Radiotherapy centre Austria

Amethyst’s Dr David Kuczer Receives Radiation Oncology Award

We’re pleased to announce that our partner radiation oncologist Dr David Kuczer has been honoured for his excellent work in the DocFinder Patients’ Choice Awards 2025.

These awards recognise the doctors who are particularly popular within their specialties, with thousands of Austrians voting for their favourite physicians from nine federal states, all of whom are incredibly dedicated to their fields, giving their best each and every day.

Once cancer is diagnosed, radiation oncologists are brought in to cover treatment and follow-up care of both benign and malignant tumours.

Dr Kuczer is a specialist in radiation oncology and radiotherapy, with many years of experience in diagnosing and treating cancer. 

He works closely with Amethyst Radiotherapy Austria to deliver highly precise radiation therapy at its Vienna private clinic.

Dr Kuczer was described as a “competent and empathetic doctor” by patients submitting responses for the awards – and this is the third time he has received the top honour, following previous successes in 2021 and 2022.

DocFinder itself, based in Vienna, is Austria’s leading healthcare platform, used by patients to both find and rate doctors. It receives more than six million user requests every month and, as such, is a particularly useful information portal for the country’s healthcare sector.

The annual Patients’ Choice Awards are determined following comprehensive analysis of patient feedback from the preceding 12 months. 

For the 2025 awards, more than 500,000 patient reports and reviews were evaluated, with winners selected from 1,400 doctors and 25 specialist fields.

Types of radiotherapy - Knee osteoarthritis medical problem

How Can Low-Dose Radiotherapy Treat Knee Osteoarthritis?

When those who have not had radiotherapy before find themselves in a medical situation where it is a possibility, the first question may not be “which type?” Few osteoarthritis sufferers will know there is one kind that could benefit them.

Those who have some knowledge of radiotherapy, either as specialists or patients who have experience of treatment, may be more aware of how many different types of radiotherapy there are and why the distinctions matter.

Indeed, there are several familiar kinds of radiotherapy with various uses:

  • Full body radiotherapy
  • Intensity modulated radiotherapy
  • Image-guidedradiotherapy
  • Stereotactic radiotherapy

The types listed above are all external radiotherapy, but there is also internal radiotherapy, where a radioactive substance is injected into a particular area of the body to focus the radiation on a specific area.

These distinctions, however, are all based on high levels of radiation being used to disrupt cancer cell DNA and shrink tumours. They do not include the distinction between these high doses of radiation and low-dose radiation.

What Causes Osteoarthritis Of The Knee?

Osteoarthritis sufferers would never have their conditions treated by high-dose radiotherapy. But low-dose radiotherapy can be very effective and patients may be particularly keen to try it for joints such as the knee, which by nature will be worst affected by osteoarthritis.

While some other joints may be rested, walking will always put a strain on a sore knee, where osteoarthritis will often occur as a result of the cartilage becoming worn down and thinned, sometimes as a result of injury.

Factors that predispose some people to be more likely than others to suffer osteoarthritis of the knee include:

  • Gender, with women being more at risk than men
  • Age, with over 50s more likely to be affected, although it can strike at younger ages
  • Joint problems, such as gout
  • Repeated injuries to the knee
  • Being overweight, as this places more strain on the knee

How Does Low-Dose Radiation Ease The Pain Of Osteoarthritis?

The effect of low-dose radiotherapy is to impede the inflammatory response, which means your knee joint will become less inflamed and therefore the pain will be a lot less than otherwise.

You may have already considered other treatments for osteoarthritis of the knee, such as surgery or taking anti-inflammatory drugs. But there could be good reasons for these not being suitable for you.

For example, speaking to the Cleveland Clinic about low-dose radiotherapy for osteoarthritis, radiation oncologist Dr Rahul Tendulkar explained: “It’s a great option for patients who can’t take anti-inflammatory drugs due to ulcers, kidney problems or other conditions.”

He added that it is also an alternative for those who are not yet ready to undergo surgery for their condition.

