Why Are Non-Invasive Treatments Such As Radiosurgery Vital?

When someone is diagnosed with a lesion, tumour or growth on the brain, they are given a wide variety of options, but if it is at all possible, they will be advised to have a treatment such as Gamma Knife at a radiotherapy centre.

Besides the fact that Lars Leksell’s pioneering stereotactic radiosurgery treatment is highly effective, fast and takes far less time to treat and recover from than conventional brain surgery would, it also has the key feature that it is non-invasive.

The concept of non-invasive and minimally invasive treatments in medical care is the core philosophy at the heart of modern medicine, and as long as a more minimally invasive treatment is effective, it is more likely to be recommended by a doctor.

Despite it being a more modern philosophical take, the balance between choosing effective treatments and the consequences of said treatments is a question that has been asked since the very start of medicine as we know it.

Primum Non Nocere

One of the core principles of medicine is the concept of doing no harm, even if the specific phrase does not appear in historic versions of the Hippocratic Oath.

The concept of “first do no harm”, which is at the core of modern questions about appropriate treatments comes from Hippocrates’ Epidemics Book I (Section II, Second Constitution, Section 5).

In it, he notes that the “physician” must have what he defines as “two special objects” in mind when it comes to the treatment of disease; either they must do good or do no harm to a patient. 

This principle is at the core of minimally invasive treatment; doctors should in all fields of medicine avoid overprescribing medication, recommending unnecessarily invasive treatments and doing anything more than is necessary to receive the ideal medical outcome.

In the field of brain surgery, where the margin of error is practically nonexistent, this is even more important, and in many cases outside of critical emergency treatments, the least invasive treatment is the correct option for a patient.

Mr Leksell himself came to this conclusion, albeit in a rather unusual way; he believed strongly in bloodless surgery for reasons that were as much aesthetic and based on an aversion to blood as they are based on fundamental principles or any empirical evidence available in the 1930s.

This led to a decades-long devotion to a form of surgery that required no incision, and this ultimately led to the development of the Gamma Knife and the entire field of stereotactic radiosurgery.

Practical Benefits Of Minimal Invasion

Besides philosophical and aesthetic reasons for wanting minimally invasive treatments, there is the notion of timescales and recovery to consider.

A Gamma Knife treatment takes between 30 minutes and four hours, depending on the complexity of the treatment, and whilst there is a small amount of aftercare, most people are able to go home after their radiotherapy treatment.

Contrast that with an equivalent brain surgery, which typically would require stitches or staples to be applied, and as a result of this and the need to monitor a patient’s condition, people can spend up to a week in the hospital, although this varies considerably depending on the complexity of the treatment.

This is a huge reason why surgery is avoided where possible, as the difference between half a day and a week of monitored recovery, followed by rehabilitation is massive, and the implications on a person from a personal, physical and financial perspective cannot be overlooked.

Mr Leksell was ahead of his time in this consideration, even if it took decades for others inspired by his pioneering work to develop the evidence base to change medicine.

An aspiring neurologist would pick up the mantle and ultimately change the practice of medicine in this direction, although the path he took was far from straightforward itself.

The Father Of Minimally Invasive Treatment

Whilst Hippocrates developed the basic principle and Gamma Knife was one of the first tools developed with this in mind, the man to both coin the term and fundamentally shift medicine in the direction of minimal invasion was John Wickham.

Born in Chichester in 1927, around the time Mr Leksell was starting to develop his philosophy and his skills as a neurologist, Mr Wickham wanted to follow in those footsteps and also become a neurologist, although he would ultimately switch to renal medicine.

Whilst he would be an exceptionally skilled urologist, his greatest achievement was in changing the philosophy of medicine and surgery and giving a phrase to a concept that had been on the minds of countless surgeons and radiologists regardless of speciality.

In 1984, Mr Wickham was the man to coin the term “minimally invasive treatment” in the context of surgery and wrote about it in a famous and influential article in the British Medical Journal in 1987.

From the very first line of the article, he noted that surgeons of the time favoured huge incisions compared to the then-novel practice of “keyhole surgery”, whilst patients wanted the “smallest wound possible”, which in the case of radiosurgery involves no incision whatsoever.

Whilst he invented the term, he noted that the concepts and technologies had been evolving since 1960, around the time that radiosurgery was starting to be adopted, and certain specialist fields had developed either non-invasive or minimally invasive alternative treatments for conditions.

He conceived of a world where, by the year 2017, most non-emergency surgery would be undertaken by radiologists and keyhole surgeons, with open surgeries limited to emergency treatments, and this is essentially how the field of medical development turned out.

Rather ironically, the next article was entitled “Retreat from openness”, and this is the exact world the Gamma Knife developed and a necessity to protect patients, improve recovery and give people more options for treatment without an expectation of a long recovery period.

