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.

The Innovative History And Advancements Of Neurosurgery

Neurosurgery is a famously difficult and risky procedure. However, thanks to pioneering medical researchers and highly skilled surgeons over the years, there are now some very safe, effective and less invasive ways to operate on the brain. For example, one of the most precise and innovative ways to treat brain tumours is Gamma Knife surgery.

Gamma Knife is not traditional open surgery, so it eliminates the high level of risk and complications involved with making incisions into the skull. Instead, it uses precisely focused gamma rays to target the tumour cells via an external machine. The exact location of the tumour is determined by advanced AI-assisted imaging techniques.

However, such technologically advanced procedures are a very long way from the earliest experimentations with brain surgery. Here’s an overview of how this most challenging yet potentially life-saving procedure has evolved over the years.

The earliest forms of brain surgery

Archeologists and historians have unearthed evidence that a primitive form of brain surgery known as ‘trepanation’ was performed as early as 7,000 BCE in pre-Incan civilisation in Peru, and also in Ancient Greece and Egypt, and some areas of south east Asia.

Trepanning involves detaching the scalp and drilling a hole in the skull, and was thought to relieve headaches or the pressure caused by a large tumour. It may also have been carried out to treat mental illnesses, epilepsy and head trauma.

Skulls that have undergone trepanation have been found with evidence of new bone growth, suggesting that some patients survived the procedure. However, it is difficult to assess how effective it was at relieving their symptoms. Early practitioners had a very limited knowledge and understanding of the brain, so any treatments would be very rudimentary.

The field of knowledge was advanced by Hioppcrates (470 BC-360 BC), the Ancient Greek polymath who is considered to be the founding father of modern medical ethics. He left detailed texts containing accurate descriptions of clinical head injuries, spasms, and seizures.

Cornelius Celsus lived in ancient Rome in the first century AD, and there is evidence that he carried out skillful surgery on depressed brain fractures. The Islamic school of brain surgery that flourished between 800 and 1200AD is also considered to be influential on later generations of neurosurgeons.

Despite these advancements, brain surgery was likely to have been a last resort and only carried out in rare circumstances. Before modern anaesthetics and antibiotics were invented, it was an extremely dangerous and painful procedure, and the risk of bleeding and infections probably outweighed the benefits in most cases.

The first successful brain tumour procedure

The world’s first successful brain tumour was carried out by a Glaswegian surgeon named William Macewen in 1879. The patient was a young girl named Barbara Watson who presented with a large lump over her left eye, and was suffering from recurring seizures.

Macewen had a specialist interest in neurosurgical procedures, and had explored the safest methods of accessing the brain and infection control measures. He went on to carry out a successful operation to remove the tumour, and the patient went on to make a good recovery.

Macewen published an account of the procedure and outcome in the Glasgow Medical Journal in 1879, although his achievements weren’t widely recognised until almost ten years later in 1888.

The first primary brain tumour operation involving a direct opening of the skull was carried out by Mr. Rickman J. Godlee in 1884 in a London hospital. The 25 year old patient survived the procedure, but died of apparent complications 25 days later. However, a post-mortem revealed that all traces of the tumour had successfully been removed.

20th century advancements

Like other forms of medicine, great advancements were made in neurosurgery during the 20th century thanks to a more detailed understanding of brain anatomy, better surgical techniques, and widespread use of anaesthetics and antibiotics. X-rays also enabled the position of tumours to be pinpointed more accurately.

The American neurosurgeon Harvey Cushing is credited with pioneering the framework for modern neurosurgery, which has significantly improved outcomes and patient survival rates.

Brain surgery in the 21st century

In the 21st century, minimally invasive techniques for treating brain tumours such as stereotactic radiotherapy have come to the forefront. One of the most advanced forms is the previously mentioned Gamma Knife, which makes use of computer assisted navigation for the most efficient and precise method of destroying tumour cells.

Such techniques avoid the significant risks of open surgery, and have a low risk of causing damage to the surrounding brain tissue.

To find out more about advanced radiotherapy and neurosurgical treatments for glioblastoma, please visit the Amethyst Radiotherapy site.

