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Top cancer expert labels NHS delay over ground-breaking treatment a 'scandal'

Professor Michael Baum developed the procedure for tackling breast cancer 20 years ago

    Professor Michael Baum
    Professor Michael Baum

    A Jewish leading cancer doctor has described the delay in making a ground-breaking treatment he developed available to NHS patients as a “scandal”. 

    Professor Michael Baum first worked on the treatment for tackling breast cancer, known as TARGIT IORT, 20 years ago at University College London with colleagues Dr Jeffrey Tobias and Dr Jayant Vaidya.

    It has been available almost exclusively to private patients but only now has NICE, the National Institute for Health and Care Excellence, approved funding for its use in the NHS.

    “It is a scandal that NHS patients have been denied this treatment when it has become the standard of care in Germany, Australia and many other countries,” said Prof Baum, who is now emeritus professor of surgery at UCL and is a world expert on breast cancer.  

    The treatment will spare newly dignosed cancer sufferers weeks of radiotherapy. 

    Many in the early stages of the disease will be offered a one-shot blast of radiation delivered in the operating theatre following a lumpectomy while they are still under anesthetic.

    As well as more convenient than making 15 or more separate daily journeys to hospital, the treatment — delivered by special machines at the Royal Free, Whittington and Guys hospitals in London as well as centres in Winchester, Harlow and Swindon — is less toxic, irradiating the tumour bed only and sparing other organs.

    Prof Baum said: “The concept of using IORT after lumpectomy was sketched on the back of an envelope after a meeting between me and the CEO of Photoelectron Corp in 1995.  

    “The justification for it was related to some work Dr Vaidya had published around that time.”   

    Rather than being hailed as a breakthrough, the single-shot technique was derided and regarded with suspicion by doctors who did not believe radiating only the tumour bed could possibly be effective, according to Prof Baum.  

    “The hostility we were subjected to was as profound as that I experienced when supporting breast-conserving surgery as an alternative to mastectomy in the 1970s,” he said.

    Dr Tobias, professor of cancer medicine at UCL, who is also Jewish, recalled: “They laughed at us when we started doing this work.”   

    Of the delay in getting NICE approval, he said: “We are very good at creativity in this country, but pretty rotten at implementation”.

    Successful clinical trials on more than 3,000 patients have already led to adoption of the treatment in 35 countries, including Israel, which has seven of the £450,000 machines.

    The NICE approval was delayed for a year by an appeal from the Royal College of Radiologists, Prof Tobias said.  

    There was a fear that with breast cancer representing one-third of the workload in radiotherapy departments, some departments might be adversely affected by the widespread use of IORT.

     Ada Rapaport-Albert, a London-based professor of Jewish studies who was diagnosed with breast cancer in 2014, said the treatment, which she received spared her a mastectomy and may have saved her life. 

    “It was the best medical experience I have ever had. I was discharged the day after my operation fit enough to do DIY when I got home,” she said.

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