radiotherapy

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 centre - hodling hands

Different Support Therapies During Your Cancer Treatment

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The most effective cancer treatments do not start and end in a radiotherapy centre but focus on ensuring that anyone who is diagnosed receives the physical and mental support they need to have the best chance of the best outcome.

Oncology specialists know more than anyone else that cancer treatment is inherently holistic in nature, and highly effective radiotherapy also needs to be combined with a wider, supportive approach that ensures that people know that they do not need to fight this alone.

Whilst this is important for its own sake, especially given how much cancer can affect people mentally, a complete support system has a considerable impact not just on mental well-being, but also on the effectiveness of many cancer treatments and their long-term outcomes.

According to some studies, chronic stress can cause cancers to advance, and conversely, support therapies have been linked to better clinical outcomes.

With that in mind here are some of the support options available during cancer treatment.

Psychological Support

From the moment of diagnosis, counselling is available, and can be organised in whichever way a person feels most comfortable with, and there often various types of talking therapies available based on what a person needs at the time.

Some people prefer a one-to-one therapy session where they can work through with a professional the often powerful and complex feelings that inevitably come with a diagnosis or over the course of treatment.

At the same time, other people prefer having family members or loved ones with them during support meetings, and all of this can be arranged in the best way possible to help the healing process.

Alternatively, it can also be undertaken in a group therapy setting, as it can often be incredibly helpful for someone to discuss their experiences with people who are going through the same types of experiences and can discuss ways in which they managed to work through.

Support Groups

Whilst structured therapy is available, there are also more informal support groups available that are set up for people to discuss their experiences outside of a therapeutic setting, which can sometimes be necessary to ensure people can open up.

It can also be a place where people going through treatment can share advice and discuss the everyday ways in which cancer can affect people, as well as make new friends and become part of a community at the same time.

As well as this, it can help to talk to someone who has undertaken the same or similar treatments and compare experiences, which can do a lot of help with the understandable fears that can arise when major treatments are suggested and planned.

Finally, it can be a place to regain confidence. Cancer can affect not only the relationships you have with other people but the one you have with yourself.

There are a lot of different groups, some of which specialise in a specific type of cancer, some are small enough to take place in someone’s house whilst others fill a function room. Some involve guest speakers and activities, whilst others are more informal and about discussing feelings.

As well as this, much like the treatment centre, a support group can be an excellent place to not only find other people but find other support services, such as massages, yoga, mindfulness meditation and other complementary therapies to discuss with your doctor.

Nutritional Support

Given that nutrition and diet can have a considerable effect on both mental well-being and physical health.

One of the main first steps of prehabilitation, the steps taken to get ready for treatment, as well as during and after treatment, doctors and the rest of the support team can provide advice and guidance about the small lifestyle, nutrition and dietary choices that can be made to help with recovery.

As with anything diet related, a small change that sticks is far more important than attempting an unrealistic plan and being unable to keep it consistently. Adding a few vegetables to existing meals, drinking less alcohol rather than quitting entirely and doing some exercise will all make huge differences.

The treatment team will explore a person’s individual circumstances and give sustainable advice, with explanations for how they can help mitigate the effects of treatment, with full nutritional information, monitoring of BMI and weight, as well as interviews during consultations.

Nutrition and physical activity do not just help with physical health but they can both improve mood and mental wellbeing, making them a vital part of treatment available to people that are undergoing cancer treatment.

radiotherapy centre - radiologist looking at the MRI image

World Cancer Day Highlights That Every Patient Is Unique

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To be told you have cancer is a mortifying experience and one nobody ever wants to have to deal with, but the good news is that treatments are advancing all the time and that the prognosis for most patients is far better than it used to be.

There are various reasons people tend to live longer after a diagnosis, including the quality of treatment, the development of new and more effective drugs and better screening to bring about early diagnosis.

However, another very important factor is the understanding that the right treatment for one patient might not be the best way forward for another. This is partly about the treatment schedule and methods, but also the personal aspect.

Treating every individual patient as unique is not just a matter of good service or dignity, but a necessary means of maximising the chances of each patient beating their cancer or, short of that, extending life by as much as possible. This is the approach we take at our radiotherapy centre.

World Cancer Day Campaign Is All About Unique People

The importance of seeing every patient in unique terms is to be the theme of this year’s World Cancer Day on February 4th. The title of the theme is ‘Unique by Unique’ and the campaign of awareness based on this philosophy will run until 2027.

Stating that “behind every diagnosis lies a unique human story – stories of grief, pain, healing, resilience, love and more,” the campaign notes that the best health outcomes take a holistic approach, which incorporates a wide range of needs.

A particular theme of the campaign is the notion that medics should “treat the person, not just the disease” as a means of people-centred care. It notes that cancer patients “don’t always feel heard, seen or understood.”