Dr Tendulkar revealed the results of low-dose radiotherapy have been very promising, commenting: “In one recent trial, about 70 per cent of patients who received radiation saw a drop in their knee pain, compared to about 40 per cent in the placebo group.”

The treatment starts with a scan to assess the knee, followed by a short session of treatment lasting just a few minutes. Future repeats are possible.

Not only is this swift and simple without any downtime, but the radiation aspect is not something to be concerned about.

Does Low-Dose Radiation Have Any Side Effects?

The word radiation is often associated with high doses with significant medical effects, which is certainly true for the far higher doses used in treating cancer. But the levels of radiation are so much lower for osteoarthritis treatment and side effects are uncommon at low doses.

To put this in perspective, it is worth noting that everyone is commonly exposed to low doses of radiation every day from various sources:

  • Background radiation from the environment, especially in the presence of certain minerals in the ground
  • Food containing potassium, such as bananas

Because the human body is perfectly geared up to handle radiation at this level, the amount that will be given in a low-dose radiotherapy session will not add sufficiently to that to challenge the threshold at which radiation will have adverse effects.

If you are suffering from osteoarthritis in your knee, or indeed other joints, you may find that low-dose radiotherapy offers a new way of finding pain relief, one that may be especially useful if you are in that category of people who cannot take anti-inflammatories.

Indeed, you may find that it is more effective than the treatments you have relied on so far. For that reason, it may be well worth your investigating the treatments we can provide to help you increase your mobility and suffer far less pain.

external radiotherapy - Meal prep lunch box containers with quinoa

What Should Be In Your Diet Whilst Undergoing Radiotherapy?

When being treated for cancer, every aspect of your treatment and overall care matters.

This is why we take a holistic approach to cancer care; not only do we employ state-of-the-art external radiotherapy machinery to undertake extremely precise treatments, but we also focus on ensuring that everything alongside your treatment is designed to help you recover fully and quickly.

This not only includes highly targeted treatments and specialist options to minimise radiation exposure, but also focuses on your lifestyle, your diet and your fitness routine to ensure that your body is ready for recovery.

Why might your cancer team develop a tailored diet for you? What kinds of foods would be included, and what should be avoided?

Why Does Your Diet Matter When Undergoing Radiotherapy?

Undergoing medical treatment can put an additional strain on your body as it works to heal itself and battle cancer.

According to the World Cancer Research Fund’s guide to eating well during cancer, ensuring your body gets the calories and nutrients it needs to thrive is an essential part of the treatment process and something that is emphasised alongside your course of radiotherapy.

Maintaining a consistent weight will help keep your energy levels high and boost your mood, which in turn can help during the course of cancer treatments.

What Should You Add To Your Diet During Radiotherapy Treatment?

There is no singular “cancer diet” you should eat during your radiotherapy course, and your appetite will often vary on a day-to-day basis.

This means that nutrient-rich, calorie-dense foods are vital to ensure that your body has the vitamins, minerals and protein it needs.

Your cancer team will be able to provide tailored advice, but some general food groups to add include:

  • Healthy proteins, such as lean meat, eggs, cheese, yoghurt, beans, lentils and nuts.
  • Fruits and vegetables, particularly citrus fruits, leafy greens and colourful vegetables.
  • Healthy whole grains and minimally processed carbohydrates.
  • Plenty of fluids, including water, sports drinks, tea, yoghurt and soup.
  • Calorie-dense foods to minimise weight loss, such as avocado, peanut butter, fruit juice and butter.

What Should You Reduce During Radiotherapy?

Try to minimise highly processed foods and foods full of hydrogenated oils, as they can increase inflammation and make you feel more uncomfortable.

As well as this, red meat, alcohol and carbonated sugary drinks should be minimised and ideally cut out entirely.

Your cancer team can explain which types of food will help your recovery and which could help you feel worse.

Are There Any Foods You Should Avoid Entirely During Cancer Treatment?

Some foods should be avoided entirely, particularly if your cancer treatment affects your immune system.

In particular, these foods can carry an increased risk of foodborne diseases that should be avoided:

  • Sushi and other raw or lightly cooked fish and meat products, such as deli meat.
  • Foods with raw or soft-cooked eggs, such as homemade mayonnaises.
  • Unpasteurised dairy products, such as some types of cheese.
  • Fruits and vegetables that have not been thoroughly washed first.