Gamma Knife Radiosurgery And AI Technology: The Next Chapter

Gamma Knife radiosurgery has been regarded as one of the most effective and advanced tools for treating a range of brain tumours and vascular malformations since it was first pioneered in the late 1960s. The technology has continued to evolve, and as we stand on the threshold of a new era of artificial intelligence, exciting possibilities are emerging.

These new developments were recently highlighted in an article published in the spring edition of SCOPE magazine, with contributions from our clinical team: Hannah, Radiosurgery Physicist at Thornbury Radiosurgery Centre, and Ian Paddick, Consultant Physicist at Queen Square.

The article has a particular focus on AI-driven auto-contouring for tumour segmentation, which allows for even greater precision and more consistent patient outcomes in stereotactic radiosurgery. Here’s a look at the key conclusions of the article.

AI-driven auto-contouring for advanced precision

A significant breakthrough in Gamma Knife technology that is highlighted in the article is AI-driven auto-contouring for tumour segmentation. This involves the automation of tumour delineations from MRI scans.

When this process is carried out manually, it is time consuming and subject to the variables of human interpretation, particularly in tumours or lesions without clearly defined boundaries. Clinicians are now able to use AI frameworks to segment tumour boundaries with the equivalent accuracy to human annotators. This has advantages including:

Reducing incidences of human error: AI automation maintains a consistent approach, which potentially lowers the risk of inaccurate results. Human error or variations in interpretation of the same data is impossible to fully mitigate against, and machine learning can significantly reduce variability and oversights.

Enhancing patient outcomes: The greater accuracy of the tumour segmentation afforded by AI tools can lead to the more precise delivery of radiation to the tumour cells. This reduces the risk of damage to the surrounding healthy brain tissue, and therefore also reduces the risk of side effects and complications.

Time efficiency: Manually segmenting tumour contours, particularly in the case of brain metastasis when multiple micro-tumours may be present, is a very time intensive task. Automated tools are highly sensitive and capable of detecting contours in much shorter timescales.

This will potentially allow for faster overall treatment times, reducing waiting lists. This could have significant benefits for patients and their families, reducing anxiety and uncertainty, and allowing patients to have potentially life saving or life extending treatment sooner.

However, the article notes that while an extremely valuable tool, AI models for auto-contouring still have some limitations and drawbacks to overcome. These include the limitations in training data for AI models, which may not generalise across diverse populations, and imaging noise leading to false positives.

For the foreseeable future, clinical oversight and judgement of the contouring process will remain necessary, particularly for complex cases such as brain metastasis.

Other advancements in Gamma Knife technology

Emerging treatments

Gamma Knife surgery is currently being used as part of ongoing research into treating conditions beyond brain tumours and vestibular schwannomas. For example, studies have shown that it is effective in treating essential tremor and Parkinson’s disease, with a low risk of side effects.

Stereotactic radiosurgery is also being explored as an option for treating various psychiatric disorders, in particular obsessive compulsive disorder in patients who have not responded to conventional treatments.

Improving biological effective dose

Research is ongoing into the use of AI for optimising biological effective dose (BED). This will allow for the delivery of the most accurate and effective radiation dose and exposure times for targeting the tumour cells, while minimising the risk of damage to the surrounding areas. This is crucial to the success of the overall treatment.

Personalised treatment plans

AI tools are trained by being exposed to vast amounts of data, which would be impossible for humans to process. This enables medical teams to put together more personalised treatment plans, which are more precisely tailored to the individual patient. Ultimately, this will potentially lead to better patient outcomes.

Tools such as augmented segmentation enable medical teams to make faster and more well-informed decisions, which can accelerate the progress of potentially life saving or extending treatment.

To sum up, Gamma Knife radiosurgery has always been a leading edge method of treating a range of brain tumours and other neurological conditions. Now, as a new chapter opens up with the involvement of AI technology, treatment planning and patient care is becoming more accurate, personalised, and effective than ever before.

What Are The Advantages Of Gamma Knife For Acoustic Neuroma?

An acoustic neuroma (also called vestibular schwannoma) is a benign (non-cancerous) tumour that develops on the nerve that connects the inner ear to the brain. This nerve (which is referred to as the acoustic or vestibulocochlear nerve) is responsible for hearing and balance, and it also runs close to the main nerve that controls facial movement.

Who is affected by acoustic neuroma?

