Radiotherapy should be given at different times of day to reduce side effects, Leicester Uni study suggests

Radiotherapy should be given at different times of day to reduce terrible side effects according to a new study from Leicester University.

A breakthrough study by genetic scientists at the University of Leicester shows that radiotherapy toxicity – the side effects from radiotherapy – can be reduced by scheduling treatment according to the body’s circadian rhythm.

They found that 24 percent of patients treated in the morning had bright red skin after radiotherapy compared to 11 percent of those treated in the afternoon.

The treatment, which uses high-energy rays to target cancer cells, has typical side effects including skin pain, burning and swelling immediately after treatment.

The issues can manifest in nerve damage and weaker bones later down the line.

According to the researchers, around 90 percent of operable breast cancer patients are treated with radiotherapy, of which 45 percent experience nasty side effects in one way or another.

But the new research suggests these can be calmed down, after it revealed the pivotal role of changing the time of day of treatment according to whether a patient is a morning lark or night owl.

Dr Christopher Talbot, Senior Lecturer in Medical Genetics at University of Leicester, said: “This is all part of personalised treatment, it could revolutionise cancer treatment.

“At the moment, people are scheduling appointments in around when they have to pick the kids up from school or they get given a slot whenever the machine is available but only on the basis you must be treated. The NHS may need to adapt to this sort of treatment.”

The study tested 1007 participants for two gene variants to decipher the nature of their circadian rhythms.

All participants had either previously undergone a course of radiotherapy or were currently on one.  

Using information about how they reacted to the treatment both in the short and long term, the researchers were able to understand how timing of radiotherapy could affect different patients according to their genes.

Overall, they found that breast cancer patients suffered worse side effects to radiotherapy in the morning.

Now there is new hope for millions of patients whose side effects could be swerved by simply changing the time of day they go to the hospital.

Dr Talbot and Professor Paul Symonds, a consultant oncologist at Leicester’s Hospitals, feel that the to implement their findings, all cancer patients should have their genes sequenced at the time of diagnosis.

They added: “It’s an upfront cost but it could save a lot of people from getting bad side effects. Those people will be admitted to hospital for their reaction so the money might be a good investment.”

Hospitals should also now schedule appointments according to patients’ body clocks to optimise the treatment and reduce side effects for some breast cancer patients, charities have told The Telegraph.

Dr Kotryna Temcinaite, Research Communications Manager at Breast Cancer Now, which helped fund the research, said: “This exciting study suggests that simply altering the time of day that radiotherapy is given could help alleviate its difficult side effects for some patients. 

“If we are to ensure NHS breast cancer patients receive the best possible care, we must focus on personalising therapies to individuals – and the timing of treatment could be important in doing this.

“As a cornerstone of breast cancer treatment, thousands of patients each year experience the side effects of radiotherapy, such as burning, redness, and changes to the skin. It’s promising that smarter scheduling of appointments could help improve patients’ quality of life, but first we need to understand the potential mechanisms.

“Further, multi-centre trials are now needed to replicate these findings and confirm whether gene tests could help identify patients that may benefit from having their radiotherapy in the afternoon. If confirmed, feasibility studies would then be needed to understand how this research could be translated into a clinical setting.”

Original source: https://www.telegraph.co.uk/news/2019/01/02/radiotherapy-should-given-different-times-day-reduce-side-effects/

Original Date: Jan 2 2019

Written By: Laura FitzPatrick