MR-Linac SABR is available on the South Coast.
For surgeons, oncologists, GPs and MDT coordinators across Hampshire and Dorset, including Poole, Bournemouth, Dorchester, Portsmouth, Salisbury, Basingstoke, Chichester and the Isle of Wight. Dr Harinarayanan is a consultant clinical oncologist at University Hospital Southampton and one of a small number of oncologists in the region accredited to deliver MRI-guided stereotactic radiotherapy. This page says who is suitable, how to refer and how fast he replies.
Who to think of
Oligometastatic disease: a limited number of secondaries in the lung, liver, lymph nodes, bone, spine or adrenal. Rectal cancer where organ preservation or re-irradiation is a question. Complex pelvic recurrence. Selected primaries.
What to send
A referral letter, the histology, and the relevant imaging (CT, MRI, PET as available). No patient-identifiable details through the web form; send those to the secretary.
What happens
He reviews the imaging and replies promptly, with a view on suitability and next steps. The patient is seen at Spire Southampton; treatment is delivered at GenesisCare's London, Guildford or Oxford centres, and the patient returns to your care, or he takes on the pathway, as you prefer.
What MR-Linac SABR adds
An MRI scanner built into the linear accelerator. The target and the organs at risk are imaged at each fraction and the plan is adapted before delivery, so the margin can be tight and the dose high in sites where a CT-guided plan is limited by nearby bowel, stomach or duodenum. For selected oligometastatic disease that means ablative doses in a short course.
For the indications he treats, MR-Linac SABR is not routinely commissioned on the NHS. The one exception is GenesisCare Oxford, which has a limited NHS contract for a small number of patients on a compassionate basis; elsewhere access is private, self-pay or insured. He is happy to discuss whether an NHS route exists for a given patient.
Other treatments he delivers privately: CT-guided SABR, IMRT and VMAT, re-irradiation, chemotherapy, immunotherapy and targeted therapy, and second opinions.
Referral questions
Which patients are suitable for MR-Linac SABR?
Patients with a limited number of secondaries (oligometastatic disease) in the lung, liver, lymph nodes, bone, spine or adrenal gland, and selected primary tumours. Suitability is decided case by case on the imaging. If you are unsure, send the scans and he will say.
How do I refer?
A referral letter and the relevant imaging to the secretary by email or post, or the form on this page for a first conversation. Insured patients need the referral for their insurer; self-pay patients do not.
How quickly does he respond?
He aims to reply to referral enquiries promptly. Urgent cases: phone the secretary and say it is urgent.
Where is the treatment delivered?
MR-Linac SABR at GenesisCare's centres: Cromwell Hospital London, GenesisCare Guildford and GenesisCare Oxford. Consultations, other radiotherapy and systemic treatment at Spire Southampton.
Can he take over the whole pathway?
He can deliver the full oncology pathway privately, radiotherapy, chemotherapy, immunotherapy and follow-up, or a single defined treatment with the patient returning to your care afterwards. Say which you prefer in the referral.