Inside Amethyst Healthcare’s PPP Strategy with CEO Stephane Carre

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In today’s rapidly evolving healthcare landscape, Public–Private Partnerships (PPPs) represent more than just a financial model—they serve as a cornerstone for innovation, increased access, and long-term sustainability. Amethyst Healthcare Group, under the leadership of CEO Stéphane Carré, is championing this approach. In a recent interview with The CEO Magazine, Carré detailed how Amethyst is strategically leveraging PPPs to deliver cutting-edge cancer care to more patients across Europe.

The Role of PPPs in Modern Healthcare

Healthcare systems across Europe are grappling with a dual pressure: tightening budgets and rising demand for services. PPPs present a viable solution by combining the reach and reliability of public institutions with the agility and technological edge of private enterprise. When executed effectively, these partnerships can enhance service quality, increase efficiency, and broaden patient access.

Amethyst has been a firm advocate of this collaborative model since its inception. Through enduring partnerships with hospitals and public health organizations, the company provides advanced radiotherapy services—relieving pressure on public resources while ensuring high standards of patient care. This alignment results in a dual benefit: enhanced healthcare delivery for patients and sustainable models for providers.

Expanding Access Through Real-World Impact

One notable example of Amethyst’s PPP success is its collaboration with Centre Hospitalier de Troyes in France. By managing the hospital’s radiotherapy unit, Amethyst enables the facility to offer cutting-edge treatments without requiring a substantial capital outlay. This approach removes financial and operational barriers, significantly improving access to lifesaving care—especially in underserved regions.

In the UK, the company’s acquisition of Queen Square Radiosurgery Centre in London brought advanced Gamma Knife technology to both private and NHS patients. Since 2023, patient numbers at the center have doubled, underscoring how PPPs can rapidly enhance treatment capacity and introduce breakthrough technologies into public healthcare frameworks.

Driving Innovation While Sharing Risk

One of the key advantages of PPPs is the ability to introduce innovation without placing the entire financial or operational burden on public systems. Amethyst’s model epitomizes this principle. By investing in and managing radiotherapy centers on behalf of public institutions, the Group delivers excellence in care with a streamlined, patient-focused approach.

This model not only facilitates faster adoption of advanced technology but also enhances overall service quality—reducing waiting times, minimizing inefficiencies, and improving patient outcomes.

Scaling for Sustainable Impact

Since 2020, Amethyst has recorded an 84% increase in the number of patients treated annually, including a 70.1% rise in NHS-referred patients. These figures highlight more than just growth—they reflect the potential of PPPs to sustainably expand healthcare capacity and ease the burden on national systems like the NHS.

Looking ahead, Amethyst plans to scale its operations to 50 clinics and over 100 linear accelerators across Europe. This ambitious expansion is firmly anchored in its PPP-driven strategy, which remains a central pillar of the Group’s vision for the future.

Redefining Collaborative Healthcare

For Amethyst, PPPs are not merely funding mechanisms—they are strategic enablers. By aligning the capabilities of the private sector with the needs of the public, these partnerships create resilient systems that can grow, adapt, and consistently deliver high-quality care.

As Stéphane Carré noted in his interview with The CEO Magazine, the future of healthcare lies in intelligent collaboration. PPPs will continue to play a transformative role—not just in oncology, but across all sectors of healthcare seeking scalable, impactful, and sustainable solutions. Amethyst Healthcare is proud to be leading this transformation.

Read the full interview with Stéphane Carré in The CEO Magazine for more insights into Amethyst Healthcare Group’s inspiring journey.
Radiotherapy Treatment - MRI Scan

What’s Next For Gamma Knife Radiosurgery & AI Technology?

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One of the most effective and advanced treatment resources for brain tumours and vascular malformations is Gamma Knife radiosurgery, which first came to the fore during the 1960s and which has continued to evolve quickly ever since.

