What makes a cancer treatment so impactful is not just the effects of the disease itself or the need for treatment, but how much it can affect your life.

This is particularly true if you are travelling internationally for specialist treatment, and many people notice that their personal, social and professional lives will change over the course of treatment.

To what extent it affects you depends significantly on your diagnosis, your overall health and your individual circumstances. Some people find work helps connect them to the other critical parts of their life, whilst in other cases it is simply not possible.

It is a complex debate, and one to discuss with your cancer care team, but here are some of the biggest factors that may affect your decision to keep up with your work and social life during radiotherapy treatment.

When Is Working During Radiotherapy Possible?

Unlike surgery, where you must spend a considerable amount of time off to allow scars to heal and to rehabilitate, and unlike chemotherapy, where there are aspects of the treatment that can affect your ability to share a workplace with others, some radiotherapy courses will allow you to keep working.

In some cases, you can work as normal, whilst in other cases you may need additional accommodations to ensure you can attend appointments, work from home or have flexible hours to work around your fluctuating energy levels.

Ultimately, you are the best judge of how you feel, and if your workplace is willing to accommodate that and allow you to be flexible with how you do your work, it should be possible to work during your treatment.

In general, jobs that will allow you to work during radiotherapy:

• Will primarily consist of duties that do not require heavy lifting or other manual labour.
• Will have flexible working hours.
• Will allow you to work from home or in a quiet space.
• Allows you to defer or alter your job duties, prioritising ones you can do easily and allowing others to help you with jobs that are more difficult whilst receiving treatment.
• Will offer adaptations and reasonable adjustments to help you continue to work.

Depending on where you are working and where you are receiving treatment, there may be certain legal protections for people undergoing radiotherapy treatment and carers for those undergoing cancer treatment more broadly.

The main exception to this is if you are receiving brachytherapy; whilst the radiation fades over time, you may be warned to avoid close contact with people, particularly children and pregnant women.

What Makes Working During Radiotherapy Treatment More Difficult?

It must be noted that whilst many employers can and will be flexible to ensure that you can return to work when you are able, this does not mean you are obligated or required to.

Some people will feel like they can navigate radiotherapy more easily than others, and certain job roles are easier to do whilst managing side effects and fatigue.

At a basic level, you will need to take some time off for each appointment you have, and given that some radiotherapy courses are every weekday, it could mean starting later or working reduced hours.

Depending on how you feel after each session, you may need time to recover, and that can sometimes mean that work could get in the way of the healing process. It can sometimes be better to take a work break and recover faster than to try to keep working and affect your treatment.

Another aspect is where you are receiving treatment. If you opt for treatment in another country, then you will need to ensure that you can work remotely and factor different time zones into your work schedule.

Finally, there are mental health considerations to think about; cancer treatment can provide a lot to think about, and if you are worried about your treatment and your performance at work, it can create stress and burnout that can be counterproductive.

Should You Keep Working During Your Radiotherapy Treatment?

Everyone is in a unique situation when it comes to their cancer diagnosis and radiotherapy schedule, and your treatment and job must work around you.

Some people find it really helpful to continue to work; they want to keep connected to their colleagues and work friends, enjoy what they do, benefit from the structure that having a job provides and feel well enough on most days to be comfortable staying in post.

However, if you do not feel that way or your job cannot be done safely whilst you are managing side effects, support is often available if you need it, if you need to take long-term sick leave whilst undergoing your treatment and during your recovery.

Our private radiotherapy services offer the best treatments available, using the finest expertise, the most modern equipment and cutting-edge techniques, which combine with comprehensive aftercare to seek the best possible outcomes and provide strong support.

A key part of this process is providing individualised care. It is important that each patient receives treatment tailored to their needs, for several reasons:

• Their own age, general health and other circumstances, such as genetic factors, will vary
• Each cancer diagnosis will have its own characteristics, such as differing tumour sizes and locations
• Some cases will be diagnosed at an early stage and some will be later, when the disease may have progressed to a late stage and metastasis may have taken place
• Patients will be involved in the process and their needs and wishes will be taken into account

Apart from this, there is the important aspect of care for each individual as a person, appreciating that undergoing radiotherapy, chemotherapy, or other cancer treatments can be challenging for them and their loved ones in various ways.

The most important thing is to ensure the course of treatment is tailored to individual circumstances, which can be established by initial diagnostics.

What Is The Important New Development Involving PET Scans?

This does not just involve diagnosing a cancer, but establishing facts such as the precise location, size and extent of the disease and whether it has spread through metastasis from its original site to elsewhere in the body.