Research is ongoing into the causes of acoustic neuroma, as it is not fully understood. They most commonly affect adults between the ages of 40 and 60, although they can affect people of all ages.

In rare cases, NF2-related schwannomatosis may be diagnosed, which is a genetic condition. This tends to affect younger people, and the tumours can develop on both sides of the head.

What are the symptoms of acoustic neuroma?

Acoustic neuromas tend to grow slowly, and may not cause noticeable symptoms in the early stages, but over time they can interfere with hearing and balance. This can develop into hearing loss, usually in one ear rather than both. The most common symptoms include the following:

  • Loss of hearing in one ear, which may happen gradually
  • Problems with balance, frequent dizziness or a sensation of movement even when still
  • Hearing a persistent ringing or buzzing noise in the ear (tinitus)

Tumours that are pressing on the nerves that control facial movement may also cause numbness, weakness, pain or a tingling sensation on one side of the face.

An acoustic neuroma that has grown to a large size may also cause persistent headaches, episodes of blurred or double vision; problems with coordination on one side of the body; and difficulty swallowing or voice changes.

How are acoustic neuromas diagnosed?

Anyone who is concerned about any of these symptoms should visit their doctor, who may refer the individual for further investigation. This might include hearing tests, and an MRI or CT scan to obtain clear images of the inside of the skull.

Although acoustic neuromas are non-cancerous, they can affect quality of life and may impact your ability to drive, carry out your job, or socialise. Larger acoustic neuromas can also lead to a potentially fatal build up of fluids on the brain. Therefore it’s essential that the tumour is diagnosed and a treatment plan is put in place.

How are acoustic neuromas treated?

The type of treatment will depend on the size and location of the tumour; how the symptoms are impacting the patient; and their age and general state of health. Smaller tumours may be actively monitored for signs of further growth rather than directly treated. This will involve having regular brain scans to build an accurate picture of the tumour over time.

The patient may also have regular hearing tests to check if the symptoms are worsening. Some tumours may never require treatment, because they do not grow any larger.

If treatment is necessary, the two main options are surgery and stereotactic radiosurgery (SRS). Larger tumours are more likely to need open brain surgery to remove the tumour. Smaller tumours or patients who are unable to undergo open surgery can be treated with SRS.

In some cases, SRS may be carried out following open surgery to treat parts of the tumour that were not able to be removed.

What are the advantages of Gamma Knife surgery for acoustic neuromas?

Gamma Knife surgery is an advanced form of SRS that uses highly focused radiation beams to target the tumour while avoiding the surrounding healthy brain tissue. This reduces the risk of side effects, and in many cases the treatment can be delivered in a single session.

The procedure typically lasts between 30 minutes to several hours, depending on the size of the area being targeted. Most patients are able to return home on the same day. Compared to traditional surgery, Gamma Knife has several advantages, including the following:

  • Less invasive and much lower risk of infections or other complications
  • Much quicker treatment and recovery times
  • Much lower risk of damaging the facial nerves or hearing
  • High success rates: in the majority of cases, tumour growth is stopped or slowed

What is the long term outlook for acoustic neuroma patients?

Most patients can be successfully treated with surgery or SRS (if required). Usually, regular MRI scans will be necessary to check if the tumour is regrowing. If symptoms such as hearing loss or tinnitus persist, these may require further treatment.

If you’re concerned about your health and want to discuss matters with one of our consultants, get in touch with Mr Neil Kitchen, who will be able to help you further.

Is Exercise Safe When You Are Living With A Brain Tumour?

A brain tumour diagnosis is a life-changing experience, and many people find that the symptoms and treatment process disrupts their daily routine. There may be some activities that you previously enjoyed but now find more challenging, or are unsure if you should continue with them at all.

One common question for people living with a brain tumour is “can I still exercise safely?” Research shows that in general, exercise is safe and beneficial for brain tumour patients. However, symptoms  such as dizziness and fatigue, or the side effects of brain tumour treatment may make exercise more difficult for some people.

Therefore it’s important to adjust your exercise and manage risk, so that it will be a beneficial component of your overall self-care routine. Here are some important points to bear in mind.

