Mapping the patient pathway at an established proton therapy centre

I am a 2011 STP trainee specialising in radiotherapy physics at The Christie NHS Foundation Trust in Manchester, a leading specialist cancer hospitalwhich will begin proton therapy in 2018. Protons interact very differently in tissue from high energy x-rays which are the basis of most UK radiotherapy treatments. Use of protons can help spare healthy normal tissue and critical organ structures which lie close to the tumour and is especially effective in treatment of paediatrics.

As The Christie is building up expertise prior to the opening of the new centre, I elected to visit The Roberts proton therapy center at Penn Medicine, Philadelphia, Pennsylvania. The extensive experience of the facility and strong academic background made it an obvious choice for an elective placement. Additionally I felt it would complement my proton related MSc project.

I was extremely fortunate in being awarded the Tomkins Educational Bursary through The Christie to fund this placement. The bursary provided me with opportunities to look at the impact on the current radiotherapy service and also how future proton therapy may be integrated. I cannot thank the founder of the bursary enough for this enlightening experience.

At the Christie, I met with a variety of staff involved in protons, to plan how to maximise this opportunity. I visited Penn proton therapy center in April 2014. The sheer scale of the place and the set up was so different from the UK. I was able to observe all aspects of the service and talk with the full multi-disciplinary team, following the entire patient pathway from pre-treatment through planning to proton delivery.

As I was particularly interested in the physicist’s work, I spent time shadowing the various roles on the clinical rota, QA procedures and talking to each member of staff about their research. It was fantastic to see their problem solving skills in action. Everyone I spoke to was extremely generous with their time. To be able to see proton theory put into actual practice and to have that hands on experience is wonderful, I learnt such a lot from my visit.

Electives are an amazing opportunity to do something out of the ordinary and to experience a different healthcare environment. Things don’t always go to plan, I had an unexpected extra night in Washington DC as east coast storms grounded my flight out. Still it is a fantastic opportunity to think big, go for it and make the most out of your visit!

Frances Charlwood, Radiotherapy Physics STP, The Christie NHS Foundation Trust