Patients with early stage lung cancer in the Midlands are benefiting from a new state-of-the-art radiotherapy treatment at Queen Elizabeth Hospital Birmingham (QEHB).

The technique, called stereotactic ablative body radiotherapy (SABR), uses the latest developments in radiation technology to deliver much higher doses of radiation to the tumour with pin-point precision.

This reduces the risk of surrounding healthy tissue being damaged and also increases the cure rates for patients undergoing the new treatment.

University Hospitals Birmingham NHS Foundation Trust (UHB) has become the first trust in the Midlands to provide the new radiotherapy treatment.

And the trust is now hoping to double the number of patients it treats at QEHB using SABR from around 25 in the first year to 50-60 in future years by utilising its new CyberKnife machine.

Clinical Oncology Consultant Dr Qamar Ghafoor said the SABR treatment was available for patients with early lung cancer who are either medically unsuitable for surgery, or decline surgery altogether.

"We would prefer patients to have operations to remove their tumour but this is the best alternative we can provide. It has been a standard of treatment across parts of Europe for the last four to five years and the UK has since been catching up."

Dr Ghafoor said: "The majority of early stage lung cancer patients we have treated have been deemed medically incapable of managing major surgery. This could be due to heart problems, poor lung reserves, or other medical issues."

He added that the treatment, which is more effective than conventional radiotherapy in shrinking tumours, was also less invasive for those patients anxious about surgery.

"To be suitable for SABR the tumour needs to be isolated and not already invading into central structures," Dr Ghafoor explained.

"The reason for this is that the dose we are giving is so high that it may damage surrounding areas if it wasn't isolated.

"With conventional radiotherapy you would give the patient a lower dose spread over a longer period, but by giving them a concentrated dose it is more radiobiologically effective. You are applying a higher dose to the tumour."

The result is that treatment times for patients have also been reduced by up to a fifth, with the higher doses typically delivered in three to five treatments compared to the 20 for conventional radiotherapy.

Dr Ghafoor said the SABR treatment, which is available in 15 centres across the country but believed to be the only one in the Midlands, followed advances in radiation technology.

"It is the knowledge of what we can do, and it is the equipment we can use. We also have 4D radiotherapy capacity and online imaging which means we can take pictures as the patients are having treatment."

University Hospitals Birmingham, which is now getting referrals from across the wider region including Cheltenham, presented its initial data at a recent international conference in Ireland.

It revealed that of the first 11 patients treated at the hospital, the tumour shrunk in eight and stopped growing in the other three. And, of the eight patients where it shrunk, the tumour disappeared completely in two patients.

These results add to the mounting global testimony for the new treatment.

Dr Ghafoor said: "Based on worldwide figures for this SABR treatment, 85 per cent of tumours have not re-grown locally after five years.

"This is significantly better than standard radiotherapy where in the region of 20-25 per cent of tumours have not grown after the same five year period."

At the same time, the overall five year survival rates for surgery on early lung cancer patients stands at between 60 and 70 per cent.

Case study

Retired factory worker Edward Challoner is the first person to have the new radiotherapy treatment using CyberKnife after initially discovering a small lump on his head.

The 84-year-old grandfather, from Oldbury in the West Midlands, said: "I had been having pains in my chest, but then this little lump suddenly came up on the side of my head.

"I wasn't too concerned about, but within a fortnight it had grown to the size of a small egg."

Mr Challoner, who worked for Birmid Industries in Smethwick for more than 30 years before later becoming a school caretaker, visited his doctor who arranged for the lump to be removed.

"They cut it off, but also removed the skin from a couple of inches all the way round it which they later replaced with pieces of skin from my leg."

Unfortunately for Mr Challoner, who was caretaker at Abbey Junior and Infants in Smethwick for 12 years before retiring at 65, discovered he had cancer when the lump was sent off for analysis.

"I was really shocked when they found the cancer cells, but then I was given an all-over body scan after being referred to Queen Elizabeth Hospital and they also noticed something on my lung about the size of a 10 pence piece," he added.

Mr Challoner, who lost his wife six years ago, and has three sons and six grandchildren, was advised against surgery following a heart attack several years ago.

He added: "They couldn't take the cancer away because of my heart condition as I was likely to have a stroke or something. So they offered me radiotherapy instead.

"It's great to be the first to have it on this CyberKnife. I’ve never seen a machine like this but I have had no problem using it."

Mr Challoner has now undergone a total of five sessions of the new radiotherapy treatment over the course of three weeks.

The £3.5 million CyberKnife machine is a pain-free, non-invasive alternative to surgery that uses technology similar to that used in cruise missiles to target tumours, delivering doses of radiation to sub-millimetre accuracy.

The online tumour tracking system allows the CyberKnife machine to move with the tumour during respiration, and so target it more effectively.

The Cyberknife machine, which is the first outside London, was funded as a result of the QE Cancer Appeal, run by Queen Elizabeth Hospital Birmingham Charity, which raised £6.5 million in two years.

QEHB Charity funds equipment, research and training which is over and above that which the NHS provides and aims to make a difference to the lives of patients, visitors and staff at UHB. To find out more please visit the website (see below).