Clinical oncology

Clinical Oncologists are doctors trained in the use of both radiation and medications in the treatment of patients with cancer. Used together or alone there is a huge variety in delivery techniques and schedules. Although increasing amounts of drug therapies can be delivered in peripheral sites such as at the Borders General Hospital – Melrose, St John’s Hospital – Livingstone, the Dumfries and Galloway Royal Infirmary and Victoria Hospital – Kirkcaldy all radiotherapy in South East Scotland is given at the Edinburgh Cancer Centre – part of the Western General Hospital site.

Radiotherapy uses ionising radiation (high energy x-rays) to treat cancers. As the body has a limit to how much dose it can safely receive radiotherapy is often divided into smaller ‘fractions ’which are usually, but not always, given daily. Depending on the type of radiotherapy, site and origin of the cancer, and intent of treatment this can vary from a single treatment to eight weeks of Monday to Friday treatments.

Different types of radiotherapy include:

• External beam radiotherapy – similar to getting a CT scan the radiation beam passes straight through the body.
• The Edinburgh Cancer Centre can deliver all forms of modern advanced radiotherapy as well as Stereotactic Radio-Surgery/Ablative Radiotherapy (‘SRS’/’SABR’.)
• We do not have Proton therapy – this is only available in the UK at University College London Hospital and The Christie in Manchester.
• Brachytherapy – radioactive ‘seeds ’are inserted directly into thetumour or organ
• Radioisotope therapy – a radioactive molecule in liquidform that can be swallowed or injected

Uses of radiotherapy can vary:

• It can be used with the aim of cure and this is sometimes called ‘radical ’treatment; it is in this setting that it is occasionally given alongside drug treatment such as chemotherapy.
• It can be used before or after surgery to reduce risk of recurrence; what is described as ‘neo-adjuvant ’and ‘adjuvant ’respectively.
• If, unfortunately, a cancer cannot be cured radiotherapy may still be helpful to provide some local control and in doing so hopefully prolong life and prevent or alleviate symptoms. It may also be useful for specific sites of problematic disease; such as to treat pain or bleeding for example. In this setting treatment is referred to as ‘palliative’.

Clinical Oncologists work closely with the Multi-disciplinary Team (MDT) and your named Consultant may head up the entirety of your treatment or simply be asked to consider/deliver some radiotherapy as a small part of it.

The Edinburgh Cancer Centre plays an active role in innovation with engagement in regional, national and international research. It also a large training centre for the doctors, nurses and other allied healthcare professionals of the future.