MRIdian radiotherapy for lung cancer
We are proud to be the first healthcare provider in the UK to introduce the MRIdian for people with lung cancer.
At GenesisCare, we provide specialist cancer care to thousands of people worldwide. We offer cutting-edge, innovative cancer treatments that are clinically proven to be safe and effective.
The MRIdian is a radiotherapy machine called an MR linac. This smart technology combines high-resolution magnetic resonance imaging (MRI) techniques with extremely precise radiotherapy beams that can treat tumours more accurately than conventional radiotherapy. This can mean fewer treatment sessions, reduced side effects and a greater chance of an improved outcome for many cancers.
We are the first to bring the MRIdian – the latest in precision radiotherapy – to the UK. We are now offering this ground-breaking treatment at GenesisCare for both primary lung cancer and secondary lung cancer (cancer that has spread to lungs from elsewhere in the body).
Benefits of MRIdian treatment for lung cancer
The MRIdian delivers a type of radiotherapy called stereotactic ablative radiotherapy (SABR), which is often used for treating early-stage lung cancer. However, unlike conventional SABR, MRIdian has the advantage that it can see and adjust for every movement during treatment – this is called MRI-guided radiotherapy.
We know that tumours change position, even over short periods of time, which can make it difficult to target them with conventional radiotherapy. With the MRIdian, a new MRI scan is performed at each round of treatment and the radiotherapy beams are adjusted to ensure that the tumour is being targeted and that normal tissues are being spared. This is called adaptive radiotherapy and it’s a unique advantage of MRIdian.
If your tumour temporarily moves out of position, such as when you breathe, your treatment will automatically pause. This ensures that the radiotherapy beams are precisely focused at the treatment target and helps to protect your healthy tissues from damage.
MRIdian radiotherapy is entirely non-invasive, with no additional procedure required to precisely locate the tumour.
With conventional radiotherapy for lung cancer, you may need up to 30 treatments. But with the MRIdian, the radiation is much more focussed, and you may only need three to eight treatments.
Adaptive radiotherapy, made possible by the MRIdian, means higher radiation doses can be given to tumours that would not be possible with other techniques without substantially increasing side effects. This means that there is a higher chance of tumour control, without compromising your quality of life.
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MRIdian for lung cancer treatment
The MRIdian provides a treatment option if you have primary or secondary lung cancer, and if surgery is not be possible due to your general health or the location of the tumour. Where your tumour is situated within the lung is important, because if it’s near other important tissues and organs such as your breathing tubes, oesophagus, heart or major blood vessels, it can make it difficult to safely remove it with surgery. The accuracy of MRIdian means the risk of damaging these organs is much lower than conventional radiotherapy, so higher radiation doses can be used to control the disease.
You may also be suitable for MRIdian radiotherapy if you have previously had surgery or radiotherapy to the lungs, have cancer that has spread from elsewhere in the body to the lungs, or require multiple lung tumours treated at the same time. As each treatment can take over an hour, you must also be comfortable lying flat for the duration of treatment.
Your oncologist (a consultant doctor who specialises in cancer) will decide if this treatment is right for you by discussing your lung cancer diagnosis, treatments to date and overall health with a team of oncologists who are highly trained in delivering MRIdian radiotherapy. By working together, they’ll create a personalised treatment plan that may include radiotherapy, surgery and/or drug treatments. If they recommend that MRIdian radiotherapy is the best option for you, your oncologist will explain the treatment in detail to you and provide you with written information about what to expect, as well as give you plenty of opportunity to ask questions.
If you choose to have your cancer treatment at GenesisCare, you’ll also have access to integrated cancer care, such as psychological support and wellbeing therapies, at no extra cost to you or your insurer. These therapies have been shown to reduce the burden of cancer and improve your quality of life after cancer treatment, by helping to reduce symptoms and side effects of treatments and alleviate cancer-related concerns.
This is our commitment to offer world-class care to every patient with cancer.
What are the side effects of lung radiotherapy with MRIdian?
The side effects experienced are often dependent on the location of the tumour(s) within your lungs.
You may experience the following during your treatment course, but they’ll usually disappear within three to four weeks.
Common short-term side effects include:
- Dry cough
Uncommon short-term side effects include inflammation of lung tissue, shortness of breath, fever and skin redness.