With the advent of artificial intelligence (AI) over the last year or so, new and exciting opportunities are starting to emerge… some of which have just been published in the spring edition of SCOPE magazine, with contributions from our own clinical team, including Ian Paddick (consultant physicist at Queen Square) and Hannah Bouas (radiosurgery physicist at Thornbury Radiosurgery Centre).

The focus here is on AI-driven auto-contouring for tumour segmentation, achieving greater levels of precision and more consistent patient outcomes in stereotactic radiosurgery.

Read on to find out more about the key conclusions drawn in the Scope piece.

AI-driven auto-contouring for advanced precision

AI-driven auto-contouring for tumour segmentation is a significant breakthrough in Gamma Knife technology, moving away from manual processes that are time consuming and subject to risks posed by human interpretation, particularly in lesions and tumours that don’t have clearly defined boundaries.

Using AI frameworks allow clinicians to segment tumour boundaries with the equivalent accuracy to human annotators, the advantages of which include:

– Reduced human error: Consistency is achieved through AI automation, lowering the risk of inaccurate results while reducing variability and oversights significantly.

– Enhanced patient outcomes: AI tools ensure greater accuracy of tumour segmentation, resulting in more precise radiation delivery to tumour cells and reducing damage risks to healthy brain tissue, as well as reducing the risks of complications and side-effects.

– Efficiency gains: Automation allows for more efficient contour detection in much shorter timescales, thus allowing for faster overall treatment times and reduced waiting lists.

Potential limitations of AI

Although the Scope article does note that AI is an incredibly valuable tool, models for auto-contouring still have some limitations, such as incomplete training data that may not generalise across diverse populations, or imaging noise that results in false positives.

While AI will undoubtedly become more important as a resource in the future, for now clinical oversight and judgement of contouring processes will still be necessary, particularly for more complex cases such as brain metastases.

Amethyst Radiotherapy France To Appear On Check-Up Santé

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Acclaimed French television show Check-Up Santé on BFM TV , which focuses on health information and regularly invites medical experts onto the stage to discuss important topics of the day, has asked Olivier Cosset, CEO of Amethyst Radiothérapie France, to appear as a guest on Saturday, 22nd February and Sunday 23rd February.

Mr Cossett will be on the BFM TV flagship health programme talking in depth about the latest innovations in radiotherapy and the increasingly important role the practice has to play in modern cancer treatment, delivering insights into how it is evolving to make cancer treatment more effective and accessible.

“Radiotherapy is undergoing a true revolution, with advancements that are making treatments more precise, efficient, and accessible to more patients than ever before. At Amethyst Radiothérapie France, we are committed to bringing the latest innovations in radiotherapy to improve patient care and outcomes. I look forward to discussing these exciting developments on Check-Up Santé with Fabien Guez and shedding light on how radiotherapy is shaping the future of cancer treatment.”

– Olivier Cosset, CEO of Amethyst Radiothérapie France

Amethyst Radiothépie is one of the biggest private providers of radiotherapy services in France, providing cutting-edge treatments to enhance the patient journey and improve health outcomes across the board.

The episode is due to air on 22nd February at 14:00 EST and Sunday 23rd February at 15:00 EST on BFM TV. Make sure you tune in to hear a truly fascinating discussion on radiotherapy innovation and what the future of cancer care will look like.

Also featuring on the show will be Professor Jean-Emmanuel Bibault, who will be talking about the long history of cancer (which dates all the way back to prehistoric times), just one of the points raised in his book Cancer Confidential: L’histoire du cancer, des secrets d’hier aux revolutions de demain.

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Understanding The Use Of Radiation In Cancer Treatment

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For anybody needing radiotherapy, the prospect can be daunting and includes a lot of uncertainty. Some of that will centre on the prognosis and be based on a lack of detailed knowledge of the nature of your condition. However, in the course of your treatment at our radiotherapy centre you will receive plenty of information about this.

Allied to this will be uncertainty about the use of radiotherapy. The fact it involves radiation may be unnerving for some, since radioactivity is usually perceived as a harmful thing. For this reason, you will receive lots of information about what is involved, how treatment is delivered and how it will benefit you as a patient.