There has always been and may always be room to develop and improve medical principles; diagnostic techniques are ever-improving and allowing for lesions on the brain to be spotted quicker and treated with similar rapidity, and the future of surgery may involve no incision at all.

US Ballerina Gives Up Career To Research MS In Scotland

An American ballerina has given up her dance career to research multiple sclerosis (MS) in Scotland. BBC News reports that Emily Davis worked at the Philadelphia Ballet company for six years before moving to Glasgow in 2021, where she embarked on a PhD in dance health at Glasgow Caledonian University. 

Ms Davis’ research will investigate how dance classes can help people living with MS, an  autoimmune disease where the immune system mistakenly attacks the central nervous system. It’s more common in countries that lie further north or south of the equator, and the condition is disproportionately prevalent in Scotland compared to England and Wales.

Other northern hemisphere countries such as Canada have above average rates of MS. However, it is not yet clear what the reasons for this are, although research is currently ongoing. The causes of MS are not fully understood, although scientists believe that genetics make up about 50 per cent of the risk of getting MS.

There is a theory that lack of sunshine may be another risk factor for MS, which might explain why more people in the far north of Scotland are living with MS than almost anywhere else in the world. There is also some evidence that being exposed to certain viruses, smoking, obesity, and long-term exposure to certain solvents may increase the risk. 

MS is not a terminal disease, and it can be treated but not cured. Everyone’s symptoms will vary according to the particular part of the brain or spinal cord that has been damaged. Some people only have mild symptoms and they only have a minor impact on their day to day lives, while others may live with a degree of disability. 

Some people with MS find that their symptoms get gradually worse over time, while others have flare ups followed by a period of recovery, which is known as relapsing remitting MS. There are medical treatments known as disease modifying drugs that can treat the underlying condition of MS, and they can slow down the progress of the disease.

Some people with MS have therapies such as physiotherapy, and complementary therapies that might include yoga, pilates, reflexology, or meditation, to treat their symptoms. MS can affect balance, coordination, mobility, energy levels and cognitive function, and research has shown that exercise can help to ease these symptoms. 

Ms Davis explained to the BBC that her research was inspired by the use of movement and dance to treat other neurological conditions such as Parkinson’s Disease. 

She said: “When I looked at dance for other neurological conditions, I found that there were only 13 studies on dance for MS, so there was only limited research in this area, and we are aware of really only a handful of dance programmes around the world.”

“We know that movement, especially rhythmic movement like dance, can be really beneficial for movement disorders like Parkinson’s disease. Scottish Ballet is at the forefront of dance for MS in the UK and globally, so it’s been the best place to start.”

Professor Lorna Paul, a rehabilitation expert in allied health science at Glasgow Caledonian University, commented on Ms Davis’ work: “Emily’s ground-breaking research has provided evidence on potential benefits of ballet for people with MS for the first time.”

She added: “People with MS can have problems with movement and balance which can be helped with exercise. Ballet is a form of physical activity which may be more expressive, fun and with a stronger social component than traditional forms of rehabilitation.”

“Emily’s PhD has been the catalyst for the successful collaboration between Glasgow Caledonian, RCS and Scottish Ballet, and this collaboration will continue to grow and strengthen thanks to Emily’s work.”

In 2019, research by the University of Edinburgh confirmed that Scotland has one of the highest rates of MS in the world, with the highest incidences in Orkney and Tayside. It also found that women were over twice as likely to develop MS than men. 

The study was carried out by researchers from The Anne Rowling Regenerative Neurology Clinic in Edinburgh, which was established with a donation from the Harry Potter author JK Rowling, whose mother passed away with MS aged 45. 

For more information about multiple sclerosis and nerve damage, and also to find out about Gamma Knife surgery, please contact Mr Jonathan Hyam of Amethyst Radiotherapy.

Trial To Use mRNA Cancer Vaccine For Brain Tumour Treatment

A clinical trial has just been completed that may lead to a breakthrough treatment for an aggressive form of brain tumour known as a glioblastoma. Science Daily reports that the first-ever human trial of four adults has taken place for an mRNA cancer vaccine, following promising results on a trial involving ten canines. 

The mRNA treatment works by triggering the body’s own immune system to attack the cancer cells. It was developed by researchers from the University of Florida, and it is reported to show results within 48 hours of being injected. The scientists were surprised by the rapid response of the immune cells, describing the trial as a ‘breakthrough.’

Glioblastomas are grade 4 brain tumours, which means that they are cancerous and can spread quickly to other parts of the brain, and are the most common high-grade brain tumour in adults. Prognosis varies depending on the size and location of the tumour, but the average survival rate after diagnosis is just 12 to 18 months. 

