The Ferrari of cancer treatments: New radiotherapy machine which can destroy brain tumours… and even restore sight
Oh boy: Cancer paitent Helen Lau with Mylo, the son she thought she may never see
The room is dark and silent. Out of the blackness, two vivid green laser lines converge across the masked face of a figure lying motionless on a bed. Above her, a steel arm whirrs into life, rotating in choreographed movements around her head.
It could be a scene from a sci-fi film – but, in fact, we are in a radiotherapy suite at University College London Hospitals.
The green cross marks the spot where surgeons will target beams of radiation they hope will destroy the brain tumour that is causing the patient, Helen Lau, to go blind. The blue mask, with only a small mouth hole, is attached at the back to the bed – its function is to stop Helen moving. Any slip and the high-energy X-rays would plough into healthy brain tissue.
Within a couple of minutes, the machine stops moving and the treatment is over. Helen, 40, is helped off the bed and sips a cup of tea before going home with her partner Mick, 39, a telecoms engineer, and 18-month-old son Mylo.
The marketing manager from Luton is one of the first Britons to benefit from a state-of-the-art form of radiotherapy being hailed as the Ferrari of cancer treatments. The pioneering procedure targets tumours in just two minutes – five times faster than existing radiotherapy and with pinpoint accuracy. The number of treatment visits is reduced dramatically because it delivers a large dose of radiation quickly, without damaging healthy tissue around the tumour.
Until now, radiotherapy patients had to endure a daily 25-minute session or longer. Helen’s treatment involved just two minutes, five days a week for six weeks. Today was her final treatment.
‘All you hear is the whirring of the machine,’ says Helen later. ‘Otherwise it’s completely silent and you don’t feel anything. I did feel really tired after I’d finished the treatment sessions and a bit run down. But now I feel fine.’
The machine, called TrueBeam, is billed as the fastest and most accurate of its kind in the world for destroying cancer. It brings new hope to thousands of patients, especially those with deep- seated tumours.
UCLH has successfully treated 20 patients since TrueBeam was installed this September.
As well as destroying brain tumours, it can be used to stop other head, neck and lung cancers spreading. Cancer expert Dr Naomi Fersht describes TrueBeam as ‘cutting-edge radiotherapy’.
The consultant clinical oncologist at UCLH says: ‘This machine delivers radiation more effectively. The more precise and accurate you are, the more you can increase the dose.’
Radiotherapy has to be aimed precisely. Even the slightest movement – such as the patient breathing – increases the risk of errors.
Helen was six weeks pregnant when doctors discovered a tumour in her brain in October 2009. Although benign, the tumour was growing near her pituitary gland at the base of the brain and pressing on her optic nerve. This was gradually making herblind.
For patients treated with TrueBeam’s forerunners there is a three to five per cent risk of long-term side effects, such as memory loss or strokes, due to damage to health tissues. But research reveals that TrueBeam minimises this exposure – or ‘wobble factor’ – considerably.
‘Our aim is not only to halt the growth of tumours but also to ensure patients go on to enjoy a good quality of life,’ says Dr Fersht.
More than 120,000 patients every year benefit from radiotherapy, which cures more people than cancer drugs. Tumour cells are destroyed quickly by X-rays, unlike normal cells.
But the problem of hitting healthy tissue means treatment has to be delivered over a period of weeks to ensure healthy cells have time to recover. The 3 million TrueBeam unit is available to both NHS and private patients.
Professor Jeffrey Tobias, consultant oncologist and medical director of cancer charity Fight For Life, says it offers a remarkable advance: ‘The movement of the mechanical arm means we can fire radiation from multiple angles in quick succession, making it easier to tackle deep tumours that are often positioned very close to vital organs.’
Julia Solano, who manages radiotherapy services at UCLH, says: ‘I’d call it the Rolls-Royce of cancer treatments, but that sounds old-fashioned. It’s more like a Ferrari or an Aston Martin: beautifully made and with great speed and technical ability. It will be good for treating children as well because it’s so quick and so accurate.’
Helen was six weeks pregnant when doctors discovered a tumour in her brain in October 2009. Although benign, the tumour was growing near her pituitary gland at the base of the brain and pressing on her optic nerve. This was gradually making her blind.
‘My vision started to go blurry but I thought it was to do with the pregnancy or my contact lenses,’ explains Helen. ‘So I went to the optician to have my lenses checked and they said something was not quite right behind my eye. Those first weeks were so scary, not knowing why I was losing my sight.’
Pioneering: The new treatment has less side-affects and each session is only two minutes
Helen was referred to Moorfields Eye Hospital in London, where a scan was carried out. ‘We were driving up the M1 when they called and said they had to get me an emergency bed at the National Hospital for Neurology and Neurosurgery in London. I was told to pack an overnight bag – that’s when I realised it was serious.
‘We just drove in silence. We were both thinking the worst. When we got home, I just burst into tears and said “I’m going to die!” Mick had to calm me down.’
The scan confirmed that Helen had a tumour pressing on her optic nerve. At three months pregnant, she underwent brain surgery at UCLH to remove the jelly-like mass known as a craniopharyngioma.
Helen says: ‘It’s pretty rare and they don’t know what caused it – the pregnancy hormones could have made it grow. If I hadn’t had my eyes checked, I don’t know what would have happened. All I could
think about were the things I was going to miss, that I might not even have a baby.’
Surgeons removed most of the tumour and Helen could see when she came round from the anaesthetic.
In May 2010, she gave birth to Mylo without complications. But just a few months later, Helen started getting vision problems again. The tumour was back and even larger.
‘This time, I knew the signs and I went to the doctor straight away. It had grown back really quickly and was the size of a Brussels sprout.’
It is often impossible to remove a brain tumour completely. Previously, radiotherapy was not offered to all brain tumour patients because in some cases the risks were believed to outweigh the benefits, even if a second bout of surgery might be necessary.
But the TrueBeam process means radiotherapy may now be offered earlier on to stop the tumour regrowing.
Helen underwent the treatment in June. A scanner was used to produce a 3D image of Helen’s head and this was used to plot the position of the tumour on a computer.
The radiographer has to adjust the position of the machine several times during conventional treatments. But TrueBeam rotates continuously around the patient to deliver the radiation in correspondence to the computer brain map. The machine is also synchronised with the patient’s breathing pattern.
Helen has responded well to her treatment and the hope is her tumour will not grow back. ‘Now I’ve got my independence back and can enjoy being a mother,’ she says.