How Can You Make It Easier To Get The Nutrition You Need During Cancer Care?

  • Eat small meals more frequently if you struggle to manage large meals in a single sitting.
  • Eat your biggest meals when you feel at your hungriest. If you struggle to eat in the morning, have a large main meal later in the day, or conversely, have a cooked breakfast.
  • Avoid spicy food and food with overly strong smells to minimise nausea. Instead, opt for water, toast and easy-to-digest dry foods.
  • Take your time and relax. There is no rush to clear your plate.
  • Make meal preparation as simple as possible. Let other people help, buy ready-made meals, use delivery services, shop online or anything that can make your life easier.
  • If you struggle to swallow, opt for soft foods, avoid anything too cold or too warm and use a straw. Nourishing drinks are available if you do not feel you can face solid food at all.
  • Keep hydrated and make sure you have the right amount of fibre for how you are feeling. If you are struggling with stomach pains and constipation, reduce your fibre intake.
  • Try new foods and taste profiles. Radiotherapy can alter your taste sensations, so you may find you enjoy different spices and textures.
  • Talk to your cancer team before taking any supplements, to ensure they do not conflict with your treatments or medication and will provide positive effects.
  • Have a walk or light exercise before eating, as this can help to build up an appetite.
Radiotherapy treatment - first linear accelerator technology IMRT

Can Radiotherapy Be Used Multiple Times In The Same Area?

Radiotherapy is one of the most powerful and advanced medical treatments in the world, and specialist oncologists will create individual and highly precise treatment plans to maximise its effectiveness using minimal doses.

When you travel to a specialist international radiotherapy centre, the goal is to treat complex conditions using highly accurate computerised planning, highly accurate external beam radiation and a holistic process for maximising preparation and rehabilitation.

In general, radiotherapy is undertaken as a single course of treatment either delivered over multiple sessions or cycles. In some cases, such as stereotactic radiosurgery, the dose of radiation is so precise and so powerful that the entire treatment can be completed in a single day.

However, one question that we are often asked, particularly in cases of recurrence, is whether radiotherapy can be used in the same area multiple times. Can you have radiotherapy target a tumour in the same part of the body a second or even a third time?

The short answer to this is yes, according to some of the limited number of studies in the area, but exactly when or where it is appropriate to do so will depend on a huge number of factors and will almost invariably need to be undertaken at a specialist centre.

To understand why, it is important to know what repeat radiotherapy is, what it is not, and why decisions to do another course of radiotherapy can be particularly complex.

What Is Repeat Radiotherapy?

Repeat radiotherapy, sometimes known in medical literature as reirradiation, is when a second course of radiotherapy treatment is given to the same area, where there is an overlap between treatments or where radiotherapy will affect the same organ.

It must be stated that repeat radiotherapy is not multiple doses of radiation undertaken as part of a single treatment. Most radiotherapy treatments are administered using multiple doses across several days, weeks or even months, but this does not count as repeat radiotherapy.

Instead, repeat radiotherapy is when an entirely new course of radiation targets the same area, and it is often a decision undertaken with a lot of care, consideration and often a specialist multidisciplinary team separate from the existing cancer care team.

Where Can Repeat Radiotherapy Be Used?

Because precise dose control and placement of radiation are such a vital aspect of repeat radiation, it is most commonly used in parts of the body in which the positions and placement of organs and tissue do not change as much.

These include treatment for:

  • Brain tumours and related conditions
  • Central nervous system tumours.
  • Head and Neck tumours.
  • Breast cancer.
  • Solid tumours that are easier to plan treatments for.

Whilst not a firm rule, repeat radiation is almost never considered until at least six months have passed since the last dose.

Why Has Repeat Radiotherapy Become More Common?

Historically, repeated radiotherapy was considered to be almost, if not outright, impossible due to the accuracy required for doses and placement of radiation beams.

