Radiotherapy can be extremely effective against all kinds of cancer, using radiation to disrupt the DNA of cancer cells and prevent them from dividing and multiplying. It can shrink tumours, extend life, and, in many cases, eliminate cancer.

However, like many medical interventions, radiotherapy treatment does come with side effects. These can be varied, but the most common effects include:

• Fatigue
• Difficulties with eating and drinking
• Nausea
• Sore and discoloured skin
• Hair loss
• Loss of fertility (if radiotherapy occurs in the pelvic area or around the pituitary gland at the base of the brain)

This is not an exhaustive list, but it provides a clear picture: Radiotherapy can bring some unpleasant side effects that need to be handled and managed.

However, as radiotherapy has been used since the turn of the 20^th century, these side-effects have become well understood and although they cannot be avoided, there are various ways in which they can be minimised in many cases, making the process much more manageable for patients.

What Activities Can You Still Do While Undergoing Radiotherapy?

For example, you might know people who have had cancer yet managed to do some very active things while undergoing treatment. An example of this that Alastair Welford, a 67-year-old from Warwickshire who recently began a 400-mile cycling challenge to raise money for a cancer charity, all while receiving radiotherapy for prostate cancer,

Mr Welford has not been free of side effects, but evidently they have not been so serious as to prevent him from undertaking a challenge that might be beyond many people in better health and of much younger age.

In his case, the treatment being given is MRI-guided radiotherapy. You may be familiar with MRI scans, which can be used to provide clear internal images of the body so medics can establish what is happening in a particular area without the need for an exploratory operation.

The benefit of using an MRI in cancer treatment is that it can help to locate precisely where a tumour or cluster of cancer cells is situated, as well as the size of the area. Modern use of MRI enables 3D imaging, which means that this can then be used to ensure the radiation applied in radiotherapy is directed with greater precision.

How Has More Precise Radiotherapy Been Made Possible?

Achieving increased accuracy in radiotherapy has been a key area of enhancement in the treatment. The more radiation can be directed very precisely at a cancer, the greater the medical effects in shrinking tumours and disrupting cancer cells. At the same time, the less radiation that gets into the surrounding tissue, the milder the side effects.

Indeed, the most accurately directed radiotherapy can require fewer sessions of treatment to have the necessary effects, because it is delivered more efficiently. This means reduced appointments and is therefore more practical for patients.

Radiotherapy can be delivered in different ways and for a condition like prostate cancer, external beam radiotherapy is used, directing the beams with precision at the affected area.

Among the innovations that have made possible more precise and intensified delivery of radiation is stereotactic radiosurgery. The term was invented in the late 1960s by Swedish neuroscientist Lars Leksell.

He invented the term as he introduced his defining invention to the world: the Gamma Knife. This device, despite its name, was anything but a knife, for it made non-invasive neurosurgery possible for the first time, as well as more precise radiotherapy.

The Gamma Knife is designed precisely for cases where the radiation has to be directed at very precise points, such as small tumours, but its original purpose was to deal with neurosurgery and that involves minimising the amount of brain tissue that is exposed to radiation.

How Can Stereotactic Radiotherapy Benefit Prostate Cancer Patients?

However, stereotactic radiosurgery can also be applied to other parts of the anatomy on the same principle; that it is beneficial to the patient to minimise the exposure of radiation for sensitive organs that lie close to the site of the cancer.

This can apply to prostate cancer, as that can reduce exposure to nearby pelvic organs. As well as issues of fertility, notable side effects can include incontinence. Prostate cancer patients may still suffer from these (especially infertility), but the exposure to radiation of other organs nearby will be reduced and the wider impact minimised.

Of course, not every patient will be able to jump on a bike and ride 400 miles over the course of a few days between treatment sessions. But equally, stereotactic radiosurgery is delivered in a way that will bring a lot less disruption to normal life than other forms of radiotherapy.

This will mean that it takes less time out of your schedule, while also enabling you to do more of your normal activities.

Learn more about our advanced radiotherapy treatments for different cancers on the Amethyst Group website.

Leukaemia comes in several different forms and the available treatments vary. For those with acute myeloid leukaemia (AML), there are different chemotherapy options and research has indicated some of them may be much more favourable for older patients.

If you or a family member has leukaemia, the diagnosis can be confusing. The term relates to blood cancer, but there are several different forms of the disease.

The most common types include:

• Chronic lymphatic leukaemia
• Acute lymphatic leukaemia
• Chronic myeloid leukaemia
• Acute myeloid leukaemia (AML)

The chief distinction in types is between chronic leukaemia, where the cancer is slow-growing, and acute, where it progresses quickly.

In the latter case, the disease is manifested in the bone marrow, where non-functional blood cells build up in the marrow. This absence of function impedes the ability of the marrow to produce sufficient healthy blood cells.

For a patient diagnosed with AML, this means there is an excessive production of abnormal white blood cells, which reduces the production of the normal type responsible for essential immune system functions.

How Is Acute Myeloid Leukemia Treated?

Treatments for AML can include chemotherapy as well as radiotherapy, stem cell treatments and targeted therapy.

