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    Wouldnt radiation thats so accurate that you only need 1 treatment be part of the answer?
    Cyberknife is used all over the world and generally takes one 2 – 3 hr session. If i lived remotely and had this option I would head into my nearest Cyberknife centre and have it done. No side effects so back to work/normal life the next week. Available worldwide for over a decade but most people here have never heard of it. India has 2 hospitals using it, who is 3rd world? Learn more and support getting Cyberknife to Australia:

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    Is the issue lack of hardware or lack of staff? If its lack of hardware then it really is just a case of throwing money at it.

    Or is radiotherapy not seen as cost-effective compared to other options?

    And now for my anecdote:

    My mum had breast cancer. The least nasty form as I understand it. Biopsy or two to remove the very small lump(s). Couple of weeks of radiotherapy in a regional center. I know it was fairly tight to get timeslots to get microwaved (not sure if having private insurance made a difference, probably did).

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    Anyone who can benefit from medical treatment will seek access and will argue forcefully their rights to such access. Anyone denied access to treatment on whatever grounds such as lack of knowledge, time, distance, resources can claim disadvantage or discrimination. The economic, social and other losses from premature death can be calculated and the numbers can be impressive. However there needs to be a balance between cause and effect and at present, with the aging of the baby boomers, we are going to see greater demands for access to services than our ability to provide them. The question that then needs to be raised is are we utilising our present resources to best effect? If we need to make choices regarding access to services then on what basis should we do so?

    At present many resource allocation decisions, macro and micro, are made for idiosyncratic reasons. The extent to which evidence informs those decisions is not always apparent. So while the NSW Cancer Council is acting in its capacity as a lobbyist to what extent should their claims of disadvantage in access be offset by the choices individuals have made, in the light of evidence, to continue in their lifestyle. Excesses of sunlight, calories, speed, consumption of drugs (licit and illicit) all carry risks. As individuals we seem to be able to ignore our personal responsibility in contributing to our health status by claiming that if diagnosed and if able to benefit (regardless of the magnitude of benefit) then we should have unlimited access to health care regardless of the consequences to others. The Tragedy of the Commons analogy suggests “selfish” consumption will always exceed the ability of sustainable and equitable access. By selfish I mean the interests of the individual being placed higher than the collective interests of the community or society.

    If we cannot dramatically alter the amount of resources available then we need to ensure that the manner in which we allocate them is optimal. Not all people who seek access to radiotherapy will benefit equally. The question we need to ask in parallel to whether we should increase resources to avoid the current unmet demand for radiotherapy services, is at what point does premature death become mature? If we want to keep on extending existence then we need to consider the resources required for that.

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    M Barton

    Radiotherapy is one of the most cost effective forms of cancer treatment. We have previously calculated that radiotherapy costs less per life year gained than common medical interventions such as treating high blood pressure. For non-curative treatments it is more cost-effective to use radiotherapy for problems such as bone pain than to use drugs such as morphine. So a rational use of health resources suggests a modest investment in radiotherapy.
    For the price of a Pacific Solution we could easily close the gap between actual and optimal radiotherapy services.


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