As both imaging technology principles, such as in-vivo monitoring and advances in linear accelerators, allow for more accurate and safer doses of radiation than ever before, repeat radiotherapy has become a possibility for an increasing number of conditions.

It is still relatively rare and needs to be considered on a case-by-case basis, but it allows for many more options for treatment without the need for conventional surgery.

What Do Oncologists Consider Before Repeat Radiotherapy?

  • Whether the person is the right fit to benefit from repeat radiation.
  • Whether the tumour or condition would be treated through repeat radiation.
  • Previous radiotherapy doses.
  • The original distribution and potential dosage constraints for repeat radiotherapy.
  • The particular radiotherapy technique used.

Why Is Repeat Radiotherapy Undertaken?

Radiotherapy is delivered in carefully controlled doses to ensure that they do not overwhelm the ability of healthy tissue to regenerate and recover. This is why a considerable amount of time is left between the last dose of your original treatment and any potential repeat doses.

As with any other type of major oncological treatment, it is only even considered if it will provide greater benefits to you than the effects of treatment, something that has only become consistently possible in the last decade.

A second or third round of radiotherapy needs to be treated differently from the first, and will only be attempted by specialists.

What Are The Alternatives To Repeat Radiotherapy?

  • Chemoradiation, a combination of a lower dose of radiotherapy and chemotherapy to enhance the effects of the latter.
  • Immunotherapy or targeted drugs.
  • Novocure, also known asTTFields treatment.
Types of radiotherapy - Achilles tendon sprain

How Can Low-Dose Radiotherapy Ease Achilles Tendon Pain?

Most people are not aware that there are several types of radiotherapy. One distinction is between internal radiotherapy, where a patient is injected with a radioactive substance that provides a high dose of radiation to a certain area, and external radiotherapy, using beams of radioactivity that pass through the skin to provide treatment. But there are other variations.

In particular, there is the distinction between the high-dose radiotherapy used to treat cancer and sometimes to shrink benign but troublesome tumours, and low-dose radiotherapy that offers very different benefits.

The latter can include pain relief from a range of musculoskeletal conditions that have nothing to do with cancer or tumours.

Among these is Achilles tendon pain. This can be a persistent and very troubling condition that can affect everyone from ordinary citizens going about their daily business to keen sports players who struggle with the injury as it restricts their time on the track, pitch or court.

As the tendon connects the calf muscles to the heel bone, it is very important in running and walking.

What Are The Causes Of Achilles Tendon Pain?

Several conditions can cause Achilles tendon pain:

  • Achilles tendonitis, which is an injury that causes inflammation of the tendon and is often caused by repetitive strain, excess exercise or the wrong footwear. Having bone spurs, obesity, high blood pressure, flat feet, or differing leg lengths increases the vulnerability, as may the side effects of some medications.
  • Achilles tendinosis, a long-term condition arising from untreated Achilles tendonitis that involves the breakdown of the collagen fibres that make up the tendon
  • Achilles tendon rupture, where the tendon is torn. Often an athletic injury, it can also happen to those with health conditions such as arthritis, diabetes, lupus and gout.

The last of these may be a one-off injury that will heal well with the right treatment, which can include rest, the application of ice, pressure and elevation of the leg above the heart level in the initial stages. The other two are often bracketed together under the term Achilles tendinopathy.

How Can Low-Dose Radiotherapy Reduce Achilles Tendon Pain?

Painkillers and anti-inflammatories can help ease achilles tendinopathy symptoms, but the use of low-dose radiotherapy may provide relief for some patients who suffer from persistent and chronic Achilles tendon pain.

Sometimes, surgery is required and this may be useful for dealing with underlying causes like bone spurs.

There has also been an increased focus on the development of low-dose radiotherapy as a second-line treatment.

This has been shown to help reduce pain in selected patients in dealing with the inflammation.

Whereas high doses of radiation can achieve dramatic results, such as damaging cell DNA (which is what makes it effective against cancer), lower doses of radiation can have an impact on the body’s inflammation response, reducing it and, as a consequence, allowing the patient to feel a lot less pain and soreness.

This is related to the similar benefits low-dose radiation can provide for a wide array of other musculoskeletal disorders, such as osteoarthritis.