Understanding Radiation

The first thing to understand about radiation is that it is everywhere. Background radiation is naturally present in the environment, we get some from the sun’s ultraviolet rays, and we are exposed to it at low levels from some electrical devices.

It is even naturally present in some foods, such as bananas with their high potassium content.

This fact has even led to the establishment of the ‘Banana Equivalent Dose’ measurement of radiation, which is extremely low compared to dangerous doses (such as those associated with nuclear accidents at Chernobyl and Fukushima), but helps provide an example of how safe the levels of radiation exposure are in most cases.

Understood correctly, radiation is like many other things in only being harmful in large quantities. A good example of this would be salt, which is important for our health in low quantities, but in large amounts can cause health problems (especially in the liver).

Radiation And Radiotherapy

This may leave you wondering about just how much radiation is involved in radiotherapy. As a banana equivalent dose, it is undoubtedly high, much more so than other medical procedures and scans you might have.

For instance, the radiation exposure of a dental X-ray is the equivalent of the radiation contained in two bananas. A chest X-ray may be as high as 1,000, a mammogram will be 20,000 and a chest CT scan is much higher still at 70,000.

The level of radiation that would prove fatal within a fortnight is vastly higher than this, at 100,000. This is five times as high as the dose of radiation you will receive in targeted radiotherapy.

If that still sounds like a very high dose, it is, but it is also why radiotherapy is given in limited doses and targeted specifically at the area affected by cancer. This means that a tumour can be shrunk by the radiation damaging its cell DNA, preventing it from repairing cells which consequently die.

However, such exposure can also damage surrounding healthy tissue, which is what causes the various side effects of radiotherapy. This is why your oncologist will explain these to you so you know what to expect and how to cope. Side effects can include hair loss, a loss of appetite, gastric problems and fatigue, so it is important to be prepared.

Some effects can be long-lasting and affect you long after the treatment has concluded, such as your skin looking or feeling different, hair not growing back as well, and, most significantly, infertility in cases where abdominal doses of radiation were given. However, most symptoms will soon fade away.

The Importance Of Precision

To minimise these symptoms, your treatment will be delivered with great precision, using the latest technology. Although radiotherapy has been used in cancer treatment since the turn of the 20th century, it has been refined considerably down the years, partly due to growing scientific understanding of radiation and, latterly, more precise tools.

What this does is enable the dose of cancer cell-damaging radiation to be aimed exactly where it needs to be, with little or no damage to surrounding healthy tissue.

Several devices have been designed to do this in different ways, depending on what kind of cancer it is and where it is located.

For example, the invention of the gamma knife in the 1960s provided an instrument that could provide particularly precise beams of intense radiation.

This made it ideal for use in treating brain tumours, providing a method of shrinking them without the need for invasive surgery (although, in practice, there will be instances where both methods will be used during treatment).

Staying Informed

If you are a patient with us, we will provide you with extensive information about what radiotherapy involves, both in general terms and regarding the specific form of treatment that is best suited to your circumstances.

This will ensure that you can play a part in decision-making about your treatment and that you go into every session fully aware of everything that is going on, giving you confidence and assurance in the treatment you receive.

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Can You Exercise While Undergoing Treatment For Cancer?

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The treatment pathway for cancer once diagnosed will focus on the treatments, medications, radiotherapy and other specialist care that will provide the best possible outcomes, but cancer care does not begin nor does it end with primary treatment.

Maintaining your physical and mental health is vital for treatments to be successful, and whilst exercise and physical activity are essential throughout your life and can in some cases help reduce or remove certain risk factors for cancer according to Cancer Research UK, it also has many benefits during treatment.

A common question that oncologists are asked is about the level of exercise that is advised or recommended for people undergoing cancer treatment.

This is a somewhat more difficult question to answer as whilst exercise is safe and often can help relieve certain symptoms of treatment, every case is different and an exercise plan needs to work with the body.

Your oncologist or a specialist nurse can give you tailored advice, but here are some answers to some general questions when it comes to cancer treatment.

How Much Exercise Should You Do?