Glioblastomas can be treated with chemotherapy or specialised types of radiotherapy such as Gamma Knife Surgery, depending on the location in the brain and the overall health of the patient. However, there is a strong possibility that the tumour may return even after it has been surgically removed. 

The symptoms of a glioblastoma vary according to where it is in the brain. Commonly occurring symptoms include headaches, memory problems, fatigue, problems with eyesight, speech and communication difficulties, mood swings or personality changes, trouble with cognitive function and seizures.

The new mRNA trial showed that glioblastoma patients either lived longer than predicted, or remained free of cancer for longer after other forms of treatment. The researchers are hopeful that the mRNA vaccine could eventually lead to a new model for brain cancer treatment. Further trials of the vaccine will now go ahead on a larger group of 24 patients.  

Senior author Elias Sayour, a UF Health paediatric oncologist who pioneered the vaccine, told The Independent: “In less than 48 hours, we could see these tumours shifting from what we refer to as ‘cold’ – immune cold, very few immune cells, very silenced immune response – to ‘hot’, very active immune response.”

He added: “That was very surprising given how quick this happened, and what that told us is we were able to activate the early part of the immune system very rapidly against these cancers, and that’s critical to unlock the later effects of the immune response.”

“I am hopeful that this could be a new paradigm for how we treat patients, a new platform technology for how we can modulate the immune system. I am hopeful for how this could now synergize with other immunotherapies and perhaps unlock those immunotherapies.

“We showed in this paper that you actually can have synergy with other types of immunotherapies, so maybe now we can have a combination approach of immunotherapy.”

The full study is published in the journal Cell, and the authors explain how they made use of mRNA technology that was used to develop Covid-19 treatments. However, the cancer-fighting vaccine makes use of the patient’s own tumour cells to create a personalised vaccine, greatly increasing the chance of success. 

The brain tumour vaccine also makes use of a highly sophisticated delivery mechanism involving clusters of particles rather than single particles. This is designed to alert the immune system, and clusters will have more impact than single particles. 

Duane Mitchell, M.D., Ph.D., director of the UF Clinical and Translational Science Institute and the UF Brain Tumor Immunotherapy Program and a co-author of the paper, explained: 

“The demonstration that making an mRNA cancer vaccine in this fashion generates similar and strong responses in mice, dogs that have developed cancer spontaneously and human patients with brain cancer is a really important finding, because often we don’t know how well the preclinical studies in animals are going to translate into similar responses in patients.”

“And while mRNA vaccines and therapeutics are certainly a hot topic since the COVID pandemic, this is a novel and unique way of delivering the mRNA to generate these really significant and rapid immune responses that we’re seeing across animals and humans.”

After the upcoming trial of 24 patients, plans are already in place to widen the trials to include children. 

If you would like some more information on Gamma Knife surgery and Brain cancer treatment, please contact Mr Neil Kitchen of Amethyst Radiotherapy.  

MS Patients Encouraged To Seek Help For Sensitive Symptoms

A new survey carried out by the MS Society has found that up to a third of patients avoid or delay seeking treatment because they feel embarrassed about their symptoms. Multiple sclerosis (MS) can cause a wide range of symptoms, including fatigue, poor coordination, memory problems, bladder control problems, and sexual dysfunction.

The survey was carried out as part of MS Awareness Week 2024, which took place at the end of April. This year, the MS Society has focused on highlighting those symptoms of the condition that can be difficult to talk about, in an effort to break taboos and empower people to speak up.

The survey of 1,400 people found that 85 per cent of respondents found one or more of their MS symptoms embarrassing. More than half (59 per cent) were embarrassed about bladder problems, while 27 per cent felt embarrassed about sexual dysfunction. Just under half (49 per cent) of respondents felt embarrassed about walking issues such as wavering.

The survey also revealed that 22 per cent of respondents keep their symptoms hidden from partners, while some 49 per cent would not feel comfortable discussing a sexual dysfunction problem with a healthcare professional. 

Kerry Riches, a reality TV star who took part in the last series of Big Brother, lives with relapsing MS and has spoken about her experiences of bladder and bowel problems. She is working with the MS Society as part of their MS Unfiltered theme, to help normalise talking about issues that many people find sensitive or uncomfortable to talk about. 

Kerry says: “While bladder and bowel issues will always be slightly embarrassing, for many of us living with MS it’s just something we have to come to terms with.”

My bladder is rubbish, if I sneeze I wee, I never go anywhere without a spare pair of knickers and I’ve been wearing pads since I was 24 because I am constantly weeing or leaking. I’ve even wet myself on a plane before. I’ve teamed up with the MS Society on this campaign as I want to show the unfiltered side of MS and show others that they are not alone.” 

