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.

A new study published in the British Medical Journal (BMJ) has identified a link between an injectable hormone and a heightened risk of brain tumours. The research was carried out in France, and included a team from the French National Agency for Medicines and Health Products Safety.

The study found that women who were using certain progesterone medications as contraception, or to manage gynaecological conditions such as endometriosis and polycystic ovary syndrome, were at increased risk of developing meningioma, a type of brain tumour. 

According to ITV News, there are around 10,000 NHS prescriptions for the medication, known as medroxyprogesterone acetate, every month in England. The new research has identified a further eight forms of progesterone that are used by millions of women worldwide as being a potential brain tumour risk. However, the risk is described as ‘very small.’

Previous research has shown that a high dosage of progesterone has been linked to a greater risk of meningioma. Reassuringly, the authors of the study said the association did not apply to the most commonly used progesterones in the UK. It may be applicable to some injectable forms, also known as Depo-Provera, which is used as contraception.

Paul Pharoah, professor of cancer epidemiology at Cedars-Sinai Medical Centre in the US, said: “The authors note that causality cannot be determined in an observational study such as this but, given what we know about the risk factors for meningioma, it seems quite likely that the association reported for medroxyprogesterone acetate is causal.”

He added: “It is important to note that progestogens are an important component of many types of birth control pill (oral contraceptives) and hormone replacement therapy but there are many different types of progestogens and no association with meningioma was found for the types of progestogens commonly used in the United Kingdom.”

“This means that women taking the commonly used birth control pills or hormone replacement therapy are not at increased risk of meningioma. It is important that women do not stop using their birth control pills without consulting their doctor.”

Meningiomas are a type of brain tumour that develop in the membranes that cover the brain, and are usually slow-growing and benign (non-cancerous). According to The Brain Tumour Charity, about 27 per cent of all brain tumours diagnosed are meningiomas, and they are more common in women than in men.

Although meningiomas are non-cancerous, they can compress the brain tissue, which causes a range of troublesome symptoms. These might include headaches; changes in vision; memory loss or difficulty in planning ahead or processing new information; loss of smell; seizures; and weakness in the limbs.

Research is ongoing into the risk factors for meningiomas, but the link with female hormones has previously been noted. Occasionally, they can grow faster during pregnancy. There is also an increased risk for women who are overweight or obese, which is thought to be because fatty tissue stimulates the production of female hormones. 

 The treatment of meningiomas will depend on the grade, which is on a scale of one to four. The majority of meningiomas are grades one and two, and there are no cancerous grade four meningioma tumours. The treatment will also depend on the size and location of the tumour, and the age and general health of the patient.

Grade one tumours may be actively monitored, while grade two and three tumours may be treated with a combination of surgery and radiotherapy. 

Dr Karen Noble, director of research, policy and innovation at Brain Tumour Research, said: “Any increased understanding of the risk factors of brain tumours is beneficial to the brain tumour community; it may open doors to research on preventative measures, as well as increase our understanding of why these tumours arise in the first place.”

“However, the public needs to be cautious when digesting the results from a study such as this before taking action. Although this study has linked certain progestogen treatments to an increased risk of meningioma, it has also demonstrated the safety of other progestogen treatments which were shown to not increase risk.”

Dr Noble emphasised that women should always speak to their doctor before stopping any medication.

For more information about the treatment of meningioma, please contact Mr Patrick Grover of Amethyst Radiotherapy.

Unfortunately, personality and behaviour changes are a common symptom of brain tumours. This is caused by the tumour pressing on the surrounding brain cells, and the exact nature of the changes can depend on the size and location of the tumour.

According to the Brain Tumour Charity, personality changes are most likely to occur when the tumour is located in the frontal lobe of the brain, because this contains the areas that regulate our emotions and behaviour. Pituitary gland tumours can cause changes in hormone levels that may also affect behaviour.

The shock and stress of being diagnosed with a brain tumour can also understandably lead to behavioural changes that are out of character for the person, such as depression, lack of motivation, irritability, and anxiety. Sometimes, changes may occur as a result of the treatment for a brain tumour, such as medication or radiotherapy. 

Common symptoms experienced by brain tumour patients include confusion and brain fog, loss of inhibitions or behaving in socially unacceptable ways, low mood and apathy, mood swings, difficulty in planning and organising, and difficulty in recognising emotions in oneself and others. Sometimes, a person may become aggressive or even violent. 

Brainstrust reports that there has been some new research into the correlation between radiation exposure and social cognition in brain tumour patients. The study was carried out by a group of researchers at the University of Rochester Medical Center, New York. 

