As groundbreaking innovations in cancer treatment go, it may not sound very high-tech, but a chair that allows patients to sit upright during radiation therapy could transform care for thousands.
The chair, which has a high-back chair with no armrests, was developed by Surrey-based company Leo Cancer Care to replace the current system, where the patient lies flat to undergo radiotherapy.
Sitting up straight may lead to fewer side effects, as standing upright during treatment reduces the chance of damaging healthy organs.
For example, when a breast cancer patient lies on their backs through radiation therapy, the breast tissue “sinks” closer to organs such as the heart and lungs so that they are only millimeters apart – increasing the chance that the organs will be damaged by radiation that strays .
This can increase the risk of cardiotoxicity – where healthy heart tissue is contaminated. The condition can also damage the arteries that supply the heart and disrupt the electrical system, increasing the risk of death from complications.
For example, when a breast cancer patient lies on their backs through radiation therapy, the breast tissue “sinks” closer to organs such as the heart and lungs so that they are only millimeters apart – increasing the chance that the organs will be damaged by radiation that strays
Modern, more accurate radiotherapy techniques have reduced the risks. But patients often still need to take a deep breath and hold it for up to 20 seconds — staying perfectly still — while treatment is in progress. This separates the targeted breast tissue from the heart and lungs.
When patients sit upright, gravity causes the heart and lungs to fall into a natural position, reducing proximity to the tissue to be treated. (Patients may still need to use the deep breathing technique, but it’s easier in this angle.)
It may also help lung cancer patients who have trouble breathing while lying down. The most common form of radiotherapy in the NHS is the external beam type, in which a machine revolves around the patient and directs the radiation beams towards the tumour.
It is painless, but the patient, who is lying flat, must remain motionless. And it requires complex, bulky and expensive equipment to navigate the body, locating tumor sites with enough accuracy to limit damage to healthy tissue.
When patients sit upright, gravity causes the heart and lungs to fall into a natural position, reducing proximity to the tissue to be treated. (Patients may still need to use the deep breathing technique, but it’s easier in this angle)
The new chair, which can tilt and rotate 360 degrees, could be an easier, cheaper solution: moving the patient instead of the machines.
After the patient has had a CT scan to map out the area to be treated, they are slowly turned in the chair while the radiation therapy beam zaps the tumor from all angles.
The machine used with the chair is a quarter the size of some currently in use and remains in one place.
When radiotherapy was first used more than 100 years ago, most patients were so sick that they could not sit up straight.
“That’s why treatment has evolved so much,” said Heidi Probst, a professor of radiotherapy and oncology at Sheffield Hallam University, who is collaborating with Leo Cancer Care on his research.
‘But we’ve had improvements in cancer screening and detection, and people tend to be much better these days when they’re diagnosed.
“Patients have already told us that lying down makes them feel powerless and vulnerable. Sitting seems to reduce this.’
Stephen Towe, CEO of Leo Cancer Care, compares the new approach to standard radiotherapy: ‘When you have to replace a light bulb, you don’t hold the light bulb and you rotate the house. We apply that simple concept to modern radiation therapy.’
But the technique can only be used if a patient has had an upright CT or MRI scan to plan the procedure — and most NHS scanners are designed for horizontal use.
dr. Nicky Thorp, director of professional practice for clinical oncology at the Royal College of Radiologists, says: ‘This is potentially interesting, but we need more experience with it before we can draw any firm conclusions about its usefulness.’