Everyone has different levels of activity which work best for them, and the golden rule of exercise is that any physical activity you do will contribute to improved health.

The answer will vary considerably depending on the type of treatment you are receiving, your general level of fitness and any health complications.

Whilst the NHS advice when it comes to fitness is to aim for 150 minutes of physical activity a week, any amount of physical activity will make a difference.

The more exercise you are able to do, the better, but listen to your body as well.

Do You Need To Be Consistent?

The NHS advice is often treated as a consistent target to hit and that you must do 21 minutes of exercise every day, which is not always necessarily feasible. Anyone undergoing long-term treatment will have days when they have more energy than others.

Start with gentle exercise in relatively short bursts, listening to your body in the process to know when to stop.

You do not need to be consistently meeting or breaking personal targets each and every day but try to do something active if you can at all, even if it is a short walk around the house or around the block.

The benefits of consistently being active will be felt as you continue to exercise. As you exercise more, the more you will build yourself up to longer and more intense workouts going forward.

Which Types Of Exercises Are Best?

Your specialist team will be able to provide specific advice, but the best exercises are those that you enjoy and that you feel you can do consistently. Many people will be prescribed physiotherapy specifically to get themselves started, but most gentle exercises can be undertaken by anyone undergoing cancer treatment.

The best exercises are those that push your body but not so much as to risk injury. Whilst more vigorous exercise will provide greater benefits, overtraining or training when you are sore or stiff can be counterproductive.

You could, for example, engage in pursuits such as walking, gentle yoga, light strength training, or water aerobics, all of which you can tailor to suit your own fitness ability, range of motion and mobility. What is important is to listen to your body and pay attention to the cues it gives you so you don’t over-exert yourself.

Are There Any Exercises To Avoid?

There are some types of exercises which may need to be avoided depending on the type of treatment you are undertaking.

For example, people who are undergoing treatment for bone cancer should avoid exercises which might put a strain on the bones. Hydrotherapy and swimming are excellent exercises as they provide both support and gentle resistance, allowing people to exercise more than they otherwise would.

Alongside this, certain types of surgery require some rest before a return to a full exercise regime, although in most cases there will be exercises you can do to keep yourself active before you can return to your usual routine.

Some cancer treatments can affect the immune system, and if you are used to exercising in public gyms, you should ask your medical team when you can start exercising again in order to avoid the risk of infection.

Adjusting Exercise Based on Treatment Side Effects

In the specific case of radiotherapy treatment, if you have areas of sensitive skin, make sure to wear clothing that is both loose and gentle to avoid rubbing and irritation.

It is also worth asking your radiotherapy team about swimming, as some pools use chemical treatments that can irritate sensitive skin depending on what type of treatment you receive.

If you are struggling with balance, coordination, muscle strength or numbness, then an exercise bike or gentle hydrotherapy can be beneficial forms of exercise instead. A physiotherapist can also help you to regain your balance and avoid falling.

Amethyst Radiotherapy UK Appoints Sasha Burns as New CEO.

Amethyst Group appoints Sasha Burns as CEO of UK Operations

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Amethyst Group is pleased to welcome Sasha Burns as the new Chief Executive Officer (CEO) of UK Operations. With a strong background in healthcare leadership, strategic growth, and operational excellence, Sasha will play a key role in advancing Amethyst’s radiotherapy services and expanding access to world-class cancer treatment.

Bringing over 20 years of experience across both the NHS and independent sector, Sasha has a proven track record in transformational healthcare leadership. She previously held senior leadership roles at Alliance Medical, where she served as Chief Commercial and Operations Officer, and Nuffield Health, where she oversaw a network of hospitals and well-being centres. Her expertise spans business transformation, patient care innovation, and operational strategy.

With a background as a radiographer and an MBA from Henley Business School, Sasha combines clinical insight with strategic leadership, making her well-positioned to enhance Amethyst Group’s commitment to pioneering radiotherapy services.