By using radiation rather than the chemical anti-inflammatory properties of certain drugs, this provides a new and often more effective way of treating the problem, working when the medication often does not.

Does Low-Dose Radiotherapy Produce Major Side Effects?

A reasonable question patients may ask is whether there are any side effects from the treatment.

Anyone familiar with the experience of those who have undergone radiotherapy for cancer will be aware of the effects this will have had on such patients, including nausea, loss of appetite, tiredness, sore skin and hair loss.

Minor, rare or theoretical risks are possible, but note that the difference between low-dose radiotherapy used for musculoskeletal issues such as Achilles pain and the high-dose radiotherapy used for cancer treatment is huge, with cancer treatment doses typically being 20 times as high.

To understand this in context, it is important to note that the human body is already equipped to deal comfortably with a certain level of radiation, which exists in the natural world and is sometimes naturally higher in some areas than others.

In addition, radiation is produced at low levels by many appliances, such as mobile phones.

Radiotherapy provides higher radiation doses than people will encounter in the natural environment, but not to a very large extent. It will be enough to alter the inflammatory response in the tendons, but not to cause wider side effects.

If you have been suffering from persistent tendon problems but have not gained the relief you have been looking for from other medical interventions, it may be that we can help provide lasting relief with low-dose radiotherapy.

Cancer treatment radiotherapy

Amethyst Austria Announces New SunMed Partnership

Amethyst Radiotherapy Austria, one of the leading treatment centres in the world for primary and secondary cancers, is proud to announce a new alliance with SunMed Consulting to help improve patient access to high-quality medical solutions and clinics available.

Based in Vienna, SunMed is far more than a patient referral service. Rather, the entire patient journey is managed from start to finish to ensure high standards of continuous care to facilitate the most positive health outcomes possible on a case by case basis.

The system itself is professionally structured from appointment coordination and medical documentation to travel planning, clinic communication, treatment follow-ups and post-treatment support.

SunMed prides itself on building strong and reliable bridges between people seeking advanced medical care and the most eminent doctors in fields such as oncology, gynecology, in vitro fertilisation, urology, orthopaedics and aesthetic surgery, with patient-focused guidance and ongoing support delivered throughout.

To facilitate this, the organisation has built up an international network of trusted partners, doctors and clinics, fully committed to ethical values, transparency, medical excellence and, above all, patient safety, with all operations conducted in line with the highest standards of healthcare quality and confidentiality.

Commenting on the new partnership, Dr Paul Stuchetz, Amethyst Austria CEO said: “Radiotherapy is not just a treatment, but a journey. Our partnership with SunMed ensures international patients receive seamless coordination, allowing Amethyst clinicians to focus fully on delivering precision cancer care.”

Amethyst itself delivers comprehensive patient-centred care and high-quality treatments by cancer experts, fighting disease with the most innovative technology available and using the most advanced radiotherapy techniques.

All clinics are fully equipped with advanced medical linear accelerators, which make possible highly tailored radiotherapy dose distributions with maximum normal tissue sparing, putting patient care and wellbeing at the heart of all we do.

If you’d like to find out more about the cancer care and treatments we provide, contact the Amethyst Radiotherapy Austria team today.

external radiotherapy - Keloid scar (Hypertrophic Scar) on man hand

What Are Keloids And Is Radiotherapy An Effective Treatment?

Although keloids are not harmful to your health, they can make you feel self-conscious or even cause emotional distress. This is particularly true if they are somewhere very visible, like on your face.

Let’s look at keloids in more detail, including what causes them and what you can do to treat them.

What are keloids?

Keloids are scars that appear as raised marks on your skin. They are typically hard, smooth and shiny in appearance. Keloids can develop from minor skin trauma, like acne or an insect bite, as well as from more serious injuries.

Keloids are different from hypertrophic scars. This is because keloids tend to extend beyond the site of the original wound.

By contrast, hypertrophic scars form in the location of the original wound, but don’t get any bigger than that. A keloid can be itchy and painful when it is developing. If you get a keloid over a joint, like your shoulder, it can restrict your range of movement too.

