Introduction

Shortly after the discovery of x-rays in 1895, by Wilhelm Roentgen, it was appreciated that x-rays had biological effects and in 1897 the first recorded use of radiation to treat malignant disease occurred. This paralleled the identification and isolation of radium by Marie Curie. The rays emanating from radium were shortly to be used as well for the treatment of cancer. Throughout the early years of the 20th Century, radiation in various forms was successfully used to cure and palliate cancer in an era when anaesthetics were in their infancy, blood transfusion was just beginning and antibiotics were unknown.

The aims of the course in radiation oncology are laid out in detail in this handbook, but essentially a radiation oncologist is an experienced clinician who can manage all aspects of non-surgical cancer medicine for the benefit of patients and their families.

Whilst technical competence and expertise in the application of radiation therapy is expected, the majority of training is dominated by the acquisition of a thorough knowledge of the varied natural history of malignancies and the development of an ability to care for all aspects of patients and their families. Cancer is increasing in incidence and also in relative importance as a major health problem and despite promising developments in other forms of treatment, radiation remains an extremely effective form of treatment, both for cure and palliation. It has been helped in this by enormous strides in medical imaging and increasing sophistication of radiation therapy techniques. Increasingly, combinations of radiation therapy and cytotoxic chemotherapy are giving rise to increased cure rates and also reducing the morbidity of treatment. It is therefore an exciting time to be entering the speciality, as there are enormous changes and research opportunities. Cancer medicine is one of the most dynamic fields of medicine today.

This handbook outlines the comprehensive nature of the training program required and also outlines the details of the Part I and Part II Fellowship examinations.

A career in radiation oncology offers a rapidly changing and evolving environment and considerable intellectual and emotional challenge.

Roger Allison