When planning and then delivering treatment, we use the best methods and devices available, but anyone with even a fleeting knowledge of treatments such as radiotherapy will be aware of the great advances in treatments and the resulting improved medical outcomes.

New developments in technology and medical understanding continue to offer advances and the next one may include the use of PET scans to enable the process of tailoring radiotherapy treatments for brain tumours to be taken to a new level.

According to Physics World, this possibility has emerged with the development of a new form of PET scanner, which uses a multiplex array to display images of more than one radiotracer at a time.

The publication stated that this could enable biologically individualised radiotherapy treatments to be carried out, improving patient outcomes by dealing with the problem of tumour heterogeneity, which involves variations in characteristics within tumours.

Such heterogeneity can pose a problem as some parts are more resistant to radiation than others, but existing scans, with just one screen, can only judge overall resistance, which could then, incorrectly, be assumed to be uniform across the tumour.

With multiple screens, this problem could be resolved, as different scans at different angles can be examined simultaneously, showing which parts of a tumour have higher resistance and where it is lower. This will aid the targeting of radiation in subsequent sessions.

How Can Better Scans Enhance Stereotactic Radiotherapy?

This will help maximise the precision with which the best radiotherapy technology can operate. Stereotactic radiotherapy is designed to do this, with very precise beams of high-intensity radiation.

A prime benefit of this, underlying the invention of the technique and the Gamma Knife tool for delivering it by Swedish neurosurgeon Lars Leksell in the 1960s, is to carry out radiotherapy on the brain and minimise radiation exposure to healthy tissue.

The capacity to focus radiation in this way marked a major advance, but better scanning enables this precision to be taken to even higher levels. Not only can the radiation be delivered more accurately and powerfully, but the targeting can be more accurate.

How Do 3D Scans Improve Radiotherapy?

Multiplex PET scans could add a new scanning advance to those that have already helped to improve radiotherapy. Among these are 3D scans, which enable a clearer picture of tumours and other areas with cancerous cells to be developed.

This is particularly useful when treating tumours with various forms of external beam radiation, as it enables effective targeting to fire beams of radiation at tumours from different angles.

Once again, the fact that there are systems capable of delivering radiotherapy in this way means that modern treatments can maximise the potential for both targeting and delivering radiation from different angles, enabling optimal dosages to be given in the right places.

The use of PET scans may be the next development in scanning technology, but there have already been huge enhancements in this area.

Where once diagnostics depended on biopsies and some guesswork and radiotherapy was relatively imprecise, great strides have been made.

These developments make it increasingly possible to provide tailored treatments, making the way we can respond to your condition truly individual, using the increasing volume and accuracy of scan data and other diagnostic information to plan your programme.

Learn more about our advanced radiotherapy and neurosurgical treatments for brain tumours on the Amethyst Group website.

Everyone who has been diagnosed with cancer has a different treatment plan and journey to take, and in some cases, it can take you to an international radiotherapy centre to receive personalised care in the heart of Vienna.

If your treatment plan takes you to us, whether due to our particular specialities in oncology or through a second opinion, then we will help you through the complicated elements of organising travel, accommodation, long-term stays and ensuring that friends and family can come visit you whilst you have treatment.

One aspect of treatment that can often lead to more questions if you travel abroad is what happens once your treatment course ends.

What should you do after your last radiotherapy appointment? How should you expect to feel following treatment? And given that you may need to travel long distances back, when is the best time to return home?

These answers will vary depending on your particular treatment plan and the advice provided by both your primary doctor and ourselves. However, here is some advice and guidance for what you can expect at the end of your radiotherapy treatment.

How Long Does A Course Of Radiotherapy Take?

Radiotherapy treatments are broken up into dozens of smaller sessions, with schedules that can vary significantly from multiple times per day to once every weekday, three times a week or weekly.

As the sessions are relatively short, there is a lot of flexibility to ensure that anyone being treated has time to recover and rest in between appointments.

A typical course of radiation therapy is between six and eight weeks, assuming regular doses of radiation every weekday. There are alternatives which allow for more rest time. Alternatively, high-dose radiation treatments attempt to condense the process and shorten your treatment duration.

The exact time depends on:

• • Cancer type.
  • Location in the body.
  • Any other treatments you are receiving.
  • Your overall health.

Each individual session is between 30 minutes and an hour, but the rest periods in between are so important that they should be considered part of the treatment.

A side benefit to taking radiotherapy abroad is that when you are away from home, you have a great impetus to rest and avoid too much stress and strain on your body, rather than focusing on work and other commitments.

What Happens After Your Last Radiotherapy Session?