It is estimated that there are 130,000 people in the UK living with MS, which is an autoimmune condition that affects the nerves in the brain and spinal cord. It’s almost three times more common in women than men, and is most often diagnosed when people are in their 20s or 30s. 

It is not inherited, although there is a slightly higher risk of developing MS if you have a family member with the condition. The symptoms can be wide ranging, because it affects the central nervous system that controls every movement of the body. 

Most newly diagnosed people report symptoms such as fatigue, difficulty walking such as tripping, stumbling, or a heaviness in the legs; eyesight problems; unusual sensations on the skin such as pins and needles or numbness; and difficulty with memory or concentration. It can also cause the aforementioned bladder, bowel, and sexual function problems.

Dr Panna Muqit, an NHS GP and Honorary Senior Lecturer at the University of St Andrews, explained to the MS Society:

“I speak to many patients living with MS and understand the difficulty in discussing challenging symptoms with your GP. Sharing your symptoms can prevent the problem from escalating by allowing the exploration of new treatments, or adjustments to your diet or lifestyle.”

In addition to your GP, there are other healthcare professionals, such as an MS nurse, an incontinence specialist, or a neurologist, who can assist you with potentially embarrassing MS symptoms.”

“It’s crucial to remember that you are not alone. I strongly encourage patients to engage with others who are experiencing the same symptoms through support groups or MS charities.”

The MS Society runs a free helpline for MS patients to seek advice and support, and there is a wealth of useful information available on their website. There are several ways of managing the various symptoms of MS, and healthcare professionals are trained to identify the best approaches for individual patients. 

For more information about the treatment of multiple sclerosis and Gamma Knife surgery, please contact Mr Jonathan Hyam of Amethyst Radiotherapy.

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Amethyst Radiotherapy achieves high-rise Gamma Knife source loader crane installation in Central London

Amethyst Radiotherapy a leader in cutting-edge cancer treatment, specifically Stereotactic Radiosurgery, is proud to announce the successful upgrade of its Gamma Knife machine at its prestigious Queen Square centre in Central London.

Specialised cranage equipment was used, lifting over 15 tonnes of equipment between the 2 high-rise buildings located in Central London. The Source Loader weighed approximately nine tonnes, with the radiation vault at roughly 5 tonnes – a variety of other equipment also required specialist transportation.

The Gamma Knife source loader is a sophisticated device used to precisely position radioactive sources, specifically cobalt-60, within the Gamma Knife machine.

This technology is critical for targeting and treating brain tumours with high doses of radiation, whilst minimising exposure to surrounding healthy tissues. The precision of the source loader is vital for the effectiveness and safety of Gamma Knife radiotherapy, offering non-invasive treatment options for patients with various neurological conditions and metastatic brain tumours.

Issues were faced – including an unrelated protest march which prevented the access and delivery of equipment, vehicles not following the temporary parking restrictions and more.

The complicated installation process underscores the intricate logistics undertaken by the Amethyst team to ensure a safe and efficient installation, reducing disruption to the surrounding area, whilst continuing to strive to deliver world class treatment.

Following the successful installation, the equipment will soon be resuming treatment of NHS and private patients.

Daniel Lumley, Director of Clinical Operations, Amethyst UK commented:

“The logistical challenges of transporting and installing the source loader and radiation vault were formidable, particularly given the dense urban environment of central London.”

“The use of a crane was essential for positioning these heavy and sensitive components with precision. Our team’s expertise in navigating these complexities was critical to the successful upgrade of our facilities – I’d like to thank all involved, from within Amethyst and the outside contractors who contributed to the project’s success.”

Mr Neil Kitchen, Consultant Neurosurgeon, Medical Director for the Queen Square Gamma Knife Unit commented:

“The reloading of our state of the art gamma knife treatment platform with brand new cobalt radiation sources will halve treatment times for our patients making their therapy less onerous and allowing us to treat many more patients efficiently thus reducing waiting times. As Clinical Director, on behalf of the clinical team, I would like to thank Amethyst UK and UCLH for completing this complicated task.”

Campaigners Launch Manifesto For Rare & Less Common Cancers

Cancer52, an alliance of charities representing rare and less common cancers, has launched a manifesto to raise awareness and improve outcomes for people affected by these conditions. The initiative is supported by the charity Brain Tumour Research (BTR), who campaign for better funding for research into brain tumour treatments.  

The manifesto, titled The Other Half: A manifesto to transform outcomes for people with rare and less common cancers, was launched at a reception in the House of Commons, Westminster on 16 April. The reception was attended by member, patient representatives, and MPs, and hosted by former Health Minister Will Quince, BTR reports. 

