Historically, radiotherapy patients were marked with three small tattoos to help radiographers align the patient’s body accurately during treatment. While effective, these tattoos served as a constant reminder of a patient’s illness, even after their treatment was finished.
Surface guided radiotherapy uses sophisticated 3D camera technology to accurately position patients during their treatment. Accurate positioning is vital to ensure the treatment machines can target and kill cancer cells. The new system also detects any patient movement automatically, pausing the treatment and resuming precisely where it left off. Previously any movement, even a deep breath or a cough, would have meant starting the treatment over.
Jacob Curran, SABR and Motion Management Radiographer who has led this project at ULHT, said: “It’s difficult to explain what a difference the tattoo-less treatment makes unless you have experienced radiotherapy, but it’s a huge step forward for us as a Trust and is without a doubt the future of radiotherapy. Surface guided radiotherapy allows us as practitioners to deliver safer and more accurate treatment, and means patients are not left with a permanent reminder of a really difficult period in their life.”
The team has also been recognised as the first Trust in the country to offer open mask treatment with surface guided radiotherapy for all head and neck patients.
Traditionally, patients undergoing radiotherapy are fitted with tight, restrictive masks that cover their whole face. It is widely reported that around 25% of people experience moderate to severe distress or mask anxiety whilst wearing a full-face mask[i].
At Lincoln County Hospital, patients are now fitted with a mask that has an open front, covering just their chin and forehead. It allows patients to breathe more easily and reduces anxiety and distress.
The team first trialled using an open mask in 2020 when treating a particularly claustrophobic patient.
Paula Brown, Radiotherapy Services Manager, said: “The first time we tried this it was born out of necessity for the patient, but we quickly realised the results were just as accurate with an open mask.
“In 2024 we stopped using closed masks all together. It’s a small change but has a huge impact on patient experience and comfort at what is a very difficult time in people’s lives and when they are particularly unwell.
“I’m incredibly proud of my team for what they have achieved and for always looking for ways we can improve care for our patients.”
Christine Doughty, 73, from Gainsborough received radiotherapy at the hospital after a tumour was found on her gum. Christine said: “I’m so pleased I could have the open mask; I think a full mask would have made me panic. The new masks are really comfortable and I could breathe and talk normally. It definitely made the experience a lot better.
“I had 30 rounds of radiotherapy and have been given the all clear now. I’m so thrilled with the treatment and the outcome and being able to celebrate with my family has been wonderful.”
In recognition of these achievements, the team were presented with the tattoo and mark-free radiation treatment and the patient centric head and neck treatment certificates by Vision RT. The awards recognise the centre as part of an exclusive but growing group of tattoo and mark-free radiotherapy centres around the world.
The team is now hoping to set a new standard for radiotherapy treatments across the country and is working with several other NHS Trusts to share what they have learnt and inspire them to adopt these practices.
[i] Clover, K., Oultram, S., Adams, C., Cross, L., Findlay, N., & Ponman, L. (2011). Disruption to radiation therapy sessions due to anxiety among patients receiving radiation therapy to the head and neck area can be predicted using patient self-report measures. Psycho-Oncology (Chichester, England), 20(12), 1334–1341.