Let treatment reach all

WORLD Radiotherapy Awareness Day was observed on September 7. Launched in 2025, the global initiative seeks to raise awareness among the public, policymakers and healthcare professionals about the essential role of radiotherapy in cancer care. The multi-year theme, 'One Voice for Radiotherapy', calls for greater awareness and better access to treatment. The date marks an important milestone in medical history. On September 7, 1953, the world's first patient was treated with a clinical linear accelerator (LINAC) designed for medical use at Hammersmith Hospital in London. By using high-energy X-rays to destroy cancer cells, the technology opened a new era in modern radiotherapy. Cancer treatment rests on three main pillars: surgery, systemic treatment such as chemotherapy and other cancer medicines, and radiotherapy. According to the World Health Organisation and the International Atomic Energy Agency, more than half of all cancer patients will require radiotherapy at some point. It can cure cancer and control symptoms such as pain, bleeding and breathing difficulties, including those caused by cancer spreading to the bones or brain. Yet misconceptions about radiotherapy remain widespread. Some believe it is used only in advanced cancer, while others delay treatment because of fears about severe side effects or radiation remaining in the body. In most external beam radiotherapy, patients do not become radioactive and pose no radiation risk to family members. Modern technologies, including 3D conformal radiotherapy, IMRT, VMAT, image-guided and stereotactic radiotherapy, allow radiation to be delivered more precisely while protecting surrounding healthy tissue. The need is particularly urgent in Bangladesh. According to the latest estimates from the International Agency for Research on Cancer, nearly 187,000 people in Bangladesh were newly diagnosed with cancer in 2024, while approximately 139,000 died from the disease. The burden is likely to grow with population growth, longer life expectancy, tobacco use, environmental factors and changing lifestyles. Access to radiotherapy, however, remains limited and concentrated in Dhaka and a few other major cities. Patients from Dinajpur, Barishal, Rangpur, Khulna and other districts may have to travel long distances for treatment. Transportation, accommodation, lost income and family support add substantially to the burden and can prevent patients from starting or completing treatment. Installing a radiotherapy machine is not enough. Safe, continuous treatment requires regular maintenance, quality assurance, reliable electricity and trained radiation oncologists, medical physicists, radiotherapy technologists, dosimetrists and nurses. A carefully regulated public-private partnership could help expand access. The government can provide land, infrastructure, policy support, tax benefits and partial investment, while private partners can contribute technology, expertise, management and long-term maintenance. But such partnerships must clearly define treatment charges, services reserved for low-income patients, quality standards and accountability. Success should not be measured by whether a machine is installed, but by whether it remains functional and patients can actually afford to use it. Business leaders, industrialists and expatriate Bangladeshis can also make a lasting contribution by supporting cancer centres in underserved districts, financing equipment, building patient accommodation or establishing treatment funds. Through transparent trusts or foundations, contributions of different sizes can be pooled to create functioning cancer services. A radiotherapy machine can treat thousands of patients over its working life; investing in one is therefore an investment in thousands of lives and families. Evidence-based shorter treatment schedules, or hypofractionation, should also be used where clinically appropriate. For some cancers, treatment that once required five to seven weeks can now be completed safely within one to four weeks, reducing travel and accommodation costs and allowing more patients to use limited treatment capacity. Such schedules are not suitable for everyone and must be determined by specialists according to the cancer and the individual patient. Radiotherapy is not a luxury. It is a fundamental component of comprehensive cancer care. Bangladesh needs a national plan that prioritises decentralisation, accountable public-private partnerships, social investment and financial support for disadvantaged patients. A radiotherapy centre is more than a building filled with machines. It can mean a mother returning to her children, a father spending more time with his family, or a patient living without unbearable pain. On World Radiotherapy Awareness Day, Bangladesh should commit to ensuring that no patient loses a fair chance of survival because treatment is too far away, too expensive or unavailable. Timely access to radiotherapy is not a favour or a privilege. It is an essential part of every cancer patient's right to healthcare.