Mr Quince said the focus needed to be on public awareness, knowing the symptoms, early diagnosis and treatment pathways. He added: “The life sciences are a real passion of mine, and we need to make sure this sector flourishes – which means patients here in the UK are getting the latest treatments and therapies.”

Almost half (47 per cent) of cancers diagnosed are rare or less common, and they account for 55 per cent of all cancer deaths in the UK. According to Cancer52 CEO Jane Lyons, it was “the passion of the Cancer52 community that brings the charities together, under so many circumstances, to be heard with one voice”.

The manifesto sets out three main priorities. The first is to reduce the number of deaths from rare and less common cancers by 15 per cent by 2040; the second is to increase the early diagnosis of rare and less common cancers; and the third is to call for a new national mission for rare and less common cancers, which puts patient involvement at the centre.

There are over 200 different types of cancer, and according to Cancer Research UK, rare cancers are classed as those that affect a smaller number of people, starts in an unusual place in the body, or is of an unusual type and needs special treatment. However, there is no cut and dried definition of what a rare cancer is. 

Examples of rare and less common cancers include brain tumours, kidney cancer, non-Hodgkin lymphoma, pancreatic cancer, and melanoma skin cancer. It can take longer to diagnose these types of cancers because the symptoms might be more unfamiliar to doctors and less recognisable. 

These cancers may also require more tests to confirm the diagnosis, or the test might need to be sent to a specialist laboratory for analysis, and then further specialist tests might be required. All this can lead to a delay of several weeks before the diagnosis is confirmed, leading to possibly crucial lost treatment time for the patient.  

Furthermore, the doctor may need to consult about the cancer with other specialists nationally or internationally, if they lack expertise in a particular area. It may also take longer to work out an appropriate treatment plan and assemble an experienced medical team. 

In a statement on their manifesto, Cancer52 say: “We call on the next Government to take action to reduce deaths and address the needs of the growing numbers of people with rare and less common cancers. Core to this ambition is a need to minimise the impact of inequalities on people with rare and less common cancers.”

It continues: “There are currently more deaths from rare and less common cancers than there are new cases in the UK. Cancer52 is aligned with Cancer Research UK’s call to reduce deaths from all cancers by 15% by 2040.”

“This goal is even more challenging for rare and less common cancers as incidence is increasing and survival improvements are slower than the four most common cancers.”

“Over the past decade, mortality rates for the four most common cancers have fallen around twice as fast as rare and less common cancers combined. By reducing the mortality for rare and less common cancers by 15% by 2040, around 80,400 deaths could be avoided compared with current projections.”

BTR’s  Policy and Public Affairs Manager Thomas Brayford said: “We welcome Cancer52’s latest manifesto, which helps to shine a light on rare and less common cancers. The other half now needs to be listened to.”

It is hoped that the manifesto will lend further support to the ongoing work of the All-Party Parliamentary Group on Brain Tumours. 

If you would like some information about brain tumour treatment, please contact Mr George Samandouras of Amethyst Radiotherapy.

How Can You Manage The Symptoms Of An Acoustic Neuroma?

Acoustic Neuroma (AN) is a subtype of vestibular schwannoma, a form of slow-growing brain tumour that develops in the area between the ear and the brain. It is non-cancerous, but it can cause life-changing symptoms. The biggest challenges faced by people with AN are often hearing and balance disturbances. 

According to the Brain Tumour Charity, ANs account for about 8 per cent of all primary brain tumours. They can be diagnosed at any age, although they most often affect people between the ages of 40 and 60. The majority of ANs occur in people with no family history of these types of tumours, and it is not fully understood what causes them.

The most common symptoms of ANs are hearing loss, often on one side; tinnitus (ringing or noises in the ear); numbness or weakness in the facial muscles; dizziness or vertigo; difficulties with balance; persistent headaches; vision disturbances; a hoarse voice or difficulty swallowing; and poor limb coordination on one side of the body. 

The symptoms are caused by the tumour pressing on the balance, hearing and facial nerves. If the tumour remains untreated, it may become large enough to press on the brain, which can cause more serious problems.

How are ANs diagnosed?

If you are concerned about any of the above symptoms, you should visit your GP. If your doctor thinks that your symptoms might be caused by an AN, they will arrange some tests and refer you to a specialist. The medical tests may include a magnetic resonance imaging (MRI) scan, a computerised tomography (CT) scan, and a hearing test.

How are ANs treated?

The treatment for AN may depend on the type, location  and size of the tumour, the severity of the symptoms, and the general health of the patient. They are often very slow growing, and therefore require regular monitoring rather than active treatment. Larger tumours may be completely or partially removed by surgery.

Smaller tumours or any parts of the tumour remaining after surgery may be treated with stereotactic surgery. This is not traditional surgery that involves incision, but is a method of delivering precisely focussed radiation beams from an external machine to destroy the tumour cells. 

