By Simon Cox

BBC Radio 4's The Investigation



Herceptin is an expensive drug

Dr Peter Kirkbride, the chief spokesman on radiotherapy for the NHS, said the NHS spent £100m on the breast cancer drug Herceptin in 2006.

But he told Radio 4's The Investigation only about 500 patients had benefited - at a cost of about £200,000 each.

If that was spent on radiotherapy, it could have a dramatic impact, he said.

There is a lot of publicity about the role of chemotherapy but the consensus is of all cancers that are cured, half are cured by surgeries, 40% by radiotherapy and only 10% by drugs

Dr Peter Kirkbride

National Clinical Lead for Radiotherapy

Cancer survival in the UK is still below the European average, despite recent improvements.

Herceptin was approved for use in women with early stage breast cancer in 2006 after a fast-track assessment by the National Institute for Health and Clinical Excellence.

But now some cancer doctors are concerned this focus on new cancer drugs may not be a good thing.

Dr Kirkbride said: "There is a lot of publicity about the role of chemotherapy but the consensus is of all cancers that are cured, half are cured by surgeries, 40% by radiotherapy and only 10% by drugs.

"If I was to spend £100m on radiotherapy, I could buy something like 90 machines, I could buy 30 simulators and I could probably benefit about 30,000 patients for the same amount of money."

Radiotherapy problems

Earlier this year, the National Radiotherapy Advisory Group published a report which called for a 91% increase in radiotherapy treatments in England in the next 10 years.

But the trade body for the manufacturers of radiotherapy machines has told the BBC that instead of seeing more business, it has all but dried up.

David Miles, the chairman of the radiotherapy specialist focus group of the Association of X-ray Equipment Manufacturers which formed to highlight the problem, says there has been a "collapse in critical investment".

He said: "We noticed after the government initiatives to improve the established stock of radiotherapy equipment, it actually ended in April last year. And the sales of machines then fell off drastically.

"One order has been placed in the last 20 months."

Because it takes around three years from when an order is first placed until it treats its first patient, the radiotherapy focus group at AXrEM says the NHS should have bought 20 replacements machines by now instead of just one.

'Not sexy enough'

Dr Kirkbride thinks part of the problem is raising the discipline's profile in the eyes of both the public and government.

He said: "We are not sexy enough. We don't have pharmaceutical companies backing us in the same way that some of the drugs companies support campaigns for the use of their drugs."

Professor Mike Richards, the National Cancer Director, said there should be room in the cancer budget for both.

He said: "There is no doubt that Herceptin is a good drug. There is no doubt that it has been looked at carefully by NICE and it has been deemed to be both effective and cost-effective.

"Radiotherapy is also effective and we need to make sure that it's not one or the other, but that we actually have a service that delivers both."

The Investigation - The Sick Man of Europe

Radio 4, 2000GMT, Thu 29 November

Online from Radio 4's Listen again page

Podcast from the File on 4 website