The Role Of A Clinical Nurse Specialist In Brain Tumour Care

12 May is International Nurses Day, which recognises the tremendous dedication and professionalism that nurses bring to the healthcare sector. Nurses are highly skilled and also a great source of compassion and strength for patients who are going through difficult times.

Here’s a look at the specific role of clinical nurse specialists (CNSs) in a multidisciplinary team (MDT) for brain tumour treatment.

Who Are Clinical Nurse Specialists?

CNSs, (sometimes also referred to as a neuro-oncology nurse) are key members of the MDT who have specialist expertise in treating people with brain tumours. They act as the first point of contact between you, your family and the rest of the MDT team, and will be able to deal with any queries you may have during your treatment and recovery process.

You will be introduced to your CNS shortly after your diagnosis, and they will be a consistent presence throughout your care journey. Here are some of the issues they can provide help and support for.

Explaining complex medical information

The early days after a diagnosis can be a particularly tough time for patients and families. The shock and distress of having a serious health problem can make it more difficult to absorb complex medical information. The side effects of the brain tumour itself may also make it more challenging for you to communicate or organise your thought processes.

The CNS will be on hand to explain any medical terminology in plain language and help you clarify any written materials that you find hard to understand. They can also provide you with practical advice about medications, nutrition, and managing side effects such as fatigue.

They can also explain to you the current research that is being carried out into brain tumours, so you can better understand the most suitable treatment option for you, and why your MDT team has recommended it. For example, you may have the opportunity to take part in clinical trials to access emerging treatments.

Referring you to other relevant services

If necessary, your CNS will refer you to other relevant specialist services to aid with the management of your symptoms and side effects. For example, they can refer you to a counsellor or psychologist if you are having emotional or mental health difficulties, or a pain or seizure management service.

The CNS will also be able to advise you about practical issues such as claiming benefits and financial support if you are unable to work, or a family member needs to take time off work to care for you. They may offer you a Holistic Needs Assessment (HNA), which is designed to identify any practical, financial or emotional concerns you may have.

Coordinate your appointments and review your progress

The CNS will refer you to the relevant department, such as A&E or your GP, if you have a pressing healthcare concern that does not appear to be related to your brain tumour or treatment. They will also liaise with health professionals on your behalf if they feel you need extra appointments or a review of your current progress.

Your CNS will also visit you in clinics or on the ward whenever possible, and will provide a source of emotional support as well as discuss any concerns or questions you may have. This can help patients to feel seen and heard, and provides a sense of consistency that brings a sense of reassurance and control at a difficult time.

Support for families and carers

A CNS will also offer support to families and carers, helping them to understand the treatment process, explaining how to provide care at home, answering questions and advising about how to access benefits, counselling or respite care services.

Even after the treatment process is over, the CNS will remain as a point of contact to monitor your progress and provide continuing advice about managing any long-term side effects or rehabilitation.

CNS: A vital role

The role of a CNS is key to the overall quality of care that a brain tumour patient will receive. This is especially crucial for people who are facing neurological changes, and may find that tasks and activities that were previously easy are more challenging.

It can be a very overwhelming experience for both patients and families, and the CNS will be there to provide expert, professional and compassionate advice at every step.

If you would like some information about Gamma Knife radiosurgery, please visit our website today.

What Is Trigeminal Neuralgia And How Can It Be Treated?

Experiencing a sudden onset of facial pain can be very challenging, which is why it is important that anyone who has an inexplicable onset of shooting pain on one side of their face seeks medical help immediately.

While there could be several explanations for these symptoms, one of the main reasons behind these painful attacks is trigeminal neuralgia.

Read on to find out more about what this condition is and how it can be treated.

What is trigeminal neuralgia?

Trigeminal neuralgia causes intense pain on one side of the face that feels similar to an electric shock.

It affects the trigeminal nerve, which goes from near the top of the ear and splits into three, with the nerves going towards the cheek, eye and jaw. This nerve is used to carry signals from the face to the brain.

Everybody has a trigeminal nerve on both sides of their face, but the condition typically only affects patients on one side. Sometimes, patients can experience it on both sides, but this is rare.

The attacks are often short, lasting from between a few seconds to a couple of minutes. They seem to come from nowhere and start and stop suddenly.

Those who suffer from trigeminal neuralgia can experience regular attacks of pain and, in severe cases, patients can have hundreds of incidences of pain every day. However, it is more common to feel the nerve every few days.

Some patients might find they go into remission for a bit, with the pain disappearing for months or even years. However, it does return and the periods of being pain-free might become shorter as time goes on.