They noted that difficulty in social cognition occurs in up to 83 per cent of patients with brain tumours, but this is an area that has so far not been well studied. Social cognition refers to the process of navigating social interactions, such as interpreting emotions and social cues. 

The research demonstrated that the radiation dose to the amygdala (the part of the brain that processes emotion and memory) was associated with a worse performance on an emotion recognition task. 

The higher the radiation dose, the longer the response time to tasks such as recognising the emotional states on faces expressing six basic emotions including anger, disgust, fear, happiness, sadness, and surprise. The study involved 51 patients with low-grade and benign brain tumours who were receiving radiotherapy. 

The researchers note that up to 91 per cent of people with brain tumours experience some form of cognitive impairment, and even mild cognitive dysfunction can lead to a worse quality of life. They also note that cancer-directed therapies, including radiotherapies, can cause further cognitive disruption. 

There has been extensive research into understanding and preventing radiation-related cognitive decline, but so far social cognition, which is important for the maintenance of social relationships, has not been widely studied. 

The researchers concluded that using radiation techniques that minimise exposure the amygdala could be helpful in reducing adverse impacts on their social cognition. 

There are various forms of radiotherapy. One of the most advanced techniques is Gamma Knife stereotactic radiosurgery. This involves directing gamma radiation beams through the skull to focus precisely on the tumour, and leave the surrounding healthy brain tissue intact.

The direction of the beams can be computer-controlled for the most accurate focus, and several beams are directed at once from multiple angles. 

Each individual beam is very weak, minimising any damage to the brian, but the cumulative effect of the multiple beams on the target results in an effective radiation dosage. Usually, the procedure does not need to be repeated, unlike some other forms of radiotherapy, and risks of long-term side effects are considered to be very low.

Addressing personality and behaviour changes caused by brain tumours depends on what is causing them. Everyone responds differently to triggers and treatments, so there is no one-size-fits-all solution. Some people find that counselling or talking over the situation with trusted friends or family members can be helpful. 

Some people may require medication such as antidepressants or tranquilisers, but this option should always be discussed with the medical team first. Some patients may be referred for a neuropsychological assessment to find out what might be causing the distressing changes.

Self-help techniques, such as taking gentle exercise, eating a healthy and well balanced diet, and making time to rest can make a difference. 

If you would like some further information about brain cancer treatment and Gamma Knife surgery, please contact Mr Neil Kitchen of Amethyst Radiotherapy.

The Department of Health and Social Care has launched a new taskforce to bring together experts to develop new ways to detect, diagnose and treat cancers in children and young people. The initiative aims to save lives and mitigate the long-term effects of a cancer diagnosis for young people.

The announcement follows a two-year campaign by the Children’s Cancer and Leukaemia   Group and Young Lives vs Cancer, who have been calling for a dedicated plan to improve outcomes for young people with cancer. The two charities will be involved in the taskforce, along with Cancer Research UK and the Teenage Cancer Trust.

The taskforce will request better access to DNA testing and treatment, and more investment in research. It will also seek to explore how artificial intelligence can make the process of cancer diagnosis and treatment for young people more efficient and effective, and expand data sharing arrangements to help clinicians make better informed decisions.

The taskforce will be chaired by Dame Caroline Dineage MP. Health and Social Care Secretary, Victoria Atkins, said: “Discovering your child has cancer is among the worst news a parent can receive. Thanks to the remarkable progress in treatment and research, survival rates are higher than ever. However, even then, life-changing consequences can remain.”

She added: “This taskforce will help bring together world-leading experts and those who have dedicated their lives to fighting cancer to discuss how we can go further faster and to drive progress in cancer care for children and young people.”

“I am pleased we have such a respected figure as Dame Caroline leading the discussions and we look forward to working with all those on the taskforce to make child cancer care faster, simpler and fairer for all.”

Cancer is the leading cause of death in children up to 14 years old, and a major cause of death in young people in the UK. According to the Brain Tumour Charity, brain cancer is the biggest cancer killer of children and adults under 40 in the UK. However, less that 3% of the total annual cancer research funding is spent on brain tumours.

Brain tumours reduce life expectancy by an average of 27 years, and only 12% of adults survive for five years after a diagnosis. There are on average 500 young people under the age of 19 diagnosed with a brain tumour in the UK every year. Around half of these cases are gliomas, meaning that they originate from the glial cells.

Gliomas have various subgroups. Astrocytoma is the subgroup that makes up about 43% of all brain and spinal cord tumours in children. Other types of brain tumour that most commonly affect children are ependymomas, embryonal tumours, and craniopharyngioma. It is not yet understood what causes these childhood tumours.