The final dose of radiation is not the end of treatment, and you should not plan to pack your bags and take the first flight out of Vienna.

Your last appointment will not only involve the final dose but also establish what the next steps of treatment are likely to be.

The symptoms of radiotherapy tend to linger for a short time after the final session. This is normal as the radiation works to kill off the cancer cells. It will take some time before you return to a new normal.

There will often be a follow-up session with your cancer team before you return home, to ensure that you are ready to travel, that there are no lingering effects that are causing concern, and to help arrange follow-up support with your primary doctor.

It can be a difficult time filled with complex emotions, but there is support available, and you do not have to face this alone.

When Can You Go Home After Your Final Radiotherapy Follow-Up?

You will receive one or several followr-up appointments, but where these will take place and when will depend on your recovery following the final radiotherapy session.

You must be deemed fit to fly, which may involve discussions about the right time to travel, when it is safe to do so or if the airline should be made aware of any conditions that would complicate your ability to fly or mean that you require additional equipment such as supplemental oxygen.

Depending on your treatment, you may be at greater risk of infection, although this is less likely for people who have undergone radiation without chemotherapy or other drug treatments which affect the immune system.

In most cases, once the effects of the last session of radiotherapy ease up, you can start to make arrangements for your return trip home. Ask your cancer team for advice on what you need to think about during travel, which medicines you need to take with you and what you should do if you have issues.

Usually, this takes a few weeks, but make sure to contact your cancer team if you have any concerns before you leave Austria, and make sure you receive contact information for who to get in touch with once you return home.

Many cancer treatments, from radiotherapy to chemotherapy, take multiple sessions and quite some time for the treatment to fully take effect, in order to balance their powerful effects with recovery and life’s responsibilities.

One exception to this is stereotactic radiosurgery, which, through highly powerful doses of radiation, targets tumours and lesions in the brain over time.

It is sometimes compared to a surgery, to the point of even being called Gamma Knife radiosurgery, but unlike invasive treatments to remove brain tumours, there is no need for an overnight stay, typically no need for general anaesthesia and no stitches.

How long does stereotactic take from start to finish? It can vary depending on the exact treatment plan, but here is the general progression of treatment and how long each step usually takes.

How Long Does It Take For Treatment Teams To Decide On Gamma Knife Radiosurgery?

One of the longest stages of the treatment is the initial consultation and treatment planning phase, both of which are done before any treatment is agreed to.

Oncologists and a cancer team need to agree that stereotactic radiosurgery is the best course of action to treat your brain tumour; they need to determine the complexity of the treatment, how much planning will be required ahead of time, and how urgent treatment is.

How Long Does Preparation Take For Gamma Knife Radiosurgery?

Preparing for radiosurgery involves a pre-treatment physical exam to ensure that you can lie flat on your back for the time it takes to undergo the procedure, further scans of your brain to allow specialist radiation oncologists to plan the procedure and preparations to ensure the frame or mask fits snugly on your head.

You will be given advice ahead of time, specific to your treatment, including:

• Avoiding eating or drinking anything after midnight the day before your treatment.
• Taking any medications before the treatment with sips of water, and ensuring that any medications you need to take that day are brought with you to the clinic.
• Washing your scalp, not using hair products and keeping hair loose to avoid interfering with the treatment.
• Wearing comfortable, loose-fitting clothing.
• Ensuring you have arrangements to get to and from the clinic.

 

How Long Does Planning Take For Gamma Knife Radiosurgery?

The planning stage and the actual treatment often take place on the same day, but they can take place on separate days in some circumstances.

The initial planning steps involve the administration of an IV with a contrast agent and sedatives.

The former helps with imaging tests to ensure pinpoint accuracy with Gamma Knife treatment, whilst the sedatives can help provide relaxation during the planning and treatment stages.

The imaging tests themselves, which can use computed tomography (CT scans), magnetic resonance imaging (MRI scans), or both, will determine the exact target treatment area, the size of a tumour and guide the advanced planning of the treatment.

The IV can take several minutes to take effect, the scans can take roughly half an hour, and the planning typically takes at least an hour.

This appointment can take at least three hours, including the time it takes to recover from any required sedatives.

How Long Does Gamma Knife Treatment Take?

Gamma Knife therapy itself can vary in length, depending on the complexity of the treatment.

You will once again have an IV drip fitted if the planning and treatment take place on separate days, before you lie on the treatment table, and a frame or mesh mask is secured to your head and to the table to ensure that the treatment is as accurate as possible.