What’s more, trigeminal neuralgia tends to worsen, so sufferers will typically experience longer periods of pain.

What is the cause of trigeminal neuralgia?

Trigeminal neuralgia is caused when a blood vessel puts pressure on the nerve. This is typically the superior cerebellar artery pushing on the trigeminal nerve root.

When the nerve is compressed, it affects sensations of pain from the jaw, teeth, mouth and eyes to the brain.

This is the usual cause of trigeminal neuralgia, with 85 per cent of cases caused by this.

However, trigeminal neuralgia can also be the result of having another condition, such as multiple sclerosis, arteriovenous malformation, or tumours pressing against the nerve.

Secondary trigeminal neuralgia occurs in 15 per cent of cases, and these patients often experience pain on both sides of their face, as opposed to just one. They also tend to be younger.

Any injury to the nerve can also trigger the chronic pain condition, so those who have had a stroke or facial trauma are more at risk.

Who is likely to be affected by trigeminal neuralgia?

Trigeminal neuralgia is more likely to affect women than men, and those older than 50. Hypertension is also thought to be a risk factor.

Cases under the age of 40 are far and few between, and it is very rare for children to be affected by it.

What can trigger a trigeminal neuralgia attack?

It is thought that lightly touching your face can trigger a trigeminal neuralgia attack, from washing your face to shaving.

Even putting on make-up, talking, smiling, brushing teeth, eating or drinking can lead to an onset, which makes an attack very difficult for sufferers to avoid.

A light breeze that blows over your face or air conditioning could also set off the pain, making it a life-altering condition as patients never know when an attack will occur.

Treatments for trigeminal neuralgia

The good news is that there are treatments for trigeminal neuralgia, including medications, nerve blocks, and different surgeries.

These range from rhizotomy, which involves damaging the root of the nerve and results in some facial sensory loss, to microvascular decompression, which relieves pressure from the blood vessels but is invasive.

A popular alternative to both of these is stereotactic radiosurgery. This involves targeting a beam of radiation at the root of the trigeminal nerve, so it blocks pain signals to the brain.

This is a noninvasive procedure that does not involve incisions or general anaesthetic, and typically provides pain relief for up to a few years.

The Gamma Knife treatment typically takes around 45 minutes, no recovery time is needed, and side effects are minimal.

If you have trigeminal neuralgia and want to discuss Gamma Knife stereotactic radiosurgery to treat the condition, get in touch today.

Coping With A Brain Tumour Diagnosis: Tips For Patients

When you or someone you love has been diagnosed with a brain tumour, it’s naturally a time of uncertainty and fears about the future. This can be emotionally draining, at a time when you also need to think about practical issues such as arranging finances, speaking to employers about time off for treatment, working out caring duties, and so on.

However, there is no need to face all these issues alone: there are support systems in place to help you cope, and many people who have been there before you are willing to share their insights. Charities such as Cancer Research UK have their own online forums, support groups and resources to help people navigate the challenges of a cancer diagnosis.

As a private radiotherapy centre in the UK, we are taking the opportunity to share some tips and practical advice on coping with a brain tumour diagnosis, as we approach Mental Health Awareness Week (12-18 May).

Acknowledge your feelings

Everyone will find their response to a diagnosis is different, from shock or sadness to numbness or anger. Allow yourself time to process and connect with your emotions, however uncomfortable they may feel. This will help you to put your fears into perspective and talk more honestly with family and friends or healthcare professionals about what you are feeling.

Over time, this will boost your own mental health, and enable you to develop stronger relationships with others. You may also find the process of navigating treatment and recovery easier if you are more in touch with your emotions.

Focus on what you can control

It’s normal to feel overwhelmed and anxious when you are faced with the uncertainties that lie ahead. However, there are certain things you can control, and taking practical steps to put these into practice can help you to manage your emotions.

For example, certain lifestyle changes such as eating a balanced diet, increasing your level of physical fitness, and exploring the available resources and support networks can help you to focus and feel more in control. This will also make dealing with the treatment and any potential side effects easier.

Set small achievable goals that are not related to your cancer treatment, such as walking a mile every day or at the weekend, or trying out a new recipe a couple of times a week.

Dealing with employment

A brain tumour diagnosis is life-changing, and if you are employed, it is likely that you will need to take time off work for treatment and recovery, or even stop working altogether. If you do decide to continue working, you may find that the tumour or the side effects of treatment affect your ability to do your job.