Commenting on the launch of the cancer taskforce, Chief Executive at Young Lives vs Cancer, Rachel Kirby-Rider, said: “It’s a positive step that children and young people with cancer’s unique needs are getting the focus they deserve with the setup of a dedicated Children and Young People Cancer Taskforce.”

She added: “Alongside their health, cancer can completely disrupt a young person’s life both during and beyond treatment, from education, to mental health and finances. It’s reassuring that as well as improving treatment and research, the Children and Young People Cancer Taskforce aims to transform care and reduce the long-term impacts of cancer.”

Childhood brain tumours are usually treated with surgery, radiotherapy, or chemotherapy. The medical team will decide on the most appropriate course of treatment depending on the size, type, and location of the tumour and the age and general health of the child.

The long-term effects of a brain tumour on the child’s life will vary depending on the factors mentioned above and how it is treated. However, the consequences can be profound, including learning difficulties, vision problems, and impairments on normal growth, puberty, or physical abilities such as poor balance or weakness in a limb.

The child may also be left with emotional difficulties, either because of physical changes in the brain, or because of the trauma and social isolation they may experience due to the diagnosis and treatment of a brain tumour.

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

Brain tumour treatment may be on the verge of a major breakthrough, as UK researchers have developed a simple blood test that could potentially diagnose certain types of brain cancer. The Guardian reports that the blood test could lead to an earlier diagnosis of cancer, increasing the chances of survival.

According to Cancer Research UK, just 11% of adults survive brain cancer for 10 years or more after diagnosis. On average, 12,288 new cases are diagnosed each year, and there are 5,456 deaths from brain tumours annually in the UK.

This makes it one of the most deadly cancers in the UK, leading to the deaths of more children and young people under 40 than any other type of cancer. Despite this, research into brain tumours has been historically neglected and underfunded compared to other types of cancer.

The new test could potentially make diagnosis much quicker and easier, eliminating the need for an invasive biopsy. Traditional forms of open brain surgery can be risky, particularly if the tumour is in a critical or difficult to access area of the brain. It also carries a high risk of complications, particularly for patients who are older or not in good overall health.

The test was developed by researchers at the Brain Tumour Research Centre of Excellence, run by Imperial College London and Imperial College healthcare NHS trust. The results of the first studies have shown great promise in diagnosing tumours, including glioblastomas, which are the most common type of high-grade tumour in adults.

The test works by isolating glial cells that have broken free from the tumour and entered the bloodstream. The isolated cells can be stained to make them stand out and analysed for specific indicators of disease. It is known as the TriNetra blood test. Earlier diagnosis can lead to earlier and more effective treatment, boosting survival rates.

Dr Nelofer Syed, who leads the Brain Tumour Research Centre of Excellence, said: “A non-invasive, inexpensive method for the early detection of brain tumours is critical for improvements in patient care.”

“There is still some way to go, but this solution could help people where a brain biopsy or surgical resection of the tumour is not possible due to the location of the tumour or other constraints.”

He added: “Through this technology, a diagnosis of inaccessible tumours can become possible through a risk-free and patient-friendly blood test. We believe this would be a world first as there are currently no non-invasive or non-radiological tests for these types of tumours.”

The test is targeted at gliomas. These are tumours that have developed from cells that should become healthy glial brain cells. Glial cells support the nerve cells in the brain and the spinal cord. Glioma brain tumours can be low grade and benign, or high grade and cancerous.

Kevin O’Neill, consultant neurosurgeon at Imperial College healthcare NHS trust and honorary clinical senior lecturer at Imperial College London, who leads the Brain Tumour Research Centre of Excellence with Syed, told The Guardian: “This test is not just an indicator of disease, it is a truly diagnostic liquid biopsy.”

“It detects intact circulating tumour cells from the blood, which can be analysed to the same cellular detail as an actual tissue sample. It’s a real breakthrough for treatment of brain cancers that rarely spread around the body.

“This could help speed up diagnosis, enabling surgeons to apply tailored treatments based on that biopsy to increase patients’ chances of survival. I’m very grateful to everyone who has contributed to this study, especially the patients involved.”

Dan Knowles, CEO of Brain Tumour Research, said: “The research undertaken in UK universities is world class and something we should all be proud of, but we need so much more. There is an urgent need for novel approaches, particularly in the treatment of GBM, which is fatal in most cases.”

The researchers now plan to carry out larger studies and clinical trials to consolidate the early positive results. If they continue to prove to be highly accurate, it is possible that the blood test could be widely rolled out to patients in the UK within two years.

For more information about brain stem tumours, glioblastoma treatment, and Gamma Knife surgery, please contact Mr George Samandouras of Amethyst Radiotherapy.