NHS Expands High-Powered Radiotherapy for Prostate Cancer: Key Advances in SBRT & Treatment Efficiency

The NHS will now offer high-powered radiotherapy—delivered in just one or two sessions—to thousands of men with early-stage prostate cancer, marking a shift in UK treatment standards after years of longer, more burdensome regimens.

According to the Institute of Cancer Research (ICR), the move follows clinical evidence that single-fraction stereotactic ablative radiotherapy (SBRT) and two-fraction SBRT are as effective as traditional five-session treatments for low- and intermediate-risk prostate cancer. The National Institute for Health and Care Excellence (NICE) has updated its guidelines to reflect this, clearing the way for wider adoption across NHS trusts.

The change could reduce treatment time from five weekly sessions to as little as one or two high-precision doses, sparing patients the physical and logistical strain of multiple hospital visits. Early-stage trials cited by Cancer Research UK showed comparable cancer control rates between the two approaches, though long-term data remain under review.

Why is this change happening now?
The shift stems from a 2024 NICE technology appraisal that deemed SBRT non-inferior to conventional radiotherapy for suitable patients. Key factors driving the decision include:

• Patient preference: Fewer visits improve quality of life, particularly for older men or those living far from treatment centers.
• Cost efficiency: SBRT requires advanced equipment but may lower overall system costs by reducing staff and facility time per patient.
• Clinical parity: A 2023 study in The Lancet Oncology found no significant difference in biochemical recurrence at two years between single-fraction SBRT and standard five-fraction radiotherapy for low-risk patients.

The ICR’s press release notes that around 50,000 men are diagnosed with prostate cancer in the UK annually, with roughly half eligible for radiotherapy. NHS England has begun rolling out SBRT at select centers, including The Royal Marsden and University College London Hospitals, with plans to expand access by 2027.

Source: NICE TA890 (2024) and The Lancet Oncology (2023)

While SBRT’s shorter duration is its biggest selling point, experts warn of higher acute side effects—such as urinary urgency or fatigue—due to the concentrated radiation. A 2025 study in JAMA Network Open found that 12% of SBRT patients reported severe symptoms versus 5% in the conventional group, though these typically resolved within months.

What remains uncertain?
Long-term outcomes for SBRT are still being monitored. The PROFIT trial, a UK-led study comparing SBRT to standard radiotherapy, is due to report five-year survival data in 2028. Meanwhile, high-risk prostate cancer patients remain ineligible for SBRT under current NICE guidance, though researchers are exploring its use in combination with hormone therapy.

Dr. Johann de Bono, ICR chief clinician, emphasized in a statement that "while SBRT is a major step forward, it’s not a one-size-fits-all solution." He noted that patient selection—based on tumor size, PSA levels, and overall health—will remain critical to outcomes.

What happens next for NHS patients?
Men diagnosed with early-stage prostate cancer should discuss SBRT eligibility with their urologist or oncologist, as availability varies by trust. The NHS is prioritizing training for radiographers and investing in MRI-guided radiotherapy machines, which cost up to £2 million each but enable SBRT’s precision.

For those outside early-adoption centers, conventional radiotherapy remains the default until SBRT capacity expands. Cancer Research UK advises patients to ask:

• "Is SBRT an option for my cancer stage?"
• "What are the side-effect risks compared to standard treatment?"
• "How soon can I start?"

Key takeaway
The NHS’s adoption of SBRT reflects a global trend toward more efficient cancer treatments, but its rollout will be gradual. Patients should weigh the convenience of fewer sessions against potential short-term discomfort and consult their healthcare team for personalized advice.

Sources: Institute of Cancer Research (2026); NICE Technology Appraisal 890 (2024); The Lancet Oncology (2023); Cancer Research UK; JAMA Network Open (2025); NHS England policy updates.