What causes keloids?

Keloids are thought to be caused by an overproduction of collagen during the wound-healing process. Collagen is essential for your skin when a wound is healing, but if your body produces too much of it, it can form a keloid.

Research indicates that when someone develops a keloid, their body gets stuck in the second stage of healing: the fibroblastic phase.

During this stage, the body produces collagen and cytokines. But if it stays there too long, you end up with too much collagen. In medical circles, this is often referred to as an “abnormal scar response”.

People who are prone to keloids can develop them due to seemingly insignificant skin damage. As well as acne and insect bites which we’ve already mentioned, tattoos, piercings, burns and even minor cuts can result in a keloid developing.

Do keloids go away on their own?

No, keloids do not resolve on their own. They can take months or years to develop and may not start to appear until long after your skin is damaged. In some cases, keloids can take years to appear on previously damaged skin.

Even if you have a keloid surgically removed, it can grow back. But this is where external radiotherapy comes in.

How can you treat keloids?

There are various options for treating keloids and reducing the irritation they may cause. The kind of treatment you choose will likely depend on where on your body your keloid is located, and how much discomfort it’s causing you.

The most common treatment options for keloids are:

  • Steroid injections
  • Laser therapy
  • Cryotherapy
  • Surgery followed by radiotherapy

Steroid injections, which will be administered monthly, can help to flatten the keloid, but won’t lead to it completely disappearing. Similarly, laser therapy can be used to flatten a scar, but this won’t remove it either.

Cryotherapy, meanwhile, is generally only appropriate for smaller keloids. It can reduce or remove the scar in some cases. However, with all three of these treatment options, you run the risk of hypopigmentation of the skin.

Does radiotherapy work for keloids?

Radiotherapy has been found to work as a treatment for keloids, both alone and following the surgical removal of the scar.

Radiotherapy is sometimes used as a standalone treatment for large keloids or those that have demonstrated resistance to other treatment options.

However, radiotherapy is most often used to treat keloids after surgical removal. Research has found that surgical excision of a keloid followed by postoperative radiotherapy is highly effective at preventing the keloid that is removed from recurring.

This is because the radiation therapy prevents the body from becoming trapped in the fibroblastic phase of healing. Low dose radiation is effective at preventing fibroblasts from rapidly growing, thereby preventing a new keloid from developing.

If you have radiotherapy for a keloid, you will receive a low dose of highly targeted radiation on the site where the keloid has been removed. The dosage is carefully calculated so that the healthy skin underneath the keloid is not affected.

Our consultants will work closely with you and your surgical team if you are having the keloid surgically removed, to create a treatment plan that will have the greatest chance of preventing your keloid from regrowing.

In many cases, you will only need two radiotherapy sessions following your surgery. The first will be planned within 48 hours of your operation and the second will take place around a week later. At our facility, you will receive a bespoke treatment plan before your surgery.

This ensures you can make a fully informed decision about the most appropriate treatment option for you.

Radiotherapy centre

Maja Zakarija: The Benefits Of Amethyst Vienna For International Patients

In this interview, we meet with Maja Zakarija, certified medical travel professional and Austria-accredited pharmaceutical representative, where she discusses the very real benefits of visiting the Amethyst Radiotherapy centre in Vienna for international cancer patients.

Ms Zakarija explains how there’s a common misconception among many people that treatment experiences are the same the world over – but this isn’t the case when it comes to radiotherapy and there are significant differences in how international protocols are applied in practice.

At Amethyst, we ensure that a personalised approach is applied to every case and you can benefit from a team of experts that both understand tumour biology and high-tech radiotherapy equipment.

This assures full analysis of every case, facilitating decisions as to the best possible approach for each individual. This is what can make all the difference to positive or negative health outcomes.

Watch the full interview –

 

External radiation - Old woman touching knee feeling pain

How Can Radiotherapy Help To Treat Osteoarthritis?

Osteoarthritis is a condition that affects millions of people around Europe, especially older individuals and is the most common form of arthritis. Once seen as a consequence of wear and tear, it is now understood to be a disease that can affect any joint.