As with any cancer, every patient’s circumstances are different, based on various demographic, background health, genetic and other factors, as well as how early the diagnosis takes place.

Many patients might find that this is not their experience of treatment; however. Some may encounter a formulaic, one-size-fits-all approach.

This might work well for some patients but much less so for others. That is why many patients could benefit greatly from personalised private chemotherapy treatment.

In the case of AML, chemotherapy usually starts very soon after diagnosis and can involve an extended hospital stay. Combinations of different therapies are given, each aiming to target cancer cells.

Because this can take weeks and the side effects can be significant for patients, the preferred treatment is one that is as gentle as possible, especially for older, frailer patients who may not be in sufficiently robust condition to handle some treatments.

This must be balanced with finding the most effective treatments that have the greatest impact on the cancer to produce the best longer-term patient outcomes.

Are There Any New Chemotherapy Developments For Acute Myeloid Leukemia?

Encouraging news on this front has emerged from new research in the United States. The University of Miami Miller School of Medicine has published a study with the positive conclusion that the newest chemotherapy drugs offer older adults the dual benefits of being gentler with less pronounced side effects, as well as significantly better patient outcomes.

Although AML can affect patients of any age, the prevalence is far higher in people over the age of 60, which means a combination of age and the emergence of other health conditions in later life can limit the tolerance patients have of intensive therapies.

This has seen the old, standard approach of newly diagnosed patients undergoing intensive chemotherapy (and sometimes other treatments) early on in an attempt to achieve remission with gentler, low-dose therapies that have proved more effective in terms of final outcomes (extended life and outright cures), as well as being more tolerable.

Summarising these findings, which were published in the journal Blood Advances, study leader Mikkael Sekeres said: “The landscape of AML treatment has changed dramatically with more effective therapies,” adding that recent research has led to the US Food and Drug Administration approving three new acute leukaemia drugs in the past two years.

However, he observed, incorporating new drugs into patient treatments is not a quick process.

Even so, the fact that new drugs with better all-round outcomes for older patients in particular have emerged provides good reasons for increased optimism about the ability of patients to handle the treatment and the outcomes.

How Can Personalised Therapy Help AML Patients?

If you have AML, the chemotherapy you may have had so far might have followed the more standard path and might have turned out to be gruelling. It may not necessarily be effective either, as it is in the nature of such treatments that some drugs work better on some patients than others.

This is why tailored private chemotherapy treatment may provide solutions that other treatments you have received up until now have not. Our approach is always centred on the patient as an individual and the development of new chemotherapy drugs provides more opportunities to offer something new and different.

If you come to us for cutting-edge chemotherapy treatment for AML or other forms of leukaemia, you can be sure we will provide personalised care based on the best available options, which will take all of your circumstances into account.

Learn more about our advanced chemotherapy treatments for leukaemia on the Amethyst Group website.

Breast cancer is one of the most common forms of cancer affecting women and, like so many other cancers, the prospects for the patient depend heavily on early diagnosis and treatment.

Radiotherapy treatment can play a major role, but for certain risk groups it may not be needed following a mastectomy. This article explains what has changed and what has not.

Breast cancer most commonly affects women over the age of 50, but it can affect patients below this age. Men can develop breast cancer too, although this is very rare.

The first signs are usually the discovery of an unusual lump in a breast. Screening and other tests can help to confirm if the lump is benign or cancerous.

How Is Breast Cancer Treated?

Once a diagnosis takes place, there are several treatment options. These are:

• Mastectomy (surgical removal of the whole breast)
• Breast conserving surgery (when the cancerous tissue is removed along with surrounding breast tissue, but most of the breast remains in place)
• Chemotherapy
• Hormonal therapy
• Radiotherapy

These are often used in combination. For example, adjuvant chemotherapy and hormonal therapy may be used before surgery.

In stages 1-3 of cancer, Radiotherapy can be used after surgery, both after breast-conserving surgery and a mastectomy.

However, you may rightly query whether radiotherapy will be used after a mastectomy, as recent research has indicated that this may no longer be necessary. This was the finding of an international study carried out by the University of Edinburgh in the UK and published in the New England Journal of Medicine.

What Did The Edinburgh Study Reveal About Post-Mastectomy Radiotherapy?

Normally, radiotherapy is used after various kinds of cancer surgery to target any remaining cancer cells that remain following surgery. This can apply to various cancers found in different parts of the body.

However, the Edinburgh study found that when surgery is used in conjunction with anti-cancer drugs, radiotherapy can safely be skipped with no adverse consequences for patients.

A study of patients from 17 countries revealed that the ten-year survival rates were not significantly different between those who had undergone post-operative radiotherapy and those who had not.

Specifically, there was no difference between the two groups in either the recurrence of the disease or metastasis (where secondary cancer takes place as it spreads from the original site to other parts of the body).

When Might Radiotherapy Still Be Used For Breast Cancer?

However, while this study indicates that radiotherapy may not be useful in this particular instance, when a full mastectomy has been carried out early after diagnosis, there are other instances when radiotherapy may still be an important and effective treatment.