For example, some types of brain tumour can cause cognitive difficulties such as memory loss or confusion, speech and language problems, personality changes, or fatigue. If your partner or a family member needs to act as your carer, their job might also be affected.

You are not legally obliged to tell your employer about your brain tumour diagnosis, and some people may worry that it might result in unfair treatment at work. However, your rights as an employee are legally protected and your employer should make reasonable adjustments, including allowing you to have time off for appointments and treatment.

Dealing with finances

A brain tumour diagnosis can impact your finances, and this can be an additional source of stress and anxiety at a time when you are already dealing with powerful emotions and a lot of disruption. Your ability to earn might be reduced, or even stop altogether. If this is the case, take action early to find out what benefits and other financial support you can access.

Planning a budget can help you gain a sense of control over your finances, because you will be able to see at a glance how much money you have coming in and what your outgoings are. The Brain Tumour Charity has a useful section on managing your finances, and you can also access help from organisations such as the Citizen’s Advice Bureau.

Coping with changes after treatment

After your treatment, you may have short or long-term side effects that change your life in some way. These will be unique to you and the type of tumour and treatment you have received, and your healthcare team will still be available to help you with any queries and concerns you may have.

Remember that you are not alone, and there are many support services available to help you navigate emotional, physical or practical difficulties of living with a brain tumour.

Amethyst UK Proud To Sponsor #Miles4Radiotherapy Challenge

Each year, cancer charity Radiotherapy UK organises its #Miles4Radiotherapy summer challenge, where anyone affected by the disease can either get a team of people together or participate individually, clocking up sponsored mileage either by walking, running, sailing, wheeling, scooting, boxing, horse-riding… anything goes!

And the Amethyst Radiotherapy UK team are pleased to announce that they are now official sponsors of the 2025 event, which is due to start on July 1st and will be running for two months.

This year, the aim is to bring the radiotherapy community together to complete 160,000 miles over the two-month period, with every mile representing a treatment course delivered in the UK and the thousands of cancer patients seeking out the empowering information they need to help them navigate their cancer journey.

Given that one in two of us will get cancer at some point in our lives and that one in four of us will need to have radiotherapy treatment, this seems like a particularly good endeavour to support.

Those who sign up to the challenge will receive a welcome pack and associated merchandise, as well as exclusive access to the Race At Your Pace app.

The hope is that campaigns such as this will help raise awareness, show solidarity to those with the disease and fundraise successfully to create more trusted PIF TICK-accredited radiotherapy information for every cancer patient who needs it.

CEO of Amethyst Radiotherapy Sasha Burns said: “We’re proud to support the Miles4Radiotherapy campaign. Radiotherapy is vital to cancer care, yet access remains uneven across the UK. This initiative by Radiotherapy UK highlights the need for change and we’re committed to helping more patients get the treatment they deserve.”Director of Radiotherapy UK Sarah Quinlan made further comments, celebrating the close connection the charity has with Amethyst, having worked together in 2023 to create patient videos about Gamma Knife treatment for brain tumours.

She went on to add: “Those videos have now been viewed many thousands of times, showing there is so much we can do to help patients as they go through cancer treatment. The right information, made accessible, can help reduce anxiety and support people to feel empowered once more.”

Amethyst itself delivers stereotactic radiosurgery on behalf of the University College London Hospital and the NHS Trust at the National Hospital for Neurology and Neurosurgery, the oldest standalone neurosciences hospital. 

If you’d like to find out more about treatment options, get in touch with the team today.

Potential Signs Of A Brain Tumour That You Shouldn’t Ignore

Brain tumours are thankfully rare, but there are many different types of tumour and therefore the  signs and symptoms can be very varied. The early signs can easily be missed, or misdiagnosed as another condition. Sometimes, the symptoms may be very subtle or there may even be no symptoms at all.

However, early detection will lead to the most effective brain tumour treatment pathway, and result in the best patient outcome. Therefore, it’s important to recognise potential warning signs, and always seek medical advice if you have any concerns.

Here’s a look at some of the most common brain tumour symptoms, and when to consult a doctor. As we have mentioned, these symptoms can be varied depending on the type, size and location of the brain tumour. They can also be sudden and intense, or subtle and develop gradually over time.

Persistent headaches

Almost everyone gets headaches sometimes, and they can have numerous causes. Most of the time, a headache won’t be caused by a tumour. Common causes include stress, migraines, dehydration, infections, hangovers, eye strain or bad posture.