This highlights the fact that your journey when fighting cancer will be your own for a range of reasons. Some people may be stoic in the face of adversity, some may feel angry but determined to fight the disease. Others may find it puts extreme strain on their mental well-being and relationships and need some particular support.

As a result, the treatment you need will not just be what you get from a gamma knife or a linear accelerator. It will also be about helping you deal with the emotional side, the practical arrangements you may need to make to deal with changed life circumstances and the connections you may need with those who can help, such as support groups.

Giving Guidance

Patient support need not be just external, however. One of the issues is the confusion and lack of guidance and information some people face when navigating their way through health systems.

The exact problem may vary from country to country as the systems are different, with those seeking private care then encountering something new again, but by providing lots of information and helping patients know their rights, we can help. In doing this, patients really can know we are treating them and not just their cancer.

Of course, tailoring care is also about the treatment itself. Some people may have more radiotherapy than others. Some may have it combined with surgery or chemotherapy, depending on their own medical circumstances.

Why Personal Factors Make A Difference

Underpinning all of this will be other personal factors such as age, genetics and underlying health. How far the disease has progressed when you are diagnosed and how far it subsequently progresses are further factors in shaping treatment, while ongoing treatment decisions may be made by assessing how well patients respond to therapies given already.

A critical way in which this variation in treatment and the personalisation of care are brought together is in the way you will be given information and involved in making decisions about treatment.

This can work itself out in different ways. There are instances, especially with end-of-life situations, where a patient may decide not to undergo further treatment to minimise side-effects while making the most of the time they have left.

In other instances, some patients may be very willing to undergo a certain treatment that contains risk, or involves trials of a new drug. Above all, people will appreciate being kept in the loop and treated as individuals with specific medical and supplementary needs.

The big hope is that the three year campaign will help to make some changes in how cancer treatment is provided, with the whole process being more consensual, more informative, but also centred on the needs of every individual, recognising that they differ.

If you need cancer treatment, you are not just another patient. You are unique. That is why we will aim to fulfil the aims of the World Cancer Day campaign.

radiotherapy centre - nutritious food

How Important Is Good Nutrition For Post-Cancer Recovery?

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Cancer treatment does not start nor end at the radiotherapy centre but is often a fairly lengthy process both leading up to treatment and once you are declared cancer-free. In that sense, it is more akin to a marathon rather than a sprint.

Because of this, whilst the most critical part of your cancer treatment will be the radiotherapy, chemotherapy or surgery prescribed, the preparations following diagnosis and the regime for recovery following are also incredibly vital parts of ensuring long-term health.

A big part of that is nutrition. Whilst a balanced, healthy diet can help in some respects to reduce the risk of cancer to begin with, where nutrition perhaps matters most is in recovering from cancer.

Good nutrition and a healthy diet help you to regain your strength and energy quicker, rebuild damaged and destroyed tissue from the procedures and treatments undertaken to remove any cancerous matter, and have positive impacts on both your physical and mental health.

Patterns Rather Than Prescriptions

Everyone who is recovering from cancer will have a different experience and no two healing schedules will be quite alike. As long as you are making overall progress in your recovery, it is natural for some people to spend longer recovering than others.

Generally, once your treatment is finished, so too will most of the side effects that relate to eating and nutrition. You might notice actively that your appetite improves soon after cancer treatment, but in other cases, it can take time.

The doctors involved with your treatment will let you know of any additional dietary requirements you may have following treatment, but for the most part, you can continue to follow a healthy diet following cancer treatment and it will help boost recovery.

What is important to note given the near-endless advice regarding what people should and should not eat following cancer treatment is that what matters is not the individual foods you eat but the overall patterns in your diet.

This means that much like how a restrictive diet you do not follow will not improve your health, having a healthy diet overall but with some flexibility to eat out or occasionally eat something less than healthy will not impact your recovery.

A Diet For Prevention Is A Diet For Recovery

The golden rule for setting up a recovery diet is that anything that helps to reduce the risk of cancer will also aid in cancer recovery.

This allows for a remarkable level of flexibility, as almost any healthy diet will generally help to reduce the risk of cancer as it helps people to maintain a healthy weight, reduce the cell damage that is linked to cancer and provide a boost of energy needed to get active.

Generally, when it comes to cancer prevention, the two main types of ingredients that should be included are foods rich in fibre, such as wholegrains, oats and brown rice, and dairy products or dairy alternatives such as soy, coconut and almond milk.

Both reduce the risk of bowel cancer, the former through several processes in the digestive system and the latter through calcium.

Fibre also has the side effect of helping you feel fuller for longer, which makes it easier to maintain a healthy weight, which means that foods high in fibre are also part of most healthy and balanced diets.

