Local hospital trust first in UK to introduce Ethos therapy.

Barking, Havering and Redbridge University Hospitals NHS Trust has upgraded one of its Varian radiotherapy machines, making it the first in the country to offer Ethos therapy – which uses artificial intelligence (AI) to tailor treatment to patients’ changing daily needs.

Ethos therapy is a more patient-friendly system which enables the Trust to personalise patients’ radiation treatments more precisely based on their anatomy on the day – targeting the tumour’s shape and position on a daily basis.

Siobhan Graham, Head of Radiotherapy, explained: “Cancer patients receiving radiotherapy will have a course of treatments, and on different days their internal anatomy will not be exactly the same; bladder size for example can change depending on how full it is.

“What this upgrade has allowed us to do is use AI to adapt to our patients, instead of asking our patients to adapt to our treatments. It also aims to reduce side effects even further than our normal treatments already do. This will make a huge improvement to our patients’ experience and their overall health outcomes and builds on our mission to provide great care to every patient, every day.”

The upgrade went live on Monday 3 August, treating three prostate cancer patients on its first day in action.

Grandfather Stephen McTaggart, of St Mary’s Lane, Upminster, was the first patient to receive the new adaptive treatment. He said: “They called me in advance to tell me about it, but it didn’t really register what it was. I feel quite lucky being the first, especially as originally I would have had my radiotherapy in February, however, due to Covid-19 it had to be put back. I wouldn’t have been the first to get a new treatment if I’d had it then.

“I feel lucky for all the treatment I’ve had with the Trust.”

Stephen, a contract manager, never expected to be diagnosed with prostate cancer as when he was referred for tests his PSA (prostate specific antigen) levels were low. 

He added: “I expected to come and see the consultant and be told I was in the clear.  However, they found tumours. Even though my radiotherapy was postponed due to Covid-19, I wasn’t worried as I had hormone injections as part of my treatment which kept my levels really low.

“It’s great to be having my radiotherapy now though. Knowing this new treatment is more targeted will hopefully mean it’s more successful, so I’m looking forward to the end result.”

Stephen, is married to Christina, 64, and has sons Robert, 38, Adam, 36, and granddaughter Charlotte, three. 

The two other patients who also received treatment for prostate canceron the first day Ethos therapy went live were Sothirajah Thursiyanthan, 57, and Terence Elliot, 72.

The system has upgraded CT image quality, allowing Ethos to use AI to find the exact location of the tumour in a patient’s body on each day of their treatment, so that radiation is targeted in that area. A new treatment plan is then optimised using that day’s CT image. This much more specialised ‘online adaptive’ treatment can also be delivered in a standard 15 to 20 minute radiotherapy appointment slot.

The implementation of Ethos means that radiotherapy patients will no longer have to undergo certain procedures to prepare for treatment, including more invasive procedures like gold seed markers for prostate cancer patients, which are inserted into the body to show the tumour’s location. 

The upgrade was implemented as part of the Trust’s partnership with Varian, which manufactures the radiotherapy machines. It’s another example of the Trust being at the forefront of transforming cancer treatment, delivering more patient-centred treatment. In 2017 the Trust was the first in the UK to have a Varian Halcyon treatment machine, which cut treatment times while also improving patients’ comfort, and in 2018 it was the first in the world to implement high-quality imaging on Halcyon.

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