Research into new brain tumour treatments is ongoing, but it is a sector that has been historically underfunded, particularly in the field of non-cancerous tumours. 

Managing the symptoms of AN

One of the biggest issues faced by people living with AN is difficulty with balance. The British Acoustic Neuroma Association (BANA) explains that regular exercise can help to manage the problem. During April, the charity is running a campaign to raise awareness of AN and asking participants to complete 5,000 steps a day for 10 days.

In a statement on their website, the charity comments: “Living with conditions that affect balance function can be challenging, but incorporating regular movement into your daily routine is crucial for maintaining and even improving balance.”

“Movement helps to strengthen muscles, improve coordination, and enhance proprioception, which is your body’s ability to sense its position in space. By engaging in activities such as walking, stretching or yoga, you can build strength in the muscles that support balance and improve overall stability.”

“Movement can also help to boost confidence and reduce the risk of falls, ultimately leading to a better quality of life.”

Sometimes, an AN may grow very slowly over a number of years, and they may be diagnosed after a person has been noticing difficulties with their hearing. The Royal National Institute for the Deaf (RNID) runs a free online hearing test that takes just three minutes, and the charity offers further support and advice for people living with hearing loss.

Deaf Awareness Week is coming up on May 6-12 this year, with the aim to raise the visibility of the challenges faced by people with hearing impairments. Unfortunately, deafness can still carry a stigma, and lead to discrimination at work, and difficulties with communication and personal relationships.

Hearing impairment is estimated to affect about 12 million adults in the UK, and it can cause loneliness and social isolation, as well as making everyday life and employment difficult. There are technology assistive devices that can help people with hearing loss, and some people may learn sign language or lip reading. 

If you would like some more information about acoustic neuroma treatment, please contact Mr Patrick Grover of Amethyst Radiotherapy.

Study Finds Obesity Medications May Reduce The Risk Of MS

A new study based on real-world data has found that obesity medications that are approved for medical use in the UK may also reduce the risk of developing multiple sclerosis (MS). Healthline News reports that the drugs, which are currently used to treat type 2 diabetes and aid weight loss, may be repurposed as a potential MS therapy. 

MS is a chronic autoimmune condition that affects the central nervous system. In people with MS, the immune system erroneously attacks the protective covering of the nerve fibres (known as myelin) which is located in the brain and spinal cord. This disrupts the flow of electrical signals between the brain and the rest of the body. 

The disruption to the central nervous system can lead to a range of symptoms, which may get progressively worse over time, or relapse and recur in cycles. Common symptoms include poor coordination and difficulty walking; tremor; fatigue; dizziness; vision disturbances; and cognitive changes such as problems with memory and concentration.

There is currently no cure for MS, although research is ongoing to understand the condition better and develop potential treatments and cures. Currently, the treatment of MS mostly involves managing the symptoms, and may vary according to the severity and progression of the disease and factors such as general health, age, and preferences of the patient. 

The new study was carried out by US-based researchers, and is published in Therapeutic Advances in Neurological Disorders. The researchers used real-world data from the U.S. Food and Drug Administration’s Adverse Event Reporting System database.

The researchers found that medicines that included semaglutide, and similar ingredients from the GLP-1 receptor agonists group, reduced the risk of developing MS by as much as 76 per cent. The medicines are designed to lower blood sugar levels. However, no link was found with other types of weight loss drug included in the study. 

The researchers said: ‘Drug repurposing, defined as researching new indications for already approved drugs, is gaining attention as a rapid and cost-efficient strategy for developing new treatments.’

The authors added: “Overall, this study hints at the possibility of considering anti-diabetic drugs with weight loss-inducing effects, especially GLP-1 receptor agonists, for potential repurposing opportunities in MS. These findings should be validated through complementary methodologies and prospective studies.”

The connection between obesity and MS has been previously studied, although researchers have been unable to pinpoint an exact link. It is thought that the increased inflammation levels in the bodies of obese people may make them more susceptible to MS. 

Meanwhile, another study has found that people who were obese in childhood are twice as likely to be diagnosed with MS. The Independent reports that the study was carried out by  academics from the Karolinska Institutet in Stockholm, and referred to data from the Swedish Childhood Obesity Treatment Register, which is known as Boris.

The researchers applied statistical analysis methods to data on 21,000 children diagnosed with obesity between 1995 and 2020, with an age range of two to 19. They compared the data with 100,000 with no obesity, and tracked each child for an average of six years. The results showed that the obese children were twice as likely to be diagnosed with MS. 

The average age for the diagnosis was 23 years old, described as early-onset MS. 