However, according to the Brain Tumour Charity, about 60 per cent of people living with a brain tumour do experience headaches at some stage, which are caused by a build up of pressure on the nerves and blood vessels within the brain.

Potential signs to look out for:

  • If your headaches feel different to usual, such as a dull or throbbing ache that gets worse over time, or occurs intermittently
  • If your headaches are worse first thing in the morning or whenever you wake from sleep, and recede when you assume an upright position
  • If your headaches do not respond to conventional painkillers that were previously effective, such as paracetamol or ibuprofen
  • If your headaches are triggered or worsened by coughing, bending, shouting or straining
  • If your headaches are accompanied by other symptoms, such as vomiting, seizures, muscle weakness, vision disturbance, or cognitive changes

Vision changes

If the tumour is pressing on an optic nerve or causing a swelling of the optic nerve in the back of the eye, it may lead to changes in vision. This may include:

  • Blurred or double vision
  • Episodes of sudden vision loss, often after standing up
  • Losing part of the field of your vision, such as peripheral vision

If you have any concerns about your vision, book an appointment with an optician for an eyesight test, or see your doctor.

Seizures

Seizures (commonly referred to as fits) are one of the most common first symptoms of a brain tumour in adults. All incidents of seizure should be reported to a doctor, as they can have several potentially serious causes. However, it does not necessarily mean that there is a problem.

Seizures can be relatively minor, such as a temporary jerking of the limbs, or involve convulsions and loss of consciousness. A seizure that is related to a brain tumour is more likely to cause moments of confusion, visual disturbances, or hallucinations than a full loss of consciousness.

Nausea and vomiting

A brain tumour can cause persistent feelings of nausea or vomiting, which are often accompanied by dizziness. It’s important to remember that these are usually not a sign of a tumour and can be caused by many different reasons, including: food poisoning, gastrointestinal viruses, pregnancy, and over indulgence in food or alcohol.

Nausea on its own is more likely to be caused by one of the above reasons. However, if it’s worse in the mornings and improves during the day, it gets worse if you suddenly change position, have persisted for over a week with no other obvious explanation, or are accompanied by other potential brain tumour symptoms, seek medical advice.

Persistent tiredness

Tiredness and fatigue can affect anyone, and they do not affect all brain tumour patients. The fatigue could be mild, such as sometimes feeling sluggish and slow, or almost totally debilitating, preventing an individual from carrying out their usual duties.

The fatigue might manifest as poor concentration; sleeping too much or trouble getting to sleep or staying asleep; aching muscles; anxiety and depression; feeling an exhaustion that is disproportionate to the activity carried out; lack of motivation; and a loss of interest in activities that were previously enjoyed.

When to see a doctor

The above are not a comprehensive list of potential brain tumour symptoms, and in most cases they won’t lead to a positive diagnosis of a tumour. However, if you are experiencing multiple symptoms, or symptoms that don’t improve after a few weeks and have no obvious explanation, then you should get checked out by a doctor.

If you would like to find out more about radiotherapy brain tumour treatment options, please visit our website.

The Future Of Brain Tumour Care: Key Challenges & Solutions

At the recent Healthcare Business International (HBI) conference in Paris, Amethyst Radiotherapy CEO Stéphane Carré discussed the future of cancer care with other leading experts in the field of oncology. Here’s an overview of the important topics that were raised, and how the landscape of brain tumour treatment in particular is evolving.

The role of public-private partnership

Stéphane spoke about the increasingly central role that public-private partnerships  (PPPs) are playing in oncology care. As public healthcare systems across Europe, including the NHS, are placed under tighter budgetary constraints, PPPs are seen as an efficient solution.

For example, private healthcare operator Amethyst Radiotherapy now manages two radiotherapy centres of excellence to provide Gamma Knife surgery, both located within NHS hospitals and providing care to both NHS and private patients.

The NHS in England is currently under significant pressure as it tackles waiting list backlogs, rising demand, staff shortages and historic underinvestment. PPPs can ease the strain on NHS resources and provide alternative options for both healthcare managers and patients.

By combining resources, knowledge, infrastructure and technology, the UK public and private healthcare sector will be able to offer patients the most cost-effective and innovative cancer care. This leads to improved patient outcomes and ensures that cancer care in the UK is fit to meet the demands of the future.

What are the advantages of Gamma Knife surgery?

Gamma Knife surgery is considered to be one of the safest and most effective treatments for certain types of brain tumour. It is particularly well suited to treat acoustic neuromas, meningiomas, pituitary tumours, and some metastatic tumours (secondary brain tumours that have spread from another part of the body).