Besides these, fruits and vegetables, and healthy sources of protein such as chicken, turkey, fish, lentils and beans form the foundations of a balanced diet and contribute towards overall recovery following cancer treatment.

Avoiding red meat (such as pork and beef) processed meat (such as bacon, sausages and burgers), foods rich in sugar and foods high in calories in general will help aid in recovery and naturally guide you towards food that improves overall health, which in turn helps with recovery and reducing the risk of cancer in the future.

Benefits To Mind As Well As Body

One of the biggest benefits people note when they look towards a post-cancer diet is how empowering it feels and how much control it gives people during and after their recovery.

It is not a panacea, and a lot of reporting on the relationship between foods and cancer risk is unhelpful because it focuses on individual ingredients, but it is an active step people can take to give themselves the best quality of life.

It also helps improve your mood and well-being, both of which are critical parts of cancer prevention in their own right but also can help boost energy levels and provide motivation to keep active, which is the other big step in helping prevent cancer.

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.

radiotherapy centre - Brain tomography

Who Developed The Foundations For Stereotactic Radiosurgery?

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One of the most important developments ever made in a radiotherapy centre was the invention of stereotactic radiosurgery.

Also known as the Gamma Knife method, Lars Leksell’s pioneering innovation allowed for an unparalleled level of precision in treating and removing brain conditions, including lesions, growths and trapped nerves.

However, one of the most interesting aspects of Gamma Knife is that the two core components of it were developed largely in parallel with each other.

Radiotherapy went through a wide range of developments as the understanding of how it should and should not be used increased, whilst the stereotactic aspect of Gamma Knife was not initially intended to be used for radiotherapy doses.

In fact, it was originally a surgical method looking for a reason to exist, although it did manage to contribute a great deal to neurosurgery even at an early stage.

The Horsley-Clarke Apparatus

The first stereotactic device was developed by two English doctors as their last collaboration together as peers.

The latter part of the name, Robert H Clarke, is far less well known than the former, Sir Victor Horsley, but was just as critical to the device’s creation.

Dr Clarke believed in the importance of applying mathematical concepts to the field of neurophysiology and wanted to create a workable method for producing brain atlases using Cartesian coordinates.

His counterpart, Sir Victor, was a pioneering neurosurgeon, who innovated a range of surgical techniques to make brain surgery more effective and less risky during a time when surgery as a field was changing rapidly.

He was one of the first surgeons to develop a consistent working method for treating trigeminal neuralgia and also developed bone wax and the skin flap method, as well as making several notable breakthroughs in surgical innovations that could treat epilepsy, something that would later be attempted through radiotherapy by the start of the 20th century.

Mathematics

By 1905, he had started working with Dr Clarke, and the pair developed a mathematical method for undertaking neurosurgery, where different parts of the brain could be identified through coordinates that could be mapped consistently onto a frame.

However, its biggest achievement as described in a 1908 article by the pair was the development of their neurosurgical frame, known as the Horsley-Clark Apparatus, as a system to create an atlas of the brain and a three-dimensional map of where critical brain structures are located.

The system worked in that regard, but it was ultimately designed for cat brains rather than human ones. Despite this, it was still an incredibly important first step and would shape neurosurgery for decades to come.

Influence

The system would prove highly influential, and a decade after its invention, Aubrey T. Mussen commissioned an adaptation of the frame designed for human brains, inspired by the three working at the National Hospital in London.

However, the brass frame does not appear to have ever been used on human brains and did not receive a lot of attention at the time.

In fact, it would take another 15 years after Aubrey’s adaptation for Martin Kirschner to use a similar system to treat an actual patient.

In 1933, the German doctor used a minimally invasive surgical method to insert an electrode into the trigeminal nerve and burn it, treating a condition Sir Victor pioneered the surgical method for with a system extremely similar to stereotactic radiosurgery aside from the use of a physical electrode.

However, by the 1940s, the Horsley-Clark method would reach both its peak of importance and obsolescence within the span of three years.

Human brain atlas

In 1947, after the end of the Second World War, Henry Wycis and Ernest Spiegel used a Horsley-Clarke frame with a cartesian coordinates system to develop the first human brain atlas in history, as well as use the system as part of the now-controversial field of psychosurgery.

The later Talairach coordinates system would evolve from this, which used the brain atlas information to create a grid system more relevant to the actual structure of the human brain.

In 1949, Lars Leksell would effectively make the Horsley-Clarke method obsolete by developing his Gamma Knife system to use a system of polar coordinates as part of his stereotactic radiotherapy system.

This system, alongside a new generation of more advanced three-dimensional imaging systems that allowed brain surgeons to be more precise, led to the obsolescence of the Horsley-Clarke method.

However, without these two doctors and their pioneering system, the Gamma Knife would not have existed.