Study authors, associate professor Emilia Hagman and professor Claude Marcus, told the PA news agency: “One of the effects of obesity in childhood is that it causes a low-grade, but chronic, inflammation, and most probably this inflammation increases the risk to develop several diseases such as MS.

“It is also believed that chronic low-grade inflammation increases the risk for other such diseases are asthma, arthritis, type 1 diabetes, and some forms of cancers. However, we know that weight loss reduces the inflammation and most likely the risk to develop such diseases.”

Commenting on the study, Dr Clare Walton, head of research at the MS Society, said: “We don’t know for sure what causes MS, but research suggests it’s likely triggered by a mix of genetic and environmental factors, such as some viral infections and lower levels of vitamin D.”

However, it’s important to note that the exact causes of MS are not fully understood, and in many cases it may not be connected to weight or other lifestyle factors. 

If you are interested in finding out more about multiple sclerosis treatment or Gamma Knife surgery in the UK, please contact Mr Jonathan Hyam of Amethyst Radiotherapy.

MS Awareness Week: How To Talk About ‘Embarrassing’ Symptoms

Multiple Sclerosis (MS) Awareness Week is on 22-28 April this year, and charities and other health organisations are coming together to help improve the lives of people affected by this distressing condition. This year, the focus will be on the symptoms of MS that can be difficult to talk about.  

MS is a neurological condition that causes damage to the central nervous system. The MS Trust explains that the term ‘sclerosis’ means scarring, which in the case of MS means damage caused to the nerves in the brain and the spinal cord. The term ‘multiple’ refers to the fact that the damage can occur in more than one place.

The damage occurs when the immune system mistakenly attacks the covering that protects the nerves, which is called myelin. The body can repair the damage up to a point, but eventually the myelin wears thinner or may be eroded completely. This makes it more difficult for messages to travel between the body and the brain.

Sometimes, the messages are able to reroute themselves, but over time the condition can get progressively worse and the messages are not able to travel quickly or at all, resulting in a range of symptoms. These are wide ranging, because MS affects everyone differently. The symptoms can also vary in intensity from day to day.

Some of the most common symptoms include tiredness and fatigue, skin sensations such as numbness or tingling, memory and cognition problems, eyesight problems, and walking difficulties such as weakness or heaviness in the legs, and frequent stumbling or tripping. 

MS can also cause problems with the bladder and bowel, and sexual difficulties. These are obviously very personal issues that many people are reluctant to discuss with a health professional. This year MS charities and other related parties are working together to help break down the stigma and make it easier for people to discuss their problems.

MS can cause people to need to urinate more frequently and urgently, and have more difficulty in emptying their bladder, or episodes of incontinence. This can obviously restrict the quality and enjoyment of life for the person with MS, leading them to avoid everyday activities such as exercising and socialising. 

It’s important to be aware that these symptoms can be caused by other factors, such as an enlarged prostate in men; pregnancy, childbirth, or fibroids in women; urinary tract infections;  abdominal surgery; and excessive consumption of caffeine or alcohol. However, they should always be discussed with a health professional.

Sometimes, the problems can be eased or resolved by a few lifestyle changes. These include monitoring fluid intake and trips to the bathroom to understand how this might affect the bladder; staying properly hydrated; and avoiding substances that irritate the bladder such as caffeine, alcohol, spicy foods, and fizzy drinks. 

Strengthening the pelvic floor with some exercises can also be beneficial, and it also helps to maintain a healthy weight and avoid smoking. Bladder problems may also be treated with medication, botox injections, or a catheter. 

MS can also cause bowel problems such as constipation, incontinence or diarrhoea. All of these symptoms may occur in one person, and the problems may fluctuate over time. If you also notice blood in your stools, you should see a GP immediately, as this may be a sign of bowel cancer. 

It may be difficult or feel embarrassing to bring up this topic with a health professional, but they will be used to dealing with these symptoms and will be able to suggest a range of treatments. These might include changing your diet to include more fibre and fluids; taking regular exercise, and adopting the correct posture while on the toilet.

Bowel problems can also be treated with medications, enemas, pelvic floor exercises, or surgery. 

Sexual difficulties are commonly experienced by a range of people, and it is estimated that they affect about 50-90 per cent of all men with MS, and about half of all women. These figures may not be accurate because many people find that the topic is awkward or difficult to discuss with a healthcare professional.

MS may cause difficulties either directly, through erectile dysfunction in men or lack of arousal in women; or indirectly through a lack of stamina, incontinence, or emotional problems such as lower self esteem or feeling less attractive. 

There is support available, which may include talking therapies or medication to treat related conditions such as incontinence. 

If you would like some more information about the treatment of multiple sclerosis and nerves damage, please contact Mr Jonathan Hyam of Amethyst Radiotherapy. Further information is available about Gamma Knife surgery.