The treatment is not a conventional surgery that involves incisions, but is a type of radiation therapy that is delivered from an external machine. The name Gamma Knife was chosen to express the high degree of precision involved in the delivery of the gamma rays. Multiple beams of electromagnetic radiation are targeted from different angles at the tumour site.

Individually, the beams are too weak to damage the healthy cells as they pass through the skull, but when they intersect at the specifically targeted area, they effectively destroy the tumour cells while causing no damage to the surrounding brain tissue.

This provides a minimally invasive procedure that has a much lower risk of serious side effects than conventional open brain surgery. Gamma Knife treatment can usually be delivered in one session and has minimal downtime, so it can be a much less stressful and time consuming treatment option than other types of surgery for brain tumour patients.

For both the NHS and the private sector alike, it also boosts time and resource efficiencies, allowing for faster treatment pathways and ultimately increasing the capacity for first-class brain tumour care.

What are the ongoing challenges of brain cancer care?

Although rapid advancements have been made in the field of brain cancer care in recent years, the sector still faces significant challenges. These include rising demand as there is a  growing awareness of potential brain tumour symptoms among both the public and GPs, leading to earlier diagnosis and thus more referrals to specialist healthcare teams.

The population of the UK is ageing, with about 10 million people currently over the age of 65 (18 percent of the overall population). Meanwhile, the number of people aged between 65-79 is expected to rise by a third to over 10 million by 2070. Age is one of the risk factors for a brain tumour, so there is expected to be a corresponding rise in diagnoses.

At the same time, financial pressures in both the public and private healthcare sectors are driving the demand for a sustainable and efficient model for the best quality of care.

How the latest technological innovations can help

Despite the growing challenges in the field of brain cancer treatment, technology is providing new opportunities and driving innovation. For example, AI and machine learning are being used to interpret MRI scans to provide a much more accurate and quicker annotation of tumour boundaries.

When carried out manually, this process is painstaking and time consuming, and subject to the variabilities of human interpretation. AI-driven auto-contouring for tumour segmentation is proving to be equally as effective as manually produced annotations, particularly for more complex and diffuse tumours that do not have clearly defined boundaries.

This means that patients can benefit from more timely and precisely delivered radiation treatment, with reduced risk of effects and complications, and a higher chance of a successful outcome.

If you would like to find out more about Gamma Knife surgery, please contact one of our team today.

What Is A Multidisciplinary Team For Brain Tumour Treatment?

A brain tumour diagnosis is a distressing time, and there is a lot of new information to take in. Naturally, you and your loved ones will be anxious to understand what your treatment options are. If you are in the UK, national guidelines recommend that brain tumour patients are treated by a group of specialists known as a multi-disciplinary team (MDT).

Here’s a closer look at who the members of an MDT are, and how they shape a brain tumour treatment pathway.

What does an MDT team do?

An MDT consists of healthcare professionals with different specialties who work together to form the best treatment plan for each patient. This ensures that individuals receive personalised care that is uniquely tailored to their needs and wishes, and the treatment plan is formed after input from multiple viewpoints with different areas of expertise.

The MDT will continue to manage your care throughout your treatment and follow up journey. This will ensure a consistent approach, and your progress will be regularly monitored and discussed with the relevant team members, and adjustments will be made if and when they are deemed necessary.

Who are the members of an MDT?

The members of an MDT will typically consist of the following:

Neurologist

A neurologist is a specialist in medical non-surgical abnormalities in the brain and spinal cord, and is often involved in the initial assessment of brain tumour patients, and the ongoing management of tumour-related seizures.

Neurosurgeon

A neurosurgeon will be involved if the tumour is operable, to remove part or all of the tumour.

Oncologist

A clinical or neuro oncologist specialises in the non-surgical management of brain tumours, such as radiotherapy or chemotherapy. A medical oncologist may be part of the MDT to deliver chemotherapy, immunotherapy, or other types of drug treatments.

Radiographer

A diagnostic radiologist uses imaging technology to create images of the brain that are used to accurately show the size, shape and location of the tumour. A therapeutic radiographer is involved in administering the radiation treatment.

Specialist nurses

A specialist nurse will be appointed to the team to offer support and advice, and will usually be your first point of contact.

Healthcare professionals you may meet post-treatment

Alongside your brain tumour treatment, your GP will remain involved in your day to day care and will be your first point of contact for health issues that aren’t or do not appear to be related to your brain tumour or treatment.

