# Advanced-practice radiation therapists doing contouring and on-treatment reviews

Source: https://onco.cc/ideas/idea-acc-advanced-practice-radiation-therapists/  
OnCo record `idea-acc-advanced-practice-radiation-therapists` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Radiation therapists, the staff who deliver daily treatment, can be trained to outline normal organs on scans and to review patients during treatment, work that oncologists now do.

## Summary

The UK, Canada, and Australia have advanced-practice radiation therapist roles covering organ-at-risk contouring, on-treatment review, palliative planning, and image-guidance decisions, with evidence of equivalence to physician performance and reduced waiting times. Most countries have no such role. Recognising and funding advanced practice would enlarge the effective workforce without new professions.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Departments with advanced-practice therapists will cut referral-to-treatment time by at least 20% and free at least 15% of oncologist clinical time, with contouring concordance to oncologist reference at or above inter-oncologist variability.
- Rationale: Contouring of normal structures and routine on-treatment review are protocol-driven tasks well suited to a trained non-physician workforce, as demonstrated in existing programmes.
- Proposed test: A multi-centre implementation study with blinded contour-concordance scoring, waiting-time and physician-time measurements, and patient experience surveys.
- Maturity: being-tested-at-scale
- Actor: regulator

## Sources

- Bottleneck evidence (Not enough oncologists, nurses, pathologists, physicists): Yang et al., Projected supply of and demand for oncologists and radiation oncologists through 2025 (JOP 2014): https://doi.org/10.1200/JOP.2013.001319

## Connected records

- fronts: [Radiation Therapy](https://onco.cc/fronts/radiation/)
- technologies: [IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/)
- bottlenecks: [Not enough oncologists, nurses, pathologists, physicists](https://onco.cc/bottlenecks/b-workforce/), [Surgery and radiotherapy cure most, get least](https://onco.cc/bottlenecks/b-surgery-radiation-innovation/)
- key papers: [Projected supply of and demand for oncologists and radiation oncologists through 2025: an aging, better-insured population will result in shortage](https://onco.cc/key-papers/paper-yang-j-oncol-pract/)

---
JSON: https://onco.cc/api/v1/entities/idea-acc-advanced-practice-radiation-therapists.json