Following ongoing discussions and a July 2025 ASTRO member survey about the potential role of advanced practice radiation therapists (APRT) at U.S. cancer care facilities, ASTRO issued the following statement from Board of Directors Chair Sameer Keole, MD, FASTRO:

“The American Society for Radiation Oncology (ASTRO) has a longstanding history of working with radiation therapists and all fellow members of the interdisciplinary radiation oncology treatment team. This is at the core of how we collectively function in the clinic with the shared goal to deliver the highest quality care to patients receiving radiation therapy and follow the scientifically proven standards of care.

As scientific advancements, technology enhancements and treatment best practices evolve, so do the roles within the oncology treatment team. In recent years, the role of an APRT has come to the forefront, and we want to share our perspectives on this issue.

ASTRO understands the need to increase the radiation therapy workforce and to enhance career opportunities for radiation therapists, both of which will improve cancer care and patient care access.

While there is a wide range of what an APRT role may encompass internationally, ASTRO has concerns about expanding the U.S. therapist’s role into the sphere of practice of medicine and its potential impact on safe, high-quality patient care. We oppose delegating core physician responsibilities to APRTs, specifically clinical evaluation or management tasks such as prescribing radiation, approving treatment plans and making medical decisions.

For those interested in greater clinical care responsibilities, existing pathways to become a care provider are well developed in the U.S. and available to interested radiation therapists, including physician assistant and nurse practitioner programs; medical school; and medical physics/dosimetry training. ASTRO also acknowledges the potential value of professional advancement opportunities in management, research and education for radiation therapists interested in these domains.

ASTRO recognizes that a few large centers in the United States with advanced capabilities have locally defined an APRT role based on the specific needs of their institution. However, there is no nationally recognized definition, and ASTRO cannot support a nationally defined role at this time.

ASTRO remains steadfast in recognizing that radiation therapists are critical members of the radiation oncology team with the goal of delivering the safest and most effective care to patients.”