“I am excited to join Amethyst Group and contribute to its mission of delivering innovative, high-quality radiotherapy care. As demand for advanced cancer treatments grows, I look forward to supporting the UK operations in expanding access and driving excellence,” said Sasha Burns.

Amethyst Group continues to strengthen its clinical expertise, patient-focused care, and cutting-edge radiotherapy technology across its European network. Sasha’s appointment reflects our ongoing commitment to innovation, growth, and leadership in oncology care.

Radiotherapy treatment - Patient Radiation therapy mask

Radiotherapy Treatment Success Better For Non-Smokers

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The increased risk of developing cancers among smokers has been widely publicised over the years, but research has found that those who quit their habit are also more likely to achieve success with their radiotherapy treatment. 

Smokers can develop long-term problems during treatment

Cancer Research UK has recently published research showing that smokers have a greater chance of developing long-term problems when undergoing treatment for breast cancer. 

Radiotherapy is a standard treatment given to cancer patients, as it has been shown to be one of the most effective means of destroying cancer cells and reducing the risk of it returning. 

However, there is a very small chance that other tissue, such as the lungs, can get an incidental dose of the radiotherapy. This could result in patients developing complications from their treatment, such as radiation-induced lung cancer.

However, Carolyn Taylor, professor of Oncology at The University of Oxford, reassured patients that “for people who don’t smoke, the risks of developing a radiation-induced lung cancer are very, very small”.

This is unless they are long-term smokers who do not give up when they start their breast cancer treatment, as their risk is much higher. 

Taylor’s team of researchers found that the risk of dying from lung cancer due to their treatment for non-smokers is less than one per cent. Therefore, it is much safer for them to go ahead with the treatment to eradicate breast cancer and give them the best chance of survival. 

However, this risk increases to up to six per cent for smokers that carry on with their habit during treatment. 

Quitting can reduce this risk

The study also showed that long-term smokers who are able to quit before their radiotherapy can substantially reduce their risk of developing radiation-induced lung cancer. 

It could even fall to as low as those who have never smoked before, which is why it is really beneficial for smokers to try and break their habit before they undergo radiotherapy if they can. 

Taylor recognises that this could be too much to ask from lots of smokers, as receiving a breast cancer diagnosis is already a “really stressful time”. 

She added: “For long-term smokers, trying to give up smoking just after being diagnosed with cancer strikes me as a really big ask.”

Therefore, it is important they seek out the available smoking cessation resources if they do think they are able to do it, as it could have a big impact on their future health. 

How the Tobacco and Vapes Bill could help

The government’s Tobacco and Vapes Bill, which was introduced in parliament on November 5th 2024, could help current and future patients have the most successful cancer treatment possible. 

It will do this by extending the indoor smoking ban to certain outdoor settings, such as children’s playgrounds and outside schools and hospitals, and preventing the sale of tobacco products to anyone who is 15 or younger this year to create a smoke-free generation. 

Health and social care secretary Wes Streeting said: “Unless we act to help people stay healthy, the rising tide of ill-health in our society threatens to overwhelm and bankrupt our NHS. Prevention is better than cure.”

Smoking alone kills 80,000 people in the UK every year, and more than 100 GP appointments an hour are attributed to smoking. 

When it comes to cancer, two in three long-term smokers are likely to die from a smoking-related disease and tobacco smoke causes 27 per cent of cancer deaths in the UK. 

It is the cause of at least 16 types of cancer, as well as other conditions, such as heart disease. It is also the biggest cause of lung cancer in the country, accounting for six in ten cases. 

The longer someone smokes, the greater risk they have of poor health, which is why it is essential not to put off quitting, as one day they might need radiotherapy for breast cancer and smoking will increase their risk of developing lung cancer from their treatment. 

Improvements in radiotherapy

Although smokers might find this research worrying, the good news is that radiotherapy treatments are improving all the time. Not only is the course of medication becoming much shorter, so patients do not have to undergo long, difficult treatments, but it is also much more targeted.

Therefore, the likelihood of the radiation hitting healthy tissue is much lower than it used to be. 

