Professor Murray Brunt and his team at Keele University have just upended a tradition in cancer care: for decades, women recovering from breast cancer surgery have faced three weeks of daily radiotherapy appointments. Now, a landmark 10-year study proves that just five days works just as well.
The FAST-Forward trial, sponsored by The Institute of Cancer Research in London, followed over 4,000 patients for a decade after their treatment. The results, published in The Lancet Oncology, show that a one-week radiotherapy course delivers the same cancer control as the traditional three-week schedule—a finding that has already begun reshaping clinical practice across the U.K. and beyond.
The research compared the standard approach of 15 treatments over three weeks with two shorter schedules of five treatments compressed into one week. After a decade, cancer recurrence in the treated breast was strikingly low across all three groups: 3.6% for the traditional three-week treatment, 2.9% with the one-week treatment at a slightly higher dose, and 2.1% with the one-week treatment at a slightly lower dose. The lower-dose one-week schedule—now the recommended option—produced side effects virtually identical to the standard approach, with no increase in long-term breast or chest wall changes.
What makes this finding so significant extends far beyond convenience. Breast cancer is one of the world's most common cancers, and radiotherapy plays a critical role in preventing recurrence after surgery. Roughly 37,000 people in the U.K. alone receive radiotherapy for breast cancer each year. By cutting treatment from 15 sessions to five, the research team has created immediate benefits for patients and healthcare systems alike. People undergoing treatment face fewer hospital visits and less disruption to their daily lives. Radiotherapy services, perpetually stretched and under pressure, gain critical breathing room.
The impact has already begun. Since 2020, when the five-year results first drove a shift in clinical practice, tens of thousands of U.K. patients have already benefited from the shorter course on the NHS. But the potential extends globally. In lower-income countries and regions where access to radiotherapy remains limited, this streamlined schedule could mean the difference between receiving life-saving treatment and going without.
Professor Brunt reflected on what has moved him most throughout the trial: "Hearing patients talk about how much it helps to only need one week of radiotherapy has been really encouraging for everyone involved." His co-investigator, Professor Judith Bliss of The Institute of Cancer Research, emphasized the equity dimension: the more accessible schedule has proved particularly valuable for people who struggle to attend hospital repeatedly and those in lower-income countries.
The work is far from finished. Researchers are now investigating the FAST-Forward Boost trial, which explores whether an additional concentrated radiation dose for higher-risk patients can also be safely delivered within those same five days. The success of FAST-Forward has sparked a broader shift toward more efficient radiotherapy approaches—a reminder that sometimes the most transformative discoveries in medicine come not from inventing something entirely new, but from testing whether doing less, more thoughtfully, might serve patients better.