Depending on the type and severity of your symptoms, and the way they have affected your wellbeing and daily life, you may also work with the following medical staff as part of your treatment:

Neuropsychologist

A neuropsychologist specialises in the rehabilitation of patients with traumatic brain injuries, including damage that may have been caused by a brain tumour or the treatment. They may carry out assessments such as language tests that are designed to identify any difficulties, and work with you to help you manage the changes.

You may also be referred to a psychologist or a clinical psychiatrist to help you deal with mental or emotional problems that have developed as a result of your brain tumour, such as anxiety disorders or depression.

Therapists

You may be referred to various therapists as part of your rehabilitation process. These include an occupational therapist, who can help you to manage daily activities and if relevant, help you prepare for a return to work. A physiotherapist may be involved with your rehabilitation if you have difficulties with balance or muscle weakness.

If the area of your brain impacted by the tumour has affected your language and speaking skills, or if you have difficulty chewing and swallowing food, then you may be referred to a speech and language therapist. You may also be referred to a dietitian to ensure that your nutritional needs are being met.

How brain tumour patients benefit from an MDT approach

The direct involvement of a diverse range of specialists means that better-informed decisions can be made when creating your treatment plan. The team will meet to discuss your diagnosis and treatment options, which leads to better coordination and continuity of care, and higher quality patient outcomes.

Overall, the treatment plan will not just take into account the clinical aspects of your brain tumour, but will take a holistic approach that involves you as a person. You will always have the final say in the type of treatment that you receive, and your team will have your best interests at heart.

If you are interested in finding out more about radiotherapy for brain tumour treatment, please visit our website today.

World Parkinson’s Day: What Is PD And How Is It Treated?

April 11 is World Parkinson’s Day, which aims to create greater awareness and understanding of the neurological disorder that affects about 153,000 people in the UK and over six million people worldwide. Here’s a look at what Parkinson’s disease (PD) is, how it affects people, and current and emerging treatments, including Gamma Knife surgery.

What is Parkinson’s disease?

PD is a progressive neurological disorder that affects the dopamine-producing neurons in the brain. Dopamine is a neurotransmitter that is essential for coordinating smooth and balanced muscle movements. PD causes the cells that produce dopamine to deteriorate or die. This can result in tremor, stiffness, walking difficulties, and a range of other symptoms.

There are three main types of PD: idiopathic PD; vascular parkinsonism; and drug-induced parkinsonism. The most common form is idiopathic PD, which means that the cause is unknown. Vascular parkinsonism occurs when the blood supply to the brain is limited, such as when a person has experienced a stroke.

Drug-induced parkinsonism is mainly caused by a reaction to neuroleptic drugs, and not progressive as the symptoms will usually subside when the patient stops taking the drugs. There are several other rarer forms of PD that may result in more unusual symptoms.

What are the symptoms of Parkinson’s disease?

The most common form of PD (idiopathic PD) is a lifelong condition that causes a range of symptoms that slowly worsen over time. These may include:

  • Tremor
  • Stiffness
  • Slowness of movement (bradykinesia)
  • Fatigue
  • Depression
  • Anxiety
  • Memory problems
  • Constipation
  • Disturbed sleep

The symptoms and the rate of progression do not follow a fixed path, and each person will have a unique experience.

What causes PD?

Researchers still don’t fully understand what causes the most common variant of PD. There is some evidence to suggest a link between environmental stressors such as head injuries and chemical exposure and PD. Genetic mutations may also play a role in some cases. PD disproportionately affects white men over the age of 60, although it can affect anyone.

How is PD treated?

PD is treated with a combination of medication, therapy and physical activity. There is no cure, so the treatments are focused on managing the symptoms. PD medications aim to increase the amount of dopamine in the brain, or act as a dopamine substitute, or block the action of enzymes that break down the dopamine.

Physical activity is important to maintain both physical and mental health. Therapy focuses on physiotherapy; speech and language therapy; and occupational therapy to help patients manage the condition and maintain quality of life.

Researchers are constantly developing new treatments for PD. For example, gene therapy has shown some potential for addressing the underlying causes of PD rather than just aiming to manage the symptoms.

The potential of Gamma Knife surgery for treating PD

Gamma Knife surgery is an advanced form of stereotactic radiosurgery (SRS) and is emerging as a non-invasive way to manage certain PD symptoms, particularly essential tremors. SRS works by delivering a precisely calculated and targeted dose of radiation to the affected area of the brain, so the surrounding healthy tissue remains untouched.