Stereotactic radiosurgery, such as GammaKnife, works by targeting the tumour from different directions. This specific aim means there is a reduced chance of it passing through other cells, and it has very little impact on any tissue it does hit. 

These highly-focused beams of energy are typically used to treat small tumours, as they are much more targeted. 

This form of treatment would be a good choice for smokers, therefore, limiting the impact on radiation on their already unhealthy lungs.

first linear accelerator technology IMRT - radiotherapy treatment

How Can Linac-Based Radiotherapy Help Treat Patients

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Some patients who need to undergo radiotherapy will be told about linear accelerators, which are also known as linacs.

These machines provide external beam radiation to treat cancer patients, as they deliver targeted rays into the patient’s tumour. 

How do linac machines work?

Linac-based radiotherapy works by using high-energy X-Rays. They speed up electrons and conform them to the tumour’s shape and size. These then collide with a heavy metal target, which produces the X-Rays. 

When these are aimed at the cancer, they destroy the invasive cells but, as they are the right size and shape and specifically targeted, they do not harm the healthy ones. 

Therefore, it is effective at keeping surrounding tissue safe, which is why it is a popular choice of radiotherapy treatment. 

It can be used on all areas of the body, with the patient lying on a moveable couch. Lasers make sure they are in the correct position, so the radiation is beamed at the right area exactly.

The X-Rays come out of an area of the machine called a gantry, and this can be rotated around the couch, so that the X-Rays can be delivered to the tumour from a number of angles, helping to fully attack the cancerous cells. 

The amount of time the patient is in the accelerator will be down to their oncologist, who will also determine the dose they need. Once they have prescribed the treatments, the treatments are usually carried out by radiation therapists. 

At the same time, the number of treatments they require will depend on the severity of their cancer and how much radiation therapy it requires. Typically, patients have their treatment spread over a course of a few weeks. 

Although patients will hear a buzzing noise while the accelerator is on, they will not feel any pain during the treatment. 

What is it used to treat?

Linac-based radiation therapy is commonly used on malignant tumours, as it can deliver high doses to the cancerous cells. It is also used for benign lesions, with electrons being beams being used on superficial lesions.

They can also be used for Total Skin Electron Therapy (TSET), which treats cutaneous T-cell lymphoma. This condition, a form of non-Hodgkin lymphoma, involves lymphomas appearing on the skin all over the body. 

Linac is also used in Total Body Irradiation (TBI), which provides the body with a low dose of immunosuppression, and is typically used during bone marrow transplantation procedures. 

Patients undergoing prone breast irradiation may also need linac radiation, as this helps reduce radiation toxicity to the lung and heart by letting the patient lie on their front for the treatment. 

Prostate treatment with a hydrogel space also requires a linear accelerator technology. This procedure involves injecting liquid Hydrogel between the prostate and the rectum so there is extra space in this area, reducing the toxicity from the radiation. 

Side effects of linac radiotherapy?

Like all radiotherapy, linac-based treatments come with side effects. 

These can include irritated, dry, red or itchy skin at the site of the radiation; loss of appetite or difficulty swallowing; bladder irritation and urinary problems; changes in bowel habits; headaches and fatigue; and low immunity due to it affecting bone marrow function. 

What other types of treatments are available?

While linear accelerator radiation treatments are very effective at destroying cancer cells, there are other procedures available. 

For instance, internal radiation therapy might be a better option for some patients, such as those with head, neck, breast, cervix, prostate and eye cancers. As these can be harder to treat in a linac machine, oncologists could prescribe internal radiation therapy, such as brachytherapy, instead.

Alternatively, stereotactic radiotherapy or radiosurgery is a better option for those with brain tumours, as this involves higher doses of radiation in a reduced number of sessions. 

As well as brain cancers, it can be used to treat other small tumours with millimetric accuracy, whether they are primary or secondary cancers. 

Doctors might also suggest Arc Therapy or Rapid Arc Therapy (VMAT) instead, as this is another effective treatment for cancer.