The importance of staying active with a brain tumour diagnosis

Engaging in regular physical activity will maintain strength, suppleness and cardiovascular fitness, which in turn will help to reduce the risk of developing other health problems or having falls and injuries. Exercise also has mental health benefits, promoting a more positive state of mind, improving sleep quality, and managing fatigue or anxiety.

Considerations for brain tumour patients

It’s important to consider how your symptoms and overall state of health might impact your ability to exercise. The treatment you are undergoing may also have side effects that could affect the way your brain and body functions, so it’s recommended to discuss your exercise routine with your medical team to ensure that it is suitable and safe.

Balance and coordination issues: Some types of brain tumour can affect balance and coordination, particularly frontal lobe tumours that press on the areas of the brain that control movement. This might mean certain activities such as dancing or running are more difficult and will have a higher chance of falls and injuries.

Activities that support the body such as swimming, aqua aerobics, gentle yoga or using some types of gym equipment may be good options.

Muscle weakness: Frontal lobe tumours, or those located in the brain stem, can cause muscle weakness or numbness, often on one side of the body. In this case, it’s a good idea to speak to your healthcare team, who may refer you to a physiotherapist. They can guide you on the most suitable rehabilitation exercises for your condition.

Fatigue: One of the most common issues faced by people with brain tumours is fatigue. This may be caused by the tumour itself, or by treatments such as chemotherapy or radiotherapy. Persistent fatigue can take away your motivation to exercise, or mean that you have an inconsistent and less effective approach.

However, exercise will ultimately improve your energy levels and help to combat fatigue. Avoid overwhelming yourself, but set small manageable goals. Plan your exercise for the time of day when you feel most energetic, such as in the morning. If you are too tired for physical activity, engage your brain with a stimulating activity, such as a crossword puzzle.

Build up gradually to increased activity levels and remember that rest is also important, so don’t feel guilty when you are having a quieter day. Count small wins, such as doing the washing up or emptying the dishwasher when you didn’t feel like it.

If you are having radiotherapy or chemotherapy

Your medical team might advise against swimming if you are undergoing radiotherapy or chemotherapy. This is because radiotherapy may make your skin more sensitive to the chlorine in the water. Chemotherapy can weaken the immune system, so you may be more vulnerable to germs in swimming pools.

For post-surgery recovery, gentle low-impact exercises are recommended, with walking one of the best options. Light stretching can also help encourage movement back into the body.

After Gamma Knife surgery, it is likely that you’ll be advised to avoid strenuous physical exercise, so make sure you talk through your options with your cancer care team.

Light intensity exercise is advised, such as relaxed cycling, slow walking, light housework, Tai Chi and bowling.

If you are feeling reasonably well

If you are not significantly impacted by any of these symptoms and are managing your treatment well, there’s no reason why you shouldn’t return to exercise that you previously enjoyed, unless your healthcare team advises against it.

Note, however, that exercise capacity will vary from patient to patient and it’s important to listen to your body and pay attention to the cues it gives you so you don’t overexert yourself or push yourself before you’re ready.

If you have any doubts or questions, it’s always best to seek medical advice, because every patient is unique and there are no one-size-fits-all solutions. This is particularly important if you have never taken regular exercise before, but are interested in starting to help manage symptoms or aid the recovery process.

Your team may recommend starting out with simple low-impact activities such as walking, gardening, or housework. Even very moderate levels of exercise can enhance your sense of wellbeing, reduce pain, manage mental health issues such as anxiety and depression, improve your appetite and help you to sleep better.

How Can You Feel Less Fatigued During Cancer Treatment?

There are a number of variables when it comes to brain tumour treatments, as each person will often need a tailored approach agreed upon at the radiotherapy centre with specialists to ensure that the goals of treatment are met based on a philosophy of minimal intrusion and maximum impact.

Exactly what type of radiotherapy treatment a person will receive and if it is in conjunction with other treatments will depend on the type of cancer. As well as this, the effects of the treatment and how a person will feel in its immediate aftermath can vary from person to person.

For example, whilst not everyone experiences it, tiredness during an intense course of radiotherapy treatment is not uncommon, because of a wide range of factors that are either directly or indirectly caused by the treatment.

Here are some of the reasons why you might be feeling tired and what you can do to help boost your energy levels and remain focused on the goal of recovery.

Why Are You Feeling Tired During Radiotherapy?