The radiation is then administered remotely using a highly advanced machine that focuses several beams onto a single point to maximise accuracy whilst minimising radiation.

This process can take as little as 30 minutes and as long as four hours, depending on the complexity of the treatment plan, how many doses of radiation are required and how much the machine needs to move around your head.

Once the treatment is completed, a chime will sound, the frame will be removed, and the IV will be taken out. You will then be taken to a recovery room to be monitored before typically being free to go home.

Most of the time, the planning and treatment stages are undertaken on the same day, and the appointment can take up to 12 hours.

How Long Does It Take To Recover From Gamma Knife Radiosurgery?

Most of the time, you can go home the same day, although in some cases you may be asked to stay in the clinic overnight for additional monitoring.

You can typically return to your normal schedule within a week, although you may receive additional instructions to manage the pain, how to clean and dress any scratches and how to speed up recovery.

Osteoarthritis of the shoulder is not discussed as frequently as other forms of osteoarthritis, such as that in the hip or knee. But it can be a painful condition that restricts your movement if it goes untreated.

Although shoulder osteoarthritis is not as common as hip or knee osteoarthritis, it is still estimated that one in three people over the age of 60 have some level of osteoarthritis in one or both of their shoulders.

What’s more, research highlights how shoulder replacements are becoming more commonplace all over Europe, with countries including Germany, Denmark, Norway and Italy all showing a steady increase in the number of people undergoing such surgery.

Osteoarthritis is one of the most common reasons for someone needing to undergo a shoulder replacement.

However, surgery is not the only option if you suffer from osteoarthritis, as there are other treatments available, including radiotherapy.

What causes shoulder osteoarthritis?

The condition occurs when the protective cartilage in the shoulder joint begins to soften and degrade. Over time, the cartilage will crack and weaken.

Eventually, it will wear off completely, which is when patients typically experience the greatest pain, swelling and reduced range of movement.

If all the cartilage in the shoulder joint is worn away, bone spurs can form, which can create additional complications if they break off and “float” within the joint.

What are the signs of shoulder osteoarthritis?

The most common sign of shoulder osteoarthritis is pain in the shoulder joint – although pain alone doesn’t always mean you have osteoarthritis. Other forms of arthritis can also cause pain, as can injuries to the shoulder joint.

Stiffness in your shoulder is another sign that you may have osteoarthritis in this joint. In addition, you will start to lose the range of motion within the joint as the condition progresses.

While many people only experience pain in their shoulder when carrying out activities like lifting heavy objects or exercising initially, this can progress to pain even when you’re not moving your arm.

To accurately diagnose osteoarthritis in the shoulder, you’ll need to have a medical exam and likely an X-ray. In some cases a CT scan may also be recommended.

How can you treat osteoarthritis of the shoulder?

The most effective treatment for your shoulder osteoarthritis will depend on the degree to which it is affecting you and how much pain you are in.

In the first instance, you will normally be given shoulder exercises to help strengthen the joint and improve your range of motion. The advice is typically to avoid any activities that cause pain.

You can also use either ice or heat to help reduce the pain and you may be given anti-inflammatory medication. However, there is another option: low-dose radiotherapy.

Low-dose radiotherapy has been proven to be effective for both relieving pain and improving the motility of the shoulder joint.

One long-term study that looked at the effects of low-dose radiation on patients with periarthritis in the shoulder found that over half (56 per cent) reported that pain relief as a result of the treatment had lasted for years.

Low-dose radiotherapy has an anti-inflammatory effect on the joint, which not only alleviates the inflammation in the short term but also prevents it from recurring in many cases.

What does low-dose radiotherapy for osteoarthritis involve?

If you choose to go down this route to help alleviate your pain and improve movement in your shoulder joint, you will need to find a radiotherapy centre you are comfortable with. Once you have done so, you can book your consultations to discuss a treatment plan.

Typically, low-dose radiotherapy sessions to alleviate chronic pain and help patients with conditions like osteoarthritis are short. You will likely only need a few sessions to feel the benefit, although your consultant will discuss a treatment plan based on your condition.

Your consultant will look at the X-rays of your shoulder to assess the level of degradation in your joint. Then they will create a plan for your treatment based on what they can see and on what you tell them about how it is affecting your quality of life.

Each low-dose radiotherapy session will often only last a few seconds, as this is all the exposure that’s required to achieve the desired results. While most patients describe the radiotherapy as painless, some report an increase in their pain levels during their course of therapy.

However, this is often a good sign as it indicates that the affected area of the shoulder is responding well to the treatment. In such cases, we would expect the pain to reduce once the course of low-dose radiotherapy is complete.