Firstly, the study only applied to the situation for patients who had undergone a mastectomy, so it does not provide any basis to change established practice for patients who have had breast-conserving surgery.

Secondly, radiotherapy can be particularly important in treating secondary cancer that has arisen from breast cancer.

Two key factors can influence the likelihood of this happening: the first being later diagnosis, which gives the cancer a greater chance to spread before treatment, while the second depends on variations in oestrogen receptor status, which makes some patients more likely to experience metastasis than others.

Radiotherapy is not the only treatment you may have for secondary cancer, with others including chemotherapy and hormonal treatments, but it is commonly used.

This will be delivered as external beam therapy and locations where this is often used include the bones or the brain, these being two of the most common sites for secondary breast cancer to manifest.

What Are the Benefits Of Personalised Radiotherapy For Secondary Breast Cancer?

Benefits arising from such treatment include the relief of symptoms and the slowing down of cancer progression. Although secondary breast cancer is usually not curable, radiotherapy and systemic treatments can often control the disease and help people live well for longer.

If you come to our private radiotherapy centre, our work will involve devising the right treatment programme based on your circumstances. That may include post-op radiotherapy if you have had breast-conserving surgery for primary cancer, or radiotherapy for secondary cancer.

Each treatment programme is geared to the needs of the individual. This is partly because of variations in your medical situation, such as where any secondary cancer has spread to, your age, your overall medical health, as well as what has (or has not) worked well in any previous treatment you have had.

Beyond this, our aim is always to ensure every patient is treated as the individual they are, tailoring each and every aspect of care to their personal circumstances in order to provide the best possible patient outcomes.

Learn more about our advanced radiotherapy treatments for breast cancer and secondary cancers on the Amethyst Group website

The beginning of cancer treatment can feel like a whirlwind at times; following a positive diagnosis, a lot of different stages of treatment progress very quickly to ensure you receive the highest quality radiotherapy treatment as soon as it is appropriate to do so.

This includes the initial tests, referrals, the specialist tests which confirm the diagnosis, the establishment of a multidisciplinary team and the development and finalisation of a treatment plan to be executed as soon as possible.

All of this takes place in a relatively short space of time before the new normal of regularly scheduled radiotherapy sessions can begin and a routine can be established around them.

However, the end of cancer treatment, whether it is the end of a specific course of radiotherapy, or a switch to an alternative treatment cycle or stage of care, is a significant milestone that can feel almost the opposite of this.

Rather than moving quickly from phase to phase of pre-treatment, there is the final session of radiotherapy and then a delay between that and the first follow-up appointment.

This is a point that can lead to a wide range of different feelings that can vary from person to person and can depend on the nature of the treatment itself.

However, one big question that many people will have if their treatment has a specified endpoint is how long it will take before they have recovered enough to return to an everyday routine.

There is no single answer, as whilst some people may feel better relatively soon after the last radiotherapy session, other people may take longer to figure out what their “new normal” is.

With that in mind, here is a broad idea of what recovery might look and feel like to you, how long you should expect to take to feel better, and what you can do to help make the recovery process as comfortable and smooth as possible.

Does Treatment End After The Final Appointment?

An important aspect of radiotherapy to remember is that it will continue to take effect for weeks and sometimes months after the final treatment session. This means that whilst the final treatment appointment is the last part of your cancer treatment, it has not necessarily ended.

Your cancer care team is more than aware of this, and your final appointment will not only involve the radiotherapy dose itself but also arranging the first follow-up appointment, answering questions about any concerns and letting you know what to expect following treatment.

There will always be someone available to act as your contact, so you are not alone during this process, and there will be regular tests in the first year or two to ensure that the cancer has fully gone away.

Your doctor will always be available to help with any health concerns as well and provide support on a local level. If you have received treatment internationally for cancer, make sure to book an appointment with them once you get back home.

How Long Should You Rest After The Final Appointment?

It is unfortunately rather common to feel pressured into returning to everyday life as soon as possible. Sometimes that pressure is placed on ourselves, whilst in other cases it can come from family, friends or employers.

As with any other illness, this stress and pressure can delay recovery, particularly for radiotherapy treatments where the dose of radiation is continuing to work to destroy cancer cells long after the final appointment.

This means that, much like during the treatment itself, you may have some days where you feel more capable and active than others. Recovery takes time, gentleness and support, and it is important to avoid pushing yourself too hard too quickly.

In general, a rule of thumb is to wait until your first follow-up appointment before considering a return to a similar level of activity you may have had before your diagnosis, although you can start undertaking gentle exercise and start to make some lifestyle changes sooner than this.

What Is The Difference Between Side Effects And Late Effects?

During treatment, your cancer team may inform you about the potential for side effects in order to ensure that you are prepared ahead of time and can take steps to minimise these effects.

For example, if a radiotherapy specialist warns of potential skin irritation that can occur during and after radiotherapy sessions, this information can help you find appropriate moisturisers, balms and treatments that can help reduce the effects.

On a similar note, late effects are potential symptoms that can occur months and sometimes years after treatment, and your cancer care team should mention these in the final appointment and first follow-up appointment.