How To Maintain Your Dignity During Radiotherapy Courses

Undertaking radiotherapy is a major step in treating cancer, whether it is aimed at potentially curing you completely or at least enabling you to live an extended life span.

By the time you start treatment, you will be familiar with the process that will take place, as your oncologist and other specialists at the radiotherapy centre will have explained to you not just what the use of radiation to attack cancerous cells and tumours aims to do – by preventing them from growing and reproducing – but also how the procedure works.

This will include aspects like how long it takes, what it is like being inside a chamber, how you will prepare and what to expect afterwards.

Why There Is More To Radiotherapy Than Radiation

In a wider context, the actual treatment, while of central importance, is brief and therefore only makes up a small part of the experience of going through radiotherapy.

That is partly because your treatment may combine radiotherapy with chemotherapy or surgery, with the latter often involving radiation being used to shrink a tumour before it is excised by a surgeon.

What the process also involves is a range of ways in which the process can be very gruelling. Firstly, there is the physical element, with a wide range of side-effects being experienced by those having radiotherapy, both in the short and long term.

These can include tiredness and fatigue, nausea, upset stomach and loose bowel movements, hair loss, skin soreness, loss of libido and sometimes (especially with pelvic radiotherapy) sex problems in the short term.

Longer-term effects, of particular concern for those with good prospects for survival, can include reduced fertility, which may have wider implications if you survive but want to have children thereafter. This may leave you with major decisions such as whether to freeze eggs or sperm, stay childless or consider adoption.

How To Fight Your Mental Battle

This last aspect highlights another key issue all cancer patients face; while you face the prospect of battling a potentially deadly disease, you will have to deal with all sorts of wider concerns, quite apart from being confronted with your own sense of mortality – something that happens even if the prospect of a full recovery is very strong.

Emotional and mental strains are a part of the battle, ranging from longer-term implications for survivors to the psychological impact on your family and, perhaps, on your own mental health, especially if this has already not been in a good state before your diagnosis.

There are various ways you can get help, from cancer charities and support groups, as well as getting to know fellow patients who may be undergoing similar treatment to yours.

Consider How Much You Want Others To Know

At the same time, while these may be useful people to open up to and share knowledge and experiences with, there will be other instances where the reverse is true.

Firstly, not everyone needs to know you have cancer or are undergoing radiotherapy unless you want them to. If you are facing the prospect of treatment starting soon, you may want to think carefully about what you share and with whom, be it in person, by phone, or on social media where a wider audience may see what is happening.

It is worth bearing in mind that some people can be quite intrusive, whether innocently or otherwise, in wanting constant updates when you may not be able to provide these. At times you may feel very ill from side effects when getting treatment and not want to be doing this.

A couple of somewhat exceptional cases of the conflict between interest and privacy arose recently in the UK when first King Charles III and then the Princess of Wales underwent surgery before each later revealed they had cancer.

The King announced this swiftly, having already been open about his treatment on a non-cancerous prostate issue, but the princess maintained her privacy over an abdominal operation for an undisclosed issue until responding to some wild speculation – further fuelled by revelations of family photos being photoshopped – by announcing she had cancer.

Even so, neither royal has disclosed exactly what kind of cancers they are being treated for.

In the case of famous individuals, whose every move gains media attention, keeping everything quiet proved impossible. Indeed, the fact-checkers have now been tackling reports repeated across several media outlets that King Charles has pancreatic cancer and has been given two years to live – all based on ‘sources’ that are impossible to verify.

For most people, this kind of attention will not be forthcoming, but there could still be rather more of it than you are comfortable with, which is why you should stick to your guns and maintain your privacy over the nature of your diagnosis and treatment, unless you are keen for people to know.

Avoid The Wrong Advice

Your dignity and privacy have another element to it as well. In addition to the fact you may need people to give you lots of time and space while you concentrate on your treatment, you don’t want to find yourself listening to too much advice from well-meaning people whose medical knowledge may be somewhat limited.

For example, there may be people who wrongly advise you to use aloe vera if you get sore skin after radiation treatment. But this is not only ineffective but, some studies suggest, may actually make things worse.

There are also foods you should avoid while being treated with radiotherapy, such as shellfish or salty foods, as these can harbour viruses and increase your blood pressure at a time when you need this least and your immune system is weaker. You must be cautious about other people offering to treat you.

What all this shows is that there are plenty of steps you can take to help yourself deal with the physical and emotional impact of having regular radiotherapy sessions.

The Priority Is You

Ultimately, what must happen is that your needs come first. You are the patient and even if you are used to making sacrifices and compromises for those around you, this is when things change. It is time for others to support you in your time of need.

The good news is that however family, friends and employers may act, you can count on the professionalism of some of the best people when you come to the radiotherapy centre for treatment.