It is not a disease with one sole cause, but a combination of several factors. Some of these relate to lifestyle, but others do not. These include:

  • Genetic predisposition, as the condition can be heredatory
  • Gender, with women more susceptible
  • Existing musculoskeletal disorders

Are Osteoarthritis Cases Increasing?

According to the Global Burden of Disease Study, in 2020, there were 595 million osteoarthritis sufferers worldwide, equating to 7.6 per cent of the global population.

As the number of people living longer increases, cases are projected to increase significantly by 2050, with osteoarthritis of the knee, the most common form of the disease, set to increase by 74.9 per cent.

Age is not the only factor in the growing prevalence of osteoarthritis, with a high BMI contributing in a fifth of cases, indicating that more sedentary lifestyles in affluent parts of the world, such as Europe, have made the problem worse. In Central Europe, prevalence was up 57.3 per cent in 2020 compared with 1990.

The growing frequency with which people are suffering from osteoarthritis has motivated the research and development of new and enhanced methods of treating the condition. While many of these involve taking medication of various types, radiotherapy can also be effective.

How Does Radiation Treatment Reduce Pain And Inflammation?

This may come as a surprise to many, who would regard radiotherapy as something used against cancer, with those having some knowledge of its mechanisms understanding that the radiation delivered by such treatment is used to damage the DNA of tumour cells, causing cell death and the shrinkage of tumours.

Although this is indeed how radiotherapy works against tumours, it can bring different benefits when used to treat osteoarthritis.

The kind of radiotherapy given is low-dosage external radiation therapy, using beams that can pass through the skin into the affected joint (such as the knee or shoulder).

It works by using the same mechanism as radiotherapy used to treat cancer cells by triggering cell death. In this instance, the radiation causes apoptosis (controlled cell death) in inflammatory cells, which has the effect of reducing the capacity of the immune system to respond to the disease by generating inflammation.

How Does Radiotherapy Affect Cytokines?

Similarly, it also suppresses pro-inflammatory cytokines, which are proteins with the specific task of triggering and directing immune responses.

Some may be familiar with the term ‘cytokine storm’, where too many cytokines can lead to excessive inflammation and an overactive immune system. This is a common problem in autoimmune conditions.

In this case, the pro-inflammatory cytokine response to osteoarthritis is not excessive, but it does result in inflammation and chronic pain, which is why suppressing it is beneficial.

Moreover, the benefits extend further as the reduction in pro-inflammatory cytokines is accompanied by an increase in anti-inflammatory cytokines, effectively reversing the normal immune response and reducing inflammation as a result.

What research has indicated is that low-dosage radiotherapy has had a beneficial effect for many patients in relieving the chronic pain of osteoarthritis. A particularly valuable benefit is that this has often been the case for patients who have not gained substantial relief from other treatments, such as physiotherapy or drugs.

As well as reducing pain, the benefits include greater mobility, which combine to provide the patient with a greater quality of life.

What Are The Side Effects Of Low-Dose Radiotherapy?

Radiotherapy is widely understood to bring side-effects for patients, and in the case of those facing very serious conditions such as cancer, this is a fact of life, with symptoms such as hair loss, skin soreness, tiredness, lack of libido and gastrointestinal issues all being commonly experienced during treatment.

However, because the dosage of radiation is significantly lower when it is being used to treat osteoarthritis, the side effects in this case are fewer and the treatment is usually safe. Among the side effects that commonly occur are nail problems and mild erythema.

The extent to which pain relief is experienced can vary and, as with any treatment, a central feature of our approach is to tailor it to your personal circumstances.

Wider health issues, age, weight, genetics, the presence of musculoskeletal issues and other factors will not only determine the likelihood of suffering osteoarthritis, but also the effectiveness of treatment and the approach that will need to be taken to provide the best possible results in each patient’s case.

Nonetheless, it remains the case that low-dosage radiation therapy is an effective tool in providing relief from osteoarthritis symptoms and may be used with increasing frequency in the years ahead, should projected increases in incidences of the disease prove accurate and no major breakthrough in other forms of treatment is forthcoming.

