More than 60,000 cancer patients a year in England are not getting the radiotherapy they need at all, while some face waits of up to six months to begin the treatment, research has found.
The situation is so dire that nearly 100 heads of radiotherapy and oncology – three-quarters of England’s radiotherapy leaders – have warned in an open letter that the government is failing patients.
International experts agree that more than half (53%) of all cancer patients will typically need radiotherapy, but exclusive analysis of the latest NHS data in England shows only 35% actually receive it. The study by the charity Radiotherapy UK found 181,023 cancer patients should have received radiotherapy but only 120,569 did, leaving 60,455 patients a year without any radiotherapy at all.
Regional inequalities are rife. In south-west England, 36% of patients receive radiotherapy, meaning around 7,200 patients miss out, while in the south-east, 33.7% receive treatment, with more than 10,100 missing out.
The leading oncologist and chair of Radiotherapy UK, Prof Pat Price, said: “Thousands of cancer patients risk dying prematurely either because they are not getting radiotherapy at all or because of huge delays in starting radiation treatment.”
She added: “Radiotherapy is one of the most cost-effective and curative cancer treatments we have. It is not a ‘nice to have’, this is a life-saving treatment.”
The government needed to urgently invest in more machines and staff and widen access to the treatment. “Otherwise, the UK will remain stuck at the bottom of the cancer survival league tables, and patients will die needlessly.”
The findings follow a 2024 study of 780,000 people, comparing treatment for eight different cancers in each UK nation, Norway, Australia and Canada. The International Cancer Benchmarking Partnership found that people in the UK were less likely to receive radiotherapy and faced considerably longer waits for treatments.
Latest NHS England figures show that in July 2025, 61% of patients waited longer than two months to begin treatment, including radiotherapy, and only 39% of patients in England began radiotherapy within 62 days of referral, less than half the national target of 85%.
Alison was 64 when she was diagnosed with stage 1 breast cancer. Faced with a 15-week wait for surgery at her south coast hospital, Alison decided to use her savings and go private. When she found out after the operation that she would have to wait up to six months for the radiotherapy on the NHS, Alison decided to see if she could be seen quicker somewhere else, as she couldn’t afford any more private treatment. Her consultant referred her to the Christie cancer centre in Manchester, where she received her radiotherapy at the end of June.
Alison praised the Christie for the care she received, but said having to travel more than 200 miles for her treatment was a traumatic experience. “You know, I’ve been through a lot in my life, but the mental anguish that I was put through cannot be overestimated,” she said. “Really, it’s horrendous.
“I spent a week in Manchester going for radiotherapy every single day. I had to ring the little bell for the end of my treatment on my own, over 200 miles away from my family. That is wrong.”
Staff shortages on top of increased demand are behind the delays. According to the Royal College of Radiologists, in 2024, seven in 10 cancer centre leaders said staff shortages were putting patient safety at risk. Experts report that radiotherapy machines are sitting idle in a number of trusts, or are unable to be used at weekends, because no staff are available to operate them. One head of radiotherapy from a large trust in the east of England said the “devastating reality” was that the workforce was at breaking point.
“After 35 years in the radiotherapy profession, I can say with certainty that the situation we face today is the worst I’ve ever seen. Across the country, radiotherapy treatment machines sit idle. Not just because of technical faults, but because there simply aren’t enough staff to run them,” they said.
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The crisis is so acute that 91 radiotherapy leaders working across England wrote to the health secretary, Wes Streeting, on Friday calling on the government to prioritise investment in radiotherapy or risk the failure of their forthcoming cancer plan.
“Radiotherapy has been held back by historical under-investment and systemic under-prioritisation,” the letter says. “As a result, radiotherapy is often left out of major policy conversations and suffers from outdated equipment, slow technology adoption, chronic workforce shortages and stark regional inequalities.
“If we fail to fund and deliver on radiotherapy, [the promise of the government’s cancer plan] will be broken before it even begins.”
Mark Lawler, a professor of digital health at Queen’s University Belfast and chair of the International Cancer Benchmarking Partnership, said: “We are global laggards for both access and timeliness of radiotherapy, behind the likes of Denmark, France, and for lung cancer even Labrador and Newfoundland. I never thought I’d hear myself saying that.”
Dr Stephen Harden, the president of the Royal College of Radiologists, said most patients faced “agonising radiotherapy delays”.
“Amid soaring demand for cancer care, staff shortages and patient delays will only get worse if nothing is done to increase the workforce. While the government has invested in new Linac radiotherapy machines, staff shortages at some cancer centres mean they can’t offer treatment on evenings and weekends.”
A Department of Health and Social Care spokesperson said: “Too many cancer patients are waiting too long for radiotherapy treatment. This government is taking decisive action to get the NHS diagnosing cancer earlier and treating it faster.
“We have already invested £70m in replacing outdated radiotherapy machines across the NHS with cutting-edge technology that will speed up treatment for thousands of patients. We are also addressing workforce shortages, with over 5,800 doctors now working in clinical radiology – almost 200 more than a year ago. Since July 2024, 160,000 more people had cancer diagnosed or ruled out on time.
“Our forthcoming national cancer plan will include further details on how we will improve outcomes for cancer patients, including setting out comprehensive improvements to radiotherapy care for patients, such as how we can harness artificial intelligence to speed up treatment.”
