Radiotherapy will experience increased demand as result of rising prevalence of prostate cancer in particular, along with other cancers, which are heavy users of this therapy, but it will also be affected by changes in techniques which require more intensive planning:

1. There will be a requirement for more primary treatment of prostate cancer. As a result of increased incidence and shifts in preference away from surgery towards radiotherapy there will be an increase in demand. As cancer becomes a longer-term illness there will also be an increased requirement for palliative radiotherapy and treatment on a prophylactic basis.

2. Brachytherapy will improve the patient experience by reducing serious side effects. This improvement in quality will also increase demand while at the same time raising cost and the requirement for technical skills.

Technical advances in radiotherapy

Over the last 20 years the indications for radiation therapy have doubled, yet there are still many experts who feel radiotherapy will soon be obsolete. However, just as for surgery, there is little justification for this future scenario. Technological advances have led to the ability to plan and deliver non-uniform distributions of radiotherapy dose: molecular imaging allows us to look at the function of tumours so we can map resistant areas and titrate treatment (we can now selectively avoid normal tissues of functional importance), radiotherapy is the only treatment which can be modulated in time and space.