Radiotherapy centre - Ledderhose's disease on the bottom of a foot

How Can Radiotherapy Help Treat Ledderhose Disease?

When the word radiotherapy is mentioned, most people immediately think about treatment for people with advanced cancer, or possibly a benign tumour that needs shrinking. However, our radiotherapy centre can treat many other conditions that have nothing to do with cancer or tumours.

Among these is Ledderhose Disease, which is also known by its medical name, plantar fibromatosis.

You may be diagnosed with this condition if you report to your doctor with pain in the sole of your foot. The disease manifests in the form of lumps, or nodules, called plantar fibromas, that form on the plantar fascia, the layer of connective tissue that supports the arch of the foot.

Although benign and usually slow-growing, they can sometimes grow very quickly and cause great discomfort, not least because their location means the full weight of the patient’s body presses down on them with each step. This can make standing or walking difficult.

The condition is often associated with similar forms of fibromatosis, such as Dupuytren’s disease, which causes the digits of the hand to contract.

What Are The Causes Of Ledderhose Disease?

Causal factors can include liver disease, alcohol disorder, epilepsy, diabetes mellitus and trauma to the foot. Genetic factors, especially a family history of the condition, can play a part, while the condition is more likely to affect those who are male and middle-aged or elderly.

The condition is diagnosed by a physical examination to establish the possibility of the condition, followed by an MRI or ultrasound to confirm it. If the condition is confirmed, the treatment will depend on the severity of the condition.

How Can Ledderhose Disease Be Treated?

When the fibroids are small, it may be a manageable condition with the use of padded insoles to relieve pressure or physical therapy. However, this will be insufficient if the fibroids become large and while corticosteroid injections can be effective, this is where low-dose radiation therapy can be particularly effective.

The use of radiotherapy has the same essential function in this case as when it is used to treat other conditions, such as tumours.

In each instance, the radiation helps inhibit fibroblast activity and slows disease progression.

If you come to us for radiotherapy treatment for Ledderhose Disease, you may have some significant questions to ask:

  • How effective is the treatment in the near term?
  • What are the longer-term benefits?
  • Is it better than the alternatives?
  • Are there major side effects?

Studies have found that on all these counts, low-dose radiotherapy is an effective and positive option. Note that results vary between patients and suitability depends on individual assessment.

How Effective Is Radiotherapy For Ledderhose Disease?

For example, a survey by the University Medical Centre in Groningen, Netherlands, published in Radiotherapy and Oncology in 2022, revealed that the treatment produced effective results in most patients, with both short and long-term benefits.

Researchers had set out specifically to consider the longer-term impact, and the positive findings were an endorsement of the approach. The study was conducted by following up patients who had been treated at the medical centre between 2008 and 2017.

The findings were that patients had a comparable quality of life with the wider population, thanks to the effectiveness of the treatment, while those who had undergone radiotherapy did not suffer major side-effects, with mild erythema and dry skin the only commonly noted symptoms. This latter fact can be attributed to the lower dosage of radiation.

While this study does provide supportive evidence that this is an effective treatment option, further research and clinical judgment are still required. Evidence quality will vary across treatment options.

Referring to such treatments, which include extracorporeal shock wave therapy, cortisone injections, orthotics and modifications to shoes, the conclusions stated: “The level of scientific evidence for efficacy of these options varies.”

Is Radiotherapy For Ledderhose Disease Better Than Surgery?

This leaves one further option, which is surgery to remove the growths. This may be used if all else (including radiotherapy) proves ineffective, but it is a last resort.

The Groningen study conclusions said of this option: “Surgery might be an effective option, especially for severe cases, but it cannot prevent the recurrence and often leaves painful scars and other complications.”

What this indicates is that radiotherapy may be the most effective means of treating serious cases of Ledderhose Disease, providing the long-term benefits with low recurrence and no scarring. Any side effects are usually mild and temporary but can vary between individuals.

If you have this disease and have found other treatments to be ineffective or only partly effective, mild radiotherapy could prove to be the crucial medical intervention that can restore your mobility, minimise pain and enhance your quality of life.