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.

radiotherapy centre austria - breast cancer awareness concept

When Should You Go Home Following International Cancer Care?

Travelling abroad for treatment is a major commitment to your health, as you get access to state-of-the-art equipment, elite specialists in the field of oncology and access to a wide range of multidisciplinary therapies and treatments not always available in your home country.

We know the importance of the entire care experience when treating cancer, so at our international radiotherapy centre in Vienna, we can provide assistance at every step of your treatment, from advice on securing necessary visas, arranging accommodation and providing continued support throughout your stay.

Part of the considerations will include the travel arrangements, both outbound to Austria and back home. The latter is of particular importance, as depending on the nature of your treatment plan, you may need to spend some time resting and recuperating before you are deemed fit to fly.

However, whether to begin the next stage of your recovery at home or to avoid taking too much time away from work, home and family commitments following a one-day treatment such as some stereotactic radiosurgery procedures, you may be asking when you should return home following the end of treatment.

The short answer is that you should return when your doctor agrees that you are fit to fly and you feel well enough to do so.

To explain why, it is important to understand how treatment may affect travel arrangements, how travel can affect your initial recovery, and what you should do if you are advised to remain in Vienna.

How Is Travel Affected By Cancer Treatment?

Travelling long distances can be stressful on the body, and flying in particular exerts several forces, changes in oxygen levels in the cabin and atmospheric pressures that are typically well-tolerated by the body but can cause issues following certain types of treatment or if you are feeling unwell.

In many cases, this will not affect your ability to fly, but in certain situations, caution may be advised in some cases.

These situations include following conventional surgery (but not stereotactic radiosurgery), if you have a lower red blood cell count, feel breathless or light headed climbing a flight of stairs or are immunocompromised and are at greater risk of catching an infectious disease,

Even if there are no serious risks to travel, if you are feeling particularly fatigued or in pain, a prolonged journey in a confined space could be more uncomfortable than it needs to be.

If you are concerned about return travel arrangements, discuss them with your cancer care team. They will be able to provide tailored advice regarding whether it is safe to travel and any precautions you may need to take.

How Does Radiotherapy Affect Travel Arrangements?

Unlike surgery or chemotherapy, which typically require a few weeks to recover before flying, radiotherapy can vary depending on your exact treatment and how you have been progressing with the early stages of your recovery.

In many cases, you can theoretically travel immediately after your final dose of radiotherapy, although for practical reasons such as existing travel itineraries and the time required for your cancer doctor to let the airline know that you are fit to fly and if you require any specific arrangements.

In some cases, you might be particularly sensitive, sore or fatigued after treatment, and so it might be recommended that you wait until you have fully recovered or feel well enough to travel. If you have waves of energy, it may be advised to arrange travel for a day when you feel more ready for it.

Both you and your cancer team will ultimately know when the time is right, and it will be one of several topics that will be discussed during the final treatment appointments.

What Should You Do If You Are Advised To Stay?

We will help and support you every step of the way, from arranging an extension to your accommodation, travel arrangements and follow-up appointments to check in on your health and make sure you are ready to go.

Other than contacting us if you feel your symptoms suddenly improve or get worse, try to enjoy your time in Vienna. Reducing stress is a key step towards your recovery, and taking the time to relax, enjoy the sights and sounds of the historic city and having a little holiday is all part of the process of treatment and recovery.

radiotherapy centre - Female Patients Undergoing Chemotherapy

Why Are Primary And Secondary Cancers Treated Differently?

Everyone who is diagnosed with cancer will often receive tailored, bespoke care, either in terms of the schedule of treatment they receive, whether they travel to another country to receive specialist care that may not be available in their country of residence, or if they need to look into more experimental treatments.

As a specialist radiotherapy centre, we understand that effective cancer care involves a wide, multidisciplinary approach that takes into account not only the primary specialist treatment, but also physical health, mental health, nutrition, occupational therapy and many other fields.

Everyone takes a different cancer care journey, not only because there are so many different types of cancers, but also because they can also affect the body in different ways.

One element that can have a major effect on cancer treatment is the stage and grade of the cancer, as well as whether it is a primary or secondary cancer.

To explain why this distinction is important for cancer treatment, it is important to briefly explain the difference between primary and secondary cancers.

How Do Primary And Secondary Cancers Differ?

Most cancers that are diagnosed are primary cancers, which are tumours, lesions or growths that develop in one part of the body and remain there until they are treated and destroyed.

In some cases, however, cancer cells can spread to another part of the body through the bloodstream or lymphatic system. Sometimes these cells just travel and are broken down, but in other cases, they can develop and grow in a new location.

This is known as metastasis, and the cancer that develops from this is a secondary or metastatic cancer.

Many, if not most, types of cancer have the potential to metastasise if they progress for long enough, and one of the reasons why early detection of cancer can be so important is to avoid metastasis if at all possible.

A secondary cancer will be described and diagnosed based on its original location. For example, prostate cancer that has spread to the liver is not described as liver cancer but as prostate cancer that has spread to the liver or liver metastases.

Can You Have A Secondary Cancer Without A Primary Cancer?

Whilst in most cases a person will have both a primary and secondary cancer, there are some relatively rare cases where a secondary cancer tumour is found but a primary one is not.

