Dr Phillip Ley speaks to ecancer about the use of IORT at Merit Health surgical oncology.

Dr Ley's institution faces challenges in providing on-site radiation services despite having a dedicated oncologist.

Over four years, 538 cases highlight the need for coordinated patient treatment.

Political advocacy and strong leadership are essential for new service approvals.

Intraoperative therapy shows promise, especially for early-stage tumours.

Establishing a patient registry and promoting new technology are vital for improving care and overcoming community resistance.