This involves a radiation beam moving around the tumour in an arc, automatically changing the dose as it moves. Subsequently, this ensures healthy cells receive as minimal an amount of radiation exposure as possible. 

Treatment times for this form of therapy is typically only a few minutes, which means patients can be treated more quickly and avoid nasty side effects.

Radiotherapy Treatment - MRI Scan

Study Shows MRI Helps Guide Glioblastoma Radiotherapy

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Radiotherapy can be used against various forms of cancer, but some of the most cutting-edge and precise uses involve brain tumours.

There are very good reasons for this. Brain tumours vary in their impact, as some are benign and simply need to be shrunk to prevent secondary problems such as pressure on the brain or nerves. Others are cancerous and radiotherapy, alongside chemotherapy and surgery, can extend the life of patients by varying amounts.

With any form of radiotherapy treatment, calibrating the right dose and hitting the right targets is vital. This is especially true when targeting a brain tumour, given the dire consequences of damaging healthy brain tissue nearby, but there is also the general consideration that the less radiation there is, the less severe the side effects.

For this reason, anything that helps increase the precision of the radiotherapy, either in its delivery or in the preparation and assessment of treatment will help ensure it is given in the right places, in the correct doses and that this is linked to the correct supplementary treatment.

The Importance Of Tackling Glioblastomas

In the cases of benign tumours, this can help with the process of enabling the patient to live a normal life. For those with cancerous tumours, the challenge is greater, especially in cases such as glioblastomas, aggressive tumours arising from glial cells that show up in the brain and spinal cord and can, if unchecked, kill sufferers within months.

With the best treatment, however, some glioblastoma patients can live for up to five years, so there are clear benefits to be gained from good treatment. Moreover, as they are the most common form of brain tumour, accounting for 32 per cent of all cases, there is plenty of incentive to develop treatments to improve outcomes for patients.

For that reason, new research in the United States has indicated that patients may benefit from a novel new use of MRI scans to help guide radiotherapy on glioblastomas, with the two being delivered simultaneously to help provide a new method of analysis.

MRI, Radiotherapy and Real-Time Data

The study on this approach was carried out by researchers at the Sylvester Comprehensive Cancer Centre in the University of Miami’s Miller School of Medicine. The research was published in the International Journal of Radiation Oncology – Biology – Physics, as well as being presented at a meeting of the American Society for Radiation Oncology.

What this showed was that having daily MRI scans delivered alongside the radiation therapy could help guide radiotherapy treatment more precisely, as well as keep track of developments, which meant oncologists could make adjustments daily to treatment when necessary to deal with the very latest developments and tackle them accordingly.

Known as MRI-linac, the method produced scan results that matched the normal standard MRI scans carried before and after courses of treatment in 74 per cent of cases.

In the other 26 per cent of instances, the MRI-linac system projected tumour growth when in fact it shrank. However, this does mean that, crucially, there were no instances where a tumour increased in size without the MRI-linac predicting this would happen. 

Why The System Could Enhance Radiotherapy For Glioblastomas

Consequently, an effective way to utilise the system is to use contrast imaging as a follow-up means of confirming if a tumour is indeed growing, which, the study suggests, will be the case in three-quarters of indicated cases.

Lead author Dr Kaylie Cullison, said: “Our study shows that these daily scans can serve as an early warning sign for potential tumour growth.”

The key finding was that using MRI scans is more effective in spotting developments than standard imaging techniques, helping offer better treatment guidance and therefore paving the way for better treatment. The research team has concluded that this could eventually become the standard approach for using radiotherapy on glioblastomas.

At present, this is not the standard way for treating glioblastomas, with Sylvester Comprehensive Cancer Centre being unique in providing this approach, but that may change over time. However, it adds to an array of new techniques, technological developments and ongoing research that could enhance the care of patients.

Radiotherapy Technology Keeps Progressing

Many of these developments have occurred in specific areas, such as the development of ever more precise gamma knife technology. Invented by Swedish scientist Lars Leksell in 1967, the invention has been further refined, first with the second version in 1975 and several times subsequently as the technology has advanced.