Commonly, you may experience pulmonary fibrosis (the scarring of lung tissue). Uncommon long-term side effects may include:
- Chest pain
- Rib fracture
- Nerve damage to the shoulder and upper arm
- Heart damage
- Damage to gullet
- Damage to breathing tubes
The side effects experienced are often dependent on the location of the tumour and its proximity to nearby organs. Your GenesisCare consultant will discuss with you which of these you may experience. It’s important that you attend your follow-up appointments so we can identify and treat any problems as soon as possible. Your consultant and radiographers can also provide advice about things you can try to help, and no question is too small if you have any queries or concerns.
We know that living with cancer can be challenging. That’s why you’ll also be offered support through life-changing therapies, such as psychological support and wellbeing therapies. These are provided to all patients at no extra cost to you or your insurer, to help you manage the side effects of treatment and symptoms of cancer.
What does MRIdian treatment involve?
Here is an outline of what to expect after your initial consultation and before, during and after your treatment. There are four stages to the process: your planning appointment, planning, treatment and follow-up. Before your first appointment, your care team will call you to explain any preparation instructions in advance of your appointments and to answer any questions.
The appointment will last two to three hours and will involve a magnetic resonance imaging (MRI) scan in the MRIdian and a computed tomography (CT) scan.
- Your radiographer will explain the process and ask you to fill in a safety questionnaire
- They’ll ask you to change into a gown and remove any metal objects such as jewellery, hearing aids, glasses or dentures
- You may have a cannula (thin tube) inserted into your arm to inject a dye that improves the quality of your scans
- You’ll be put in position for your MRI scan in the MRIdian. Your radiographer will make temporary markings on your skin and place soft pads (called coils) over your chest that help to produce high–quality images
- The scan will take about 30 minutes. You can speak to your radiographer through an intercom system. They’ll give you breathing instructions to follow to help minimise movement of your internal anatomy. You can also listen to music using special earphones
- When your MRI scan is complete, you’ll go to another room for your CT scan, which takes about 20 minutes
- You’ll be placed in the same position as your MRI scan and given breathing instructions again. You may have a cannula inserted into your arm to inject a dye that improves the quality of your scans
- After your scans, you can go home. If you had a dye injected, you should drink plenty of water to flush it from your system
Over the next week, your consultant and care team will work together to create a MRIdian radiotherapy plan that is specific to you using advanced computer technology.
Your treatment will be individualised to you so not all of the steps below will be applicable. Your MRIdian team will explain what will happen at each appointment.
You’ll carry out many of the same steps as at your planning scans, such as removing accessories, changing clothes, getting into position and having the coils placed on your chest.
Before each session, you’ll have a new MRI scan which will be compared with your planning scans. Your treatment plan will then be carefully adjusted and optimised to account for any movement of your tumour and internal organs.
Your treatment will take approximately 75 to 90 minutes. Your radiographer will ask you to follow breathing instructions for around 20 to 25 minutes during your treatment using a computer screen to help you. You can go straight home after each session. You’ll be given contact details for your care team so you can call if you have any questions.
After your treatment course has finished, you’ll be referred back to your own doctor with all the information they need to plan any further treatment you may require.
Seven to ten days later: a member of your MRIdian care team will call to see how you’re feeling and answer any questions you may have.
Four to six weeks later: you’ll have a review with your GenesisCare consultant.
In the longer term, your MRIdian care team will continue to follow up on your recovery and wellbeing through appointments, phone calls and emails.
Our GenesisCare centre in Oxford is rated ‘Good’ by the Care Quality Commission (CQC)
Our team of experts
Dr John Conibear
Special clinical interest in thoracic cancers and breast cancers.
Dr Luis Aznar-Garcia
Special clinical interest in hepato-pancreato-biliary, breast cancers, SBRT and stereotactic radiosurgery (brain metastases, benign tumours and spine).
Dr Veni Ezhil
London, Guildford, Oxford
Special clinical interest in thoracic cancers and lymphoma.
Dr Philip Camilleri
Milton Keynes, Oxford
Special clinical interest in urological cancers.
Dr Andy Gaya
London, Maidstone, Oxford
Special clinical interest in upper and lower, gastrointestinal and hepato-pancreato-biliary cancers.
Dr Alex Martin
Special clinical interest in thoracic cancers and urological cancers.
Dr James Good
Special clinical interest in colorectal, hepato-pancreato-biliary, and head and neck cancers.