
down through the night and f-f-f-f-f-fade
away.
We still want to do more…
