Future Directions
The technological advancements and understanding of the molecular basis of cancer will influence the approaches to cancer prevention, early detection, diagnosis, tumour classification, treatment and monitoring of disease. New radiotherapy techniques and technologies will continue to improve the accuracy and effectiveness of cancer treatments, while minimising treatment-related side effects and improving patient quality of life. Increased understanding of cancer biology/radiobiology and the development and application of new targeted technologies will enhance patient outcomes, quality of life and survivorship. Translational research will be increasingly important in the incorporation of sophisticated technologies into standard clinical care and delivering cost-effective and equitable cancer care across Australia. Implementation research is necessary to compare effectiveness of various treatment modalities using wider population database to determine the impact of new techniques and technologies on patient outcomes.
There is a strong trend internationally for the installation of proton and heavy ion treatment facilities24-27. Australia is likely to adopt this technology, primarily for research purposes in coming years, and is currently developing world leading capabilities in micro-beam research at the National Synchrotron Centre in Victoria. This will in turn have implications for the availability of a suitably trained workforce and the identification of investment in infrastructure. Similar to the Synchrotron, the planning of this type of facility would require a national approach and its introduction would enhance Australia’s ability to conduct research at the forefront of radiation science. Such facilities would provide opportunities to attract international research leaders to Australia and to retain more of the best and brightest research scientists.
Future research also needs to address variations in cancer outcomes for different cancers and population groups. The newer technologies with their increasing integration with patient management systems will be increasingly developed to facilitate data capture and sharing. This will also require consolidated approaches to manufacturers to ensure that appropriate data fields can be built into the record and verify systems to meet Australian data requirements. Such data collection will strengthen the quality, consistency and availability of national data on cancer treatment and research and will assist policy decisions and service planning and delivery of equitable radiotherapy for all cancer patients.
The workforce will need to be flexible and knowledgeable to adopt the outcomes of research not yet identified as having direct application to radiation oncology. For example, the implementation of nanotechnology in the medical environment may introduce new diagnostic and treatment techniques. Research opportunities and corresponding management support should be available to the workforce, irrespective of the geographic location of their workplace.
Similarly, patients should have access to participation in implementation research opportunities (e.g. through clinical trials) so that this choice is available, irrespective of the treatment facility location. It is recognised that patient participation in clinical trials is associated with the development of refined treatment regimens resulting in improved patient outcomes28.
Increased investment in research will increase access to treatments, improve the quality of the overall service, improve treatment outcomes for patients and holds the promise to increase the throughput and productivity of radiation oncology practice. A stronger investment in radiation oncology research should also enhance the transfer of knowledge from the academic to the clinical environment, allowing the timely adoption of new treatment techniques. In part, the results of investment would be measurable by the number of scientific papers published and patents issued.