Before anyone travels, we check a few things. Better you read them here first.
All guidesBefore you come
Who Can Have This Treatment
Not everyone can. Some of the reasons are about the technology and some are practical, and all of them are better discovered now than after you have booked a flight. This page sets out who the treatment suits, who it rules out, and what we need to know before anything can be planned.
The three basic requirements
Before any of the detail, three things have to be true.
- A solid tumour, confirmed on biopsy. The treatment is aimed at a physical mass that can be seen, measured and targeted on a scan.
- You can have an MRI. The scan is not optional. It is what the machine is programmed from, so anything that prevents an MRI prevents treatment.
- You can lie still on your back for an hour. Targeting depends on your position not changing during the session, and the session is a full hour, every day for four weeks.
If all three hold, the rest of this page is about the specific things that would rule treatment out or need working around.
Implants and metal: the most important section
This is the category that rules out most people who are ruled out, and the one most often forgotten at the point of enquiry. Please read it properly.
The treatment delivers a radiofrequency field inside a magnetic field, and the planning depends on an MRI. Both of those interact with metal and with anything electrically powered inside the body. There are two separate problems: devices that could be interfered with or could malfunction, and metal that distorts the field or the scan.
Implanted devices and metal
Tell us about anything on this list before travelling, not on the day of treatment.
Active implants — treatment is not given
- Cardiac pacemakers
- Implanted defibrillators
- Neurostimulators and bio-stimulators
- Cochlear implants
- Hearing aids that cannot be removed
Metal that is incompatible with MRI
- Intracranial aneurysm clips
- Metal fragments within the eye socket
- Intramedullary nails
- Stents close to the area being treated
Other metalwork, such as joint replacements or surgical clips well away from the treatment site, may be acceptable. It depends on what it is and where it sits, so it has to be assessed rather than assumed either way.
If you are not sure what is inside you
Many people are not, particularly after surgery some years ago. Do not guess. Ask your surgeon or GP for the operation note or the implant card, and send it to us before you travel. A five-minute enquiry at home is a great deal better than discovering the problem after a four-thousand-mile flight.
The other exclusions
These come from the protocol used in the published trial and remain the basis on which patients are assessed.
Circumstances in which treatment is not given
None of these is a judgement about you, and two of them can change. Someone too unwell for treatment today may be well enough in a month. Pregnancy ends. If you have been turned down for a reason that is not permanent, ask when it would be worth asking again.
What to tell us before planning
The assessment is only as good as what we know. These are the things that most often change the plan, and the things people most often leave out.
- Every implant, device and piece of metalwork, including older ones you may think are irrelevant. Bring the implant card or operation note if you have it.
- Every treatment you have had, with dates: surgery, chemotherapy, radiotherapy, immunotherapy, targeted drugs and anything on a trial. Radiotherapy to the same area matters particularly.
- Everything you currently take, including supplements and anything bought without a prescription.
- Your most recent scans and reports, ideally the images themselves rather than only the written report.
- Anything that makes lying flat difficult: breathlessness, pain, a cough, claustrophobia, back or hip problems, tremor.
- What your oncologist has said, including any plan already in place, so that nothing we do conflicts with it.
The bed moves into a wide-bore gantry rather than a closed tunnel, and it is more open than an MRI scanner. Even so, an hour a day for twenty-eight days is a real ask if enclosed spaces trouble you. Tell us in advance and it can be discussed sensibly, rather than discovered on day one.
What happens at assessment
Being suitable on paper is the start. The assessment on arrival is what confirms it.
You will have a full clinical examination, blood counts and biochemistry, and any other tests your particular situation calls for. The imaging needed for planning is arranged, and the treatment team reviews everything together before a plan is finalised.
It is possible for the assessment to conclude that treatment is not appropriate, even after you have travelled. That is uncommon, because most problems are caught in the records beforehand, which is exactly why the previous section matters. If it does happen, we will tell you plainly and explain why rather than proceeding anyway.