If you need radiotherapy, our staff will guide you through not just what you can expect in a course of treatment, but explain how various developments have enabled patients to enjoy better outcomes as a result of increasingly better technology, diagnostics and understanding of tumour treatments.

ExacTrac Dynamic - first linear accelerator technology IMRT

How ExacTrac Dynamic Technology Improves the Effectiveness of Radiotherapy

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When a cancer patient undergoes radiotherapy, it is essential that the tumour is targeted precisely. This not only ensures a greater chance of killing the cancerous cells, but reduces the likelihood of healthy cells being destroyed instead. 

ExacTrac Dynamic technology helps improve radiotherapy outcomes by offering high-tech image guidance so that the tumour is targeted more accurately.

So, how does it work?

What is ExacTrac Dynamic technology?

ExacTrac Dynamic works by accounting for the continuous motion of a patient, such as how their body moves when they are breathing or how their prostate rises if they pass gas. 

Although these fluctuations of movement might be small, it is essential they are accounted for when implementing radiation therapy so that the exact location is targeted. 

To be as precise as possible, external markers on the skin are typically used, together with imaging scans, so the radiation experts know where to position the beams for the best chance of targeting the tumour. 

However, ExacTrac Dynamic provides real-time information about the patient, such as their temperature, movement, anatomy and shape, through high-resolution surface and thermal imaging. This gives doctors the most accurate data they need to increase the success of the treatment. 

How does it work?

More than 300,000 3D surface points are acquired from the patient and a 4D thermal camera provides information about the patient’s heat signature based on this reconstructed 3D image of their body. 

This means doctors are able to gather as much information as possible about the patient’s body in real-time, allowing them to more accurately target the radiation beams. 

How effective is ExacTrac Dynamic?

According to a recent study, which was published in J Appl Clin Med Phys, ExacTrac Dynamic “with its new optical/thermal imaging system is an efficient tool for positioning and monitoring during radiation therapy”. 

As well as being highly effective, it is favourable among patients as it allows them to experience more targeted treatments. Therefore, their radiation therapy sessions might be shorter and they may not need as many to fully target the tumour. 

This means the risk of experiencing short- and long-term side effects of radiotherapy can be reduced. This can have a big impact on a patient’s mental and physical wellbeing, as these side effects can include problems eating and drinking, fatigue, hair loss, skin reactions, fertility issues and a change in libido. 

It can put patients at a higher risk of infection by reducing their white blood cell count, or make them anaemic if their red blood cells become too low. This could mean they require a blood transfusion. 

Radiation therapy can also cause a dry mouth, difficulty swallowing, changes in taste, and reduced appetite, which can cause patients to lose weight. 

Of course, the longer someone has to undergo cancer treatment, the bigger impact it has on their mental health. The physical side effects, such as tiredness, can make a patient feel depressed, while they may also feel isolated, frustrated at not being able to do the things they normally can, and anxious about their future. 

By being able to reduce the number of radiotherapy sessions, patients are less likely to suffer as much from the side effects.

What’s more, there is no need to have permanent markers on their skin, which can act as a constant reminder of their cancer journey. 

What cancers can ExacTrac Dynamic be used for?

ExacTrac Dynamic can be used for several different types of cancers where radiation therapy is an appropriate course of treatment. This includes breast, lung and prostate cancer.

It can also be effective in the treatment of brain tumours, especially as surgery is sometimes not an option and radiotherapy might be the only option available. 

Radiotherapy can also be used to shrink tumours as part of palliative care, making cancerous symptoms more bearable for patients. It can also slow down the growth of cancer, prolonging life, or reduce the size of the tumour so it is easier to operate on. 

It can also be an option to reduce pressure on the spinal cord by shrinking the tumour, control an ulcerating cancer, or treat a blood vessel blockage in the chest.

Having ExacTrac Dynamic technology helps to speed up the effectiveness of the radiation therapy, so surgery can be booked in sooner, a patient’s symptoms can be eased more promptly, and their life expectancy can be extended.