There are a multitude of factors which affect cancer treatment, some of which are related to the treatment sessions themselves whilst others are unrelated.

The physiological process of recovering and regenerating cells that are destroyed or damaged during radiotherapy can be tiring, as can the physical strain of the cancer itself, although this can vary depending on the type of cancer and its stage of progression.

The process of travelling to appointments can be draining, especially if the specialist centre is a substantial distance away from where you live.

Similarly, pain and discomfort can be tiring by themselves, but they can also affect your ability to rest if the pain keeps you from getting as much sleep as possible.

Finally, but just as important a factor in fatigue is mental wellbeing; anxiety and stress have physiological attributes that can increase fatigue and they can also reduce how well you sleep, something that is crucial to recovery.

Treatment Location And Tiredness

Another crucial factor concerning energy levels and tiredness is the type of treatment and its location.

This is particularly true for brain tumour treatments. Longer courses of radiotherapy on the brain are more likely to cause tiredness than on other parts of the body, although your oncologist will inform you of whether this is likely before your treatment.

In this case, the tiredness will peak two weeks after treatment before your energy levels will return to normal.

What Can You Do To Feel Less Tired?

Your radiotherapy team will help work with you to manage your energy levels and ensure you continue to feel as motivated as possible during treatment. This is an important part of recovery and ensures that you attend every session of radiotherapy to get the best possible outcomes.

The best plans for managing fatigue combine simple steps for boosting and maintaining energy levels, whilst saving energy wherever possible.

How To Save Energy During Radiotherapy Treatment

A support network is a vital part of cancer care for a multitude of reasons, but from a practical standpoint it enables you to get help with difficult tasks during difficult times.

People in your support network will be more than happy to help out if and when they can, and that can make all of the difference on days when you do not have a lot of energy.

Whether it is gardening, housework, shopping or anything else you are struggling with, your family and friends will be there to help out.

Alternatively, when undertaking household tasks, try to do them sitting down whenever you can to save energy, and take frequent breaks.

As well as this, write your shopping list in advance and either order from home or choose a moment when the shops are less busy to avoid being overwhelmed.

If you are working during your treatment, ask if you can work from home, reduce your hours or take a leave of absence during radiotherapy sessions.

Consulting an occupational therapist will also help with reasonable adjustments at work or adaptations at home if and when they are required.

Maintaining Energy During Radiotherapy

Diet matters considerably during radiotherapy treatment, and part of your radiotherapy care team will often include a nutritionist for this reason.

They will provide a balanced, nutritious diet plan that includes simple meals that are suitable for batch cooking and meal prepping. The latter is particularly effective as these extra meals can simply be heated when you have less energy.

Similarly, make sure you remain hydrated and drink water whenever you feel thirsty.

Exercise is particularly important, and your team will advise you on workouts that can work around your treatment. Choose the time of day when you feel like you have the most energy and work within your limits.

Take frequent breaks and naps whenever you need them to boost your energy as well and make sure you focus not only on recovery but on hobbies you enjoy as well. If you’d like more information on brain tumour treatments and how to manage your condition, get in touch with the Amethyst Radiotherapy UK team today.

Why A Gamma Knife Is Not Just Used For Brain Tumours

You may well be at least a little familiar with the Gamma Knife, a device that is commonly associated with very precise radiotherapy aimed at shrinking brain tumours. However, that is far from its only use, something that will be very relevant for sufferers of other conditions who benefit from its versatility.

The device was invented after much research by Swedish scientists Lars Leksell and Borje Larsson, with the prototype appearing in 1967. A second, more advanced version of the gamma knife was developed in 1975 and thereafter, various units appeared around the globe, including, eventually, here in Vienna.

However, Prof Leksell’s vision for gamma knife radiosurgery was not, initially, for brain tumours. His priority was to carry out neurological surgery to tackle pain and movement disorders, as well as mind disorders that would not respond to conventional psychiatric treatment.

Because there was such obvious potential for the device to be used in treating brain tumours, this was the inevitable next development. However, that does not alter the fact that gamma knife treatment remains just as useful for treating other conditions.

Common Conditions Treated By Gamma Knives

Among these are non-cancerous tumours, lesions and malformations, as well as certain nerve-related conditions. If you are suffering from one of these conditions, it may come as a surprise to learn that these, not malignant brain tumours, were the original reason for the development of the gamma knife.

