Making radiotherapy greener: why taking a greener path matters
This article examines the environmental impact of radiotherapy and argues that sustainability must become an integral part of cancer care. The authors highlight that while radiotherapy is an effective, precise and cost-efficient treatment, it also contributes to healthcare-related carbon emissions at a time when the NHS is committed to achieving net zero targets.
The article explains that the carbon footprint of radiotherapy extends beyond treatment delivery itself. A patient’s journey involves imaging, treatment planning, multiple hospital visits, equipment use, energy consumption and medical consumables. Research shows that patient travel is often the largest source of emissions, accounting for up to 80 per cent of the carbon footprint in some external beam radiotherapy pathways, while building energy use and machine operation are also significant contributors.
A major strategy for reducing emissions is hypofractionation, where fewer treatment sessions are delivered at higher doses. This approach decreases patient travel, reduces equipment usage and energy demand, lowers waste and maintains treatment effectiveness. The Royal College of Radiologists’ Green Radiotherapy Framework estimates savings of approximately 300kg of CO2 equivalent per patient through hypofractionated treatment schedules.
The authors also discuss how climate change threatens radiotherapy services through extreme weather events, which can disrupt transport, staffing and hospital operations, potentially delaying treatment and affecting patient outcomes. As climate-related risks and cancer incidence associated with environmental pollution increase, radiotherapy services must become both greener and more resilient. The article concludes that sustainability is no longer optional but essential for safeguarding healthcare delivery and public health.
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