In some cases, this is due to previous treatment that has destroyed the primary cancer, but some cells have escaped into the bloodstream, whilst in other cases, the original cancer is so small and harmless that it has escaped detection but led to the development of a secondary tumour.

It is possible that the metastatic cancer is found before the original tumour, and a major part of treatment in this case is determining the point of origin, as it can have a significant effect on treatment.

In the example above, prostate cancer that has spread to the liver is not the same as liver cancer, and would require a very different set of treatments.

Are Secondary Cancers The Same As Advanced Cancers?

Secondary cancers are also known as metastatic, Stage 4 or advanced cancers, and whilst there is a considerable amount of overlap, not all advanced cancers spread, and not all cancers that spread are necessarily advanced.

This distinction is important, as advanced cancers often require more complex, specialist and immediate treatment to control and remove before they stop responding to treatment, which can require some significant decisions to be made when it comes to where and how you receive care.

Several cancers that metastasise can be cured entirely, most notably testicular cancer, whilst others can still be controlled very well depending on where they are located and whether they respond well to treatment.

This is one reason why some oncologists will use a different or more nuanced staging and categorisation system than the traditional four stages.

Systems such as TNM (Tumour, Node, Metastasis) are preferred as they can provide more accurate information in more complex cases, such as smaller secondary cancers that can be easily treated.

Whilst the example of testicular cancer that spreads to a part of the body where it can be treated easily without any major complications would still be considered a Stage 4 cancer, the TNM system would focus on its size, appearance in the lymph nodes (a sign of spreading) and metastasis.

In any case, oncologists will carefully consider your particular situation, overall health and tumour placements before arranging any specialist treatment.

brustkrebs strahlentherapie (breast cancer radiotherapy) - pink badge on woman chest

What Should I Expect During Breast Cancer Radiotherapy?

Breast cancer is the most common form of cancer diagnosed in women within the EU region and the picture is the same when you look at the prevalence of this form of cancer in Austria. It is estimated that one in 11 women in the EU will develop breast cancer before they reach the age of 74.

This means that it is reasonably likely that you will know someone who has received a breast cancer diagnosis, either in Austria or elsewhere in the EU.

Being diagnosed with breast cancer can be scary. However, it’s important to note that with the right treatment plan, you can beat breast cancer. In fact, the avoidable mortality rate for breast cancer in Austria is nine per cent below the EU average.

Avoidable mortality means deaths as a result of conditions that could be prevented or treated. Having a low avoidable mortality rate is therefore positive, because it shows more women are receiving the treatment they need to survive the disease.

What are the treatment options for breast cancer?

The most appropriate treatment for breast cancer will depend on the size and location of the tumour. For some women, this could mean having a lump surgically removed from the breast. This is called a lumpectomy.

For others, it could mean a full mastectomy, where one breast is fully removed, or a double mastectomy where both are removed.

You will need to undergo a detailed diagnostic procedure so that your medical team can fully understand the nature of your tumour and its precise location. Often tools such as magnetic resonance imaging (MRI) and computed tomography (CT) will be used to understand the characteristics of each patient’s cancer.

After breast cancer surgery, radiotherapy is often recommended to reduce the risk of the cancer returning and destroy any remaining cancer cells.

How does breast cancer radiotherapy work?

After you have had surgery, you will usually require breast cancer radiotherapy. Our team uses high-performance treatment planning software, based on data from your MRI and CT scans, as well as your other relevant medical information, to develop the most optimal treatment plan for you.

This treatment plan is completely personalised to your cancer and therefore you can feel confident that the radiotherapy will be targeted in the most efficient way to help you on the road to recovery.

In most cases, external beam radiation will be the most appropriate option for post-surgery treatment. This is a well-known and generally reliable form of radiotherapy that works by directing one or more beams of high-energy X-ray directly at your tumour.

These X-rays damage the structure of the cancer cells, which prevents them from multiplying. We use a medical linear accelerator, commonly known as a LINAC, during our radiotherapy treatments. This piece of equipment can rotate around you during your treatment, which enables us to direct the radiation at your tumour from different angles.

The main benefit of this approach is that it maximises the cancer cells’ exposure to the radiation, while minimising exposure for the healthy cells in the breast and surrounding tissue.

Although the precise number of radiotherapy sessions you’ll require will depend on your specific diagnosis, normally this treatment is administered over the course of multiple sessions that span several weeks.

These breaks in treatment are important as they give the healthy cells time to recover before you receive your next round of radiotherapy.

How can you tell if the radiotherapy is working?

We use a technique called in-vivo monitoring during your course of treatment. This tracks the precise dose and location of the radiation administered as your course of radiotherapy progresses.

As a result, we can adjust your treatment as needed, based on how the tumour responds to the radiotherapy.

How can I prepare for breast cancer radiotherapy?

Make sure you talk to the team at the radiotherapy clinic you’re visiting to understand what will happen during each round of treatment. When you have radiotherapy you will normally be asked to undress in the area that requires treatment.

During the session, you’ll need to stay still to allow the radiographers to precisely target the X-rays. Your radiographers will leave the room during your treatment but will speak to you throughout and may give you simple instructions.

The best way you can prepare for your treatment is to give yourself plenty of time to arrive for your sessions so that you feel as calm as possible. It’s also important to allow yourself to rest when you need to.

One of the most common side effects of radiotherapy is tiredness and weakness, so be kind to yourself and don’t try to do too much.