The Gamma Knife machine delivers multiple radiation beams from different angles at the target area in the brain. Individually, these beams are too weak to cause any damage to the brain cells they cross, but when they intersect precisely at the treatment site, they are effective in killing or slowing the progression of the harmful cells.

Usually, just one treatment session is necessary, resulting in an earlier intervention and better outcomes for the patients. Currently, Gamma Knife is regarded as one of the most effective, safe, and minimally invasive treatments for certain types of brain tumour, particularly vestibular schwannoma and meningioma.

Studies have shown that SRS can be used to target the specific brain structures that are involved in motor control, (ventral intermediate nucleus of the thalamus) thus disrupting the neural circuits that cause the symptoms of essential tremor in PD patients.

The results demonstrated a high efficacy and low complication rates, suggesting that SRS could be a valuable alternative when conventional treatments are not effective, or when they are not suitable for the patient.

Research into the causes and most effective treatments for PD is continually underway, and the significant breakthroughs and advancements made in recent years offer hope for a better future for those living with the condition.

If you are interested in finding out more about Gamma Knife surgery as a potential treatment for PD, please visit our website or contact our team today.

World Neurosurgeons Day: From Cushing To The Present Era

April 8 is World Neurosurgeons Day, when the achievements of surgeons who carry out highly complex and precise procedures on the brain are celebrated. Leading edge technology such as Gamma Knife surgery has enabled the development of brain surgery that is less invasive, safer, and more effective than ever before.

However, these advancements may not have been possible without the dedicated efforts of Harvey Williams Cushing, the man widely regarded as the father of modern neurosurgery.  World Neurosurgeons Day marks the date of his birth on 8 April 1869. Here’s a look at his achievements, and how neurosurgery has evolved since his death in 1939.

The legacy of Harvey Cushing

Harvey Cushing was born in Cleveland, Ohio, and graduated from Yale College in 1891. He went on to study at Harvard Medical School in Boston, and received his medical degree in 1895.

From here, he completed an internship at Massachusetts General Hospital, where he successfully developed new anesthesia practices and was among the first medics to recognise the potential of X-rays as a diagnostic tool.

In 1896, Cushing started work at the Johns Hopkins Hospital in Baltimore, where he was mentored by the distinguished surgeon William Halsted, and was also strongly influenced by the professor of medicine Sir William Osler. He also spent a year studying with some of the finest surgeons in Europe.

By this time, Cushing had decided to focus his career on neuroscience, and he developed a reputation as one of the most meticulous brain surgeons of his generation. Previously, neurosurgery was considered a last resort with a low success rate: many procedures resulted in fatal bleeding or infections, or permanent brain damage.

Cushing introduced a range of innovations that resulted in a much higher success rate, particularly for the treatment of brain tumours. He developed a classification system for different types of tumours, and used X-rays to accurately locate the position of the tumour in the brain.

He also developed new methods for controlling bleeding and better anaesthesia techniques. One of his most significant legacies was the identification of Cushing’s syndrome, a disorder caused by excess cortisol production due to a pituitary gland tumour.

Cushing was also a prolific writer and talented draughtsman, and he made detailed notes and illustrations of all his work, and these, alongside his many publications that made original contributions to the field of neurosurgery, have educated and inspired future generations of medical professionals.

Post-Cushing advancements in neurosurgery

Neurosurgeons built on the foundations laid by Cushing to develop further groundbreaking techniques that have resulted in more precise and less invasive brain tumour treatment that has a lower risk of side effects.

For example, modern imaging techniques such MRI scans and CT scans have enabled neurosurgeons to more accurately locate the position of tumours. Recently, this process has become even more precise due to the introduction of AI technology, which can be used to automate the process of tumour delineation.

This enables tumours without clearly defined boundaries to be located in a more precise and consistent manner, reducing the risk of human error and variables in interpretation. AI assisted delineation is much quicker compared to a fully manual process of segmenting tumour contours. This speeds up the treatment process and improves patient outcomes.

For open surgery to remove brain tumours, modern procedures are designed to be less invasive with smaller incisions. Many neurosurgeons make use of robotic and AI-driven systems for more accurate and controlled guidance during procedures.

Radiosurgery and stereotactic radiosurgery

Radiosurgery was first developed to treat brain tumours by the Swedish neurosurgeon Lars Leksell. stereotactic radiosurgery involves delivering localised irradiation in one session to a precisely targeted area of the brain, in order to kill the abnormal tumour cells while having minimal impact on the surrounding healthy brain tissue.

Stereotactic radiosurgery was introduced for the treatment of inoperable arteriovenous malformations, acoustic neuromas, and brain metastasis.

