An analysis of video footage, taken during 20 operations, shows that some operating theatre teams are negatively affected by background music, during surgery.

Researchers suggest that the decision to play music during an operation should be made by the entire team, taking into account both the benefits and the risks.

The study suggests that communication within the theatre team can be impaired when music is playing. For instance, requests from a surgeon to a nurse for instruments or supplies were often repeated and there was qualitative evidence of frustration or tension within some of the teams.

Sharon-Marie Weldon, a lead author of the study from the Department of Surgery and Cancer at Imperial College London, said:

Millions of people are dying from potentially treatable cancers like breast and prostate because of a chronic underinvestment in radiotherapy resources, according to a major new Commission on access to radiotherapy.

New estimates produced for the Commission reveal that 204 million fractions of radiotherapy will be needed to treat the 12 million cancer patients worldwide who could benefit from treatment in 2035. Despite the enormity of the problem, say the authors, the cost per fraction is highly cost-effective and very low compared to the high price of many new cancer drugs.

The Commission estimates that full access to radiotherapy could be achieved for all patients in need in low-and middle income countries (LMIC) by 2035 for as little as US$ 97 billion, with potential health benefits of 27 million life years saved, and economic benefits ranging from US$ 278 billion to US$ 365 billion over the next 20 years.

‘There is a widespread misconception that the costs of providing radiotherapy put it beyond the reach of all but the richest countries. Nothing could be further from the truth’, says Commission author Professor Rifat Atun from Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA. ‘Our work for this Commission clearly shows that not only can this essential service be deployed safely and high quality treatment delivered in low- and middle-income countries, but that scale-up of radiotherapy capacity is a feasible and highly cost-effective investment.’

The Commission exposes the reality of radiotherapy services on a country-by-country basis across the world and, for the first time, calculates the costs and benefits of meeting the worldwide shortfall in resources and bridging the gap in access to effective treatment.

Radiotherapy treatment is essential for the cure and palliation of most cancers including breast, lung, prostate, head and neck, and cervical cancers. Up to 60% of all cancer patients will require radiotherapy at some point. New estimates produced for the Commission find that in 2035 over 12 million new cancer patients could benefit from radiotherapy treatment. Yet, worldwide access to radiotherapy is unacceptably low, with only 40-60% of cancer patients having access to this vital treatment.

Even in high-income countries like Canada, Australia, and the UK, numbers of radiotherapy facilities, equipment, and trained staff are inadequate.

Access is worst in low-income countries where as many as nine out of 10 people cannot access radiotherapy treatment. The problem of access is especially acute in Africa, where in most countries radiotherapy treatment is virtually non-existent, and where 40 countries have no radiotherapy facilities at all.

Radiotherapy has, until now, been overlooked as a critical need for the health of the world’s population and is often the last resource to be considered when planning cancer control systems. Persistent underinvestment in radiotherapy resources has already resulted in millions of unnecessary deaths. News-Medical

At a median follow-up of 10.9 years, an EORTC study has shown that irradiation of regional nodes in patients with stage I, II, or III breast cancer has a marginal effect on overall survival, the primary endpoint (at 10 years, overall survival was 82.3 % for regional irradiation versus 80.7% for no regional irradiation, (HR=0.87 (95%CI: 0.76, 1.00), p=0.06). The results also showed that disease-free survival, distant-disease-free survival, and breast cancer mortality were significantly improved. Side effects were very limited, although very long-term toxicity of radiation remains unknown.

The phase III EORTC 22922-10925 trial was conducted to evaluate what effect regional node irradiation, i.e., irradiation of the internal mammary and medial supraclavicular lymph nodes, would add to whole breast or chest wall irradiation following surgery in patients with stage I, II, and III breast cancer.

Prof Philip Poortmans of the Radboud university medical center, Nijmegen, The Netherlands says:

The implementation of a

Brain tumour tissue can be hard to distinguish from normal brain during surgery. Neurosurgeons use their best judgment in the operating room but often must guess exactly where the edges of the tumor are while removing it.

Even the state-of-the-art imaging equipment in today