Epilepsy is a common condition and one that a gamma knife can treat. The condition is caused by a failure of the transmission of electrical signals in nerves to function correctly, leading to irregular muscle problems and, at worst, seizures.

A gamma knife can treat this by focusing radiation on areas of the brain where abnormalities exist, as these are the source of irregular electrical signals.

This technique can work in similar ways in other conditions that involve problems with nerve signals. In some cases, such as trigeminal neuralgia, this involves using radiotherapy to block the capacity of a nerve to transmit pain, although this will take a few weeks to be effective.

In this instance, radiotherapy may be given as a means of stopping symptoms, alongside a range of other treatments, including surgery to help tackle common root causes of the condition, such as a large blood vessel compressing a nerve.

Parkinson’s disease is another neurological condition a gamma knife may aid, by helping to deliberately scar an area of the brain where the disease is causing malfunction, although the most effective and preferred form of treatment now is the use of an electrical implant to send a mild current to those areas and prevent the malfunction from occurring.

How AVM Can Be Tackled

Another brain condition gamma knife treatment can help with is arteriovenous malformation (AVM). This is a condition in which a group of arteries and veins in the brain become a jumble and do not carry out the normal function of maintaining the steady flow of blood to and from the brain.

This can lead to swelling and bursting of blood vessels because of a lack of capillaries that would normally carry blood between vessels.

The condition is very rare, but serious. A small and fortunate minority remain asymptomatic, but common symptoms include dizziness, numbness, nausea and vomiting and mental issues like dementia and hallucinations, with the worst instances leading to brain damage, seizures and strokes.

Radiotherapy using a gamma knife is one of the options for treating an AVM, which involves helping to break up the mass of arteries and can either cause it to disappear in time or at least reduce the bleeding. As with a lot of treatments, gamma knives have the benefit of being non-invasive and therefore able to access the issue when invasive surgery cannot.

Non-Malignant Tumour Treatment

Finally, there is the fact that the tumours gamma knives are used on are often non-malignant. The aim is to shrink them and, preferably, prevent them from coming back.

Indeed, this is more important because while many malignant tumours, such as glioblastoma, are incurable and the main aim of radiosurgery is to extend life, whereas the permanent reduction of a benign tumour means tackling problems that could otherwise cause problems for the patient over a period of many years or even decades.

What all this means is that if you or a family member has a condition that does not involve a malignant tumour but may be treated with a gamma knife, you can be assured this is not only normal, but closer to the original use for the device intended by Professor Leksell.

To find out more about Gamma Knife surgery, brain tumours and treatment options, get in touch with the Amethyst Radiotherapy team today.

Amethyst Radiotherapy UK Appoints Sasha Burns as New CEO

Amethyst Radiotherapy UK is pleased to announce the appointment of Sasha Burns as its new Chief Executive Officer (CEO).

With over 20 years of experience in healthcare leadership across both the NHS and the independent sector, Sasha brings a wealth of expertise in operational excellence, commercial strategy, and transformational healthcare delivery.

Sasha joins Amethyst from Alliance Medical, where she served as Chief Commercial and Operations Officer. In this role, she was responsible for delivering high-quality services, setting national standards, and driving business transformation across multiple service lines. Prior to this, she spent 10 years at Nuffield Health, where she held a variety of leadership positions, including Director of Regional Operations, overseeing 11 acute hospitals and 26 Well-being Centres across the South West.

A former radiographer, Sasha’s career began in frontline healthcare before she transitioned into management roles, leveraging industry knowledge to enhance patient care and operational efficiency. She also holds an MBA from Henley Business School, further strengthening her strategic and commercial expertise.

Commenting on her new role, Sasha Burns said: “I am delighted to join Amethyst Radiotherapy UK at such a pivotal time in its growth. Amethyst is at the forefront of delivering cutting-edge radiotherapy services, and I look forward to working with the team to continue advancing patient care, expanding access, and driving innovation in cancer treatment.”

Amethyst Radiotherapy UK remains committed to providing world-class radiotherapy, and under Sasha’s leadership, the organisation is poised to strengthen its position as a leader in the field.