The Invisible Backbone of Cancer Care: Empowering Radiation Therapists in Low- and Middle-Income Countries (LMICs) – A Vision for 2040

Background: Radiotherapy is essential to cancer management, yet access remains unequal in low- and middle-income countries (LMICs), where workforce shortages, limited infrastructure and inadequate training constrain service delivery. These gaps further widen disparities between regions and populations globally.

Objective: This article highlights the contribution of radiation therapists (RTTs) and examines priorities for strengthening their professional role towards 2040.

Discussion: It explores workforce challenges, competency-based education, continuing professional development, career progression, research participation and professional recognition. It also considers how artificial intelligence, image-guided radiotherapy and adaptive treatment technologies may reshape clinical practice. Safe implementation requires appropriate training, quality assurance, multidisciplinary collaboration and human oversight.

Conclusion: Empowering RTTs through sustainable education, institutional support, leadership opportunities and policy development is essential to building a skilled workforce and improving access to safe, equitable and high-quality cancer care in LMICs.