Gamma Knife surgery

One of the most effective and low-risk forms of stereotactic radiosurgery is Gamma Knife surgery. This makes use of multiple radiation beams with a level of accuracy greater than 0.5mm.

The individual beams are too weak to damage normal brain tissue as they are directed onto the target area, but the beams intersect on the target area to provide effective impact on the abnormal cells.

This minimally invasive procedure has a much lower risk of side effects compared to other forms of brain surgery, and most patients can return home on the same day and will require just one session of treatment.

If you would like to find out more information about Gamma Knife surgery, please get in touch with a member of our team today.

Meningioma Overview: Causes, Symptoms And Treatment Options

Meningioma is the most common type of brain or spinal cord tumour diagnosed in the UK. According to Cancer Research UK, it accounted for 27 out of every 100 brain tumours diagnosed in England between 1995 and 2017, and they are more common in women than in men.

In the majority of cases, meningiomas are benign (non-cancerous), but they can cause symptoms that interfere with daily activities and affect quality of life.

Our expert consultant neurosurgeon, Mr. Matthias Radatz, provides a comprehensive guide to meningiomas in this informative video. Here’s an overview of the condition, including the causes, symptoms, and meningioma treatment options.

What is a meningioma?

Meningiomas originate in the meninges, which is a membrane that forms the protective lining between the brain and skull or spinal cord. There are various subcategories of meningioma, depending on the location in the brain or spine. They usually grow slowly (with an average rate of one to two centimetres per year) and do not spread from or to other parts of the body.

Sometimes, multiple meningiomas may occur in different locations. If the tumour is growing inwards, it may give rise to neurological symptoms due to compression on the brain. Medical professionals group meningiomas into grades one to three, depending on the predicted rate of growth. Grade one is the slowest rate, while grade three is the highest rate.

What are the causes of meningioma?

Doctors do not fully understand the causes of meningioma. In some rare cases, there is a genetic predisposition called Neurofibromatosis type 2 (NF2). This is caused by a faulty gene that can be passed from a parent to a child, although it may develop spontaneously. NF2 symptoms may present in childhood, but they can take many years to develop.

What are the symptoms of meningioma?

The symptoms will vary according to the location and size of the tumour, and may be very subtle or do not cause any signs at all. For this reason, meningiomas are sometimes detected when a patient has a brain scan for another reason.

If meningioma symptoms are present, they may include:

  • Headache
  • Visual impairment
  • Hearing loss
  • Tinitus (ringing in the ears)
  • Seizures (fits)
  • Weakness in the limbs
  • Swallowing difficulties
  • Memory loss
  • Changes in personality or behaviour
  • Balance problems
  • Speech difficulties

Your doctor will discuss your individual symptoms with you, as more investigation may be required to establish the exact cause.

How are meningiomas diagnosed?

Diagnosis is typically made from analysing images of the brain and spinal cord. Imaging technology has advanced considerably in recent years, and even very tiny lesions can be detected. In most cases, a magnetic resonance imaging (MRI) scan will be carried out as they provide the highest level of detail.

In some cases, blood tests, hearing tests, or vision tests may also be required.

How are meningiomas treated?

The severity of the meningioma will vary depending on the number, size and location of the tumour. If it is growing very slowly and not causing any symptoms, the tumour may be actively monitored with an annual scan rather than treated.

If the tumour is causing symptoms or is growing and may cause symptoms in the future, then a treatment pathway will be devised by your medical team. Meningiomas are very individual, and planning the treatment may require multidisciplinary evaluation by specialist teams.

The main treatment options are surgery, radiosurgery and stereotactic radiosurgery (SRS). Surgery is the most invasive and risky treatment option, and it may not be suitable for all patients.

The least invasive treatment is SRS such as Gamma Knife Surgery. It is most appropriate for small tumours that are not growing very close to vital areas of the brain. SRS involves delivering one precisely calculated dose of radiation to the tumour site from an external machine.

The location of the tumour and the direction of the radiation beam are targeted with an extremely high level of accuracy, so that the tumour cells are deliberately damaged with an intense radiation dose, while very minimal or no damage is caused to the surrounding healthy tissue.

This greatly improves the effectiveness of the treatment and there is a much lower risk of side effects compared to other types of surgery. Most patients will need very little downtime after SRS treatment, and can travel home on the same day. Usually repeat treatments are not required.

If you would like to find out more detailed information about meningioma treatment and Gamma Knife surgery, please visit our website or contact one of our team today.