Alongside exercise and mental health, nutrition is a key component of a healthy lifestyle, and during a course of radiotherapy treatment, diet will be a key consideration of the multidisciplinary team.

Nutrition is key to ensuring that the body is as ready for treatment as possible during prehabilitation, that discomfort is minimised during treatment and to ensure a speedy recovery afterwards.

Part of your multidisciplinary team will include a dietitian, a health professional who not only provides dietary advice but can also assist with personalised solutions to complex nutritional issues.

Here is why nutrition matters during radiotherapy treatment.

The Body Needs Energy For Recovery

The connection between mental health, physical activity and nutrition is energy, and having sufficient energy levels is an important part of boosting recovery, maintaining high spirits and enhancing resilience to treatment.

Radiotherapy, like all treatments, requires a recovery period, even if many people can walk into the clinic, walk out and continue with their day.

A balanced diet filled with nutrients and sources of slow-release energy can help reduce or potentially avoid the sensation of crashing, extreme fatigue and Somnolence Syndrome, by providing the body with energy.

This tiredness can be caused by a range of factors, but the main reason is an inherent part of the recovery process of the body. People feel tired when recovering from illness or injury because their bodies are using energy as part of the healing process.

Radiotherapy Is Based On Weight And Size

A radiotherapy plan arranged by the multidisciplinary team takes into account a person’s height, weight and overall health, and since weight loss can sometimes occur as a result of radiotherapy treatment, maintaining nutrition is essential to ensure that the course of treatment remains effective.

If this is a factor, a dietitian will often recommend a diet high in energy and protein, including eggs, fish, meat, cheese, beans and full-fat milk, in forms that are easy to digest such as soups or milkshakes as required.

Food Is Important For Mental Health

One of the most important relationships people have is with themselves, and one way in which this manifests is in their relationship to food.

Food and drink are not just a matter of nutrition but also pleasure and appetite, and the taste changes, dry mouth and swallowing difficulties that can sometimes result from treatment can affect a person’s relationship with food.

A dietitian can help through offering variety and reducing the difficulties of maintaining energy and nutritional levels through small meals, softer diets and avoiding foods that can have complex and uncomfortable sensations such as spicy foods.

They can also offer support if foods are difficult to chew or swallow, such as by offering supplement drinks, soft foods or liquid meals as and when they are required.

Maintaining energy levels through nutrition is essential for maintaining mental health, and a dietitian’s role is likely to evolve depending on the treatment plan and multifaceted needs of the individual to ensure that a meal plan.

Maintaining The Social Aspect Of Food

Another aspect of nutrition as it pertains to mental health is the social aspect of eating, drinking and enjoying meals. A dietitian will often work with a psychologist to assist in managing the complex emotional and social elements of food.

They will often encourage people to start small and gradually build up their confidence. Starting with eating at home with friends can extend to a trip out for an easy-to-eat dessert such as ice cream.

Most people and most dining establishments are more than happy to adapt meals and make changes in response to dietary needs. Some restaurants are upfront with what they offer whilst others will discuss an individual’s requirements via email or over the phone.

Regular Discussions With A Dietitian

Most people who will receive head and neck radiotherapy will be offered the services of a dedicated specialist dietitian as part of their treatment plan, and if this is offered there will be regular meetings, discussions or calls to ensure that a person’s needs are met.

These discussions could be as simple as having an opportunity to ask questions or discuss certain sensations such as taste changes or swallowing pain, but can also include advice on which foods and drinks to eat, which to avoid, and what specialist help is available.

As with other parts of an MDT, these meetings are important to the outcomes of radiotherapy treatment as part of a comprehensive, holistic treatment plan that is in effect before, during and following the conclusion of radiotherapy treatments.

This March marks the 21st anniversary of Brain Tumour Awareness Month, and every radiotherapy centre plays a part in ensuring that as many brain tumours are treated as possible, with advanced technology and diagnostics assisting with this aim.

Initially launched by a group of brain tumour charities that would later form Brain Tumour Research, Brain Tumour Awareness Month focuses on fundraising for the treatment and prevention of brain tumours, as well as supporting people who are undergoing treatment.

As well as this, one major goal of Brain Tumour Awareness month is to ensure that people are aware of major common signs and symptoms that could be caused by a brain tumour, so that people can book an MRI or CT scan as soon as possible.

The symptoms of a brain tumour can vary somewhat depending on the type of tumour, its grade, its position in the brain and which parts of the brain it is affecting.

Headaches

Whilst a symptom of several conditions, including tension, stress or fever, a headache which feels different from normal can be a symptom of a brain tumour, especially if they do not seem to go away.

Headaches are caused by raised intracranial pressure, where the tumour pushes against the skull. This can cause not only headaches that tend to be dull, constant and do not go away, but also nausea and eyesight changes such as double or blurred vision.

They are also often more noticeable in the morning, and if this is the case, then an appointment with a doctor should be booked so that tests can be arranged.

Sickness And Drowsiness

Similar to headaches, there are a range of conditions which have nausea, vomiting and drowsiness as potential causes, but as noted above, they can be a symptom of raised intracranial pressure.

If other common causes such as food poisoning, alcohol, dehydration, pregnancy or common conditions such as the flu can be ruled out, if the nausea does not show any signs of improvement even after vomiting, and is accompanied by headaches and vision changes, it could be a symptom of a brain tumour.

Many common brain tumour symptoms are accompanied by others and persist, which means that they should be examined if there is no sign of potential improvement.

Abnormal Vision Changes

Most people will experience some form of gradual vision change over their lives, but a sudden change in vision may need to be examined by an ophthalmologist in order to rule out other potential causes.

Brain tumours can increase pressure on the optic disc and optic nerve, both of which can cause blurred vision, double vision, sudden temporary loss of vision or a loss of peripheral vision, causing objects to suddenly appear.

Exactly how vision is affected will depend significantly on where a tumour is located, and it is important to explain these symptoms to a doctor, book an eye test or go to hospital if these symptoms are severe and sudden in appearance.

Personality Changes

Some symptoms are first noticed by close friends and family, such as changes in personality or behaviour.

These can vary from person to person but can include increased forgetfulness, irritability, anxiety, depression, mood swings or a loss of inhibitions.

This tends to be caused by brain tumours that affect the frontal lobe, which manages emotional regulation and understanding the emotions of other people.

As with headaches, not all changes in personality can be attributed to brain tumours, with stress, tension or personal life events all contributing to behavioural change. However, any sudden personality or behavioural changes should be examined.

It can be useful for the person or someone close to them to document any personality changes and how this differs from their usual behaviour.

Seizures

A common symptom of brain tumours is seizures or epilepsy, a common pattern of seizures. According to the Brain Tumour Charity, two-thirds of people diagnosed with a brain tumour will experience at least one seizure caused by their tumour.

Seizures themselves have varying symptoms, from uncontrollable jerking motions (often known as fits), stiffness, losing awareness, unusual sensations or collapsing. In some cases, the person is not aware that they are having a seizure.

Seizures and epilepsy will typically require a visit to a specialist, as epileptic fits can be potentially life-threatening depending on where they occur, and part of this process is determining any potential causes and treatment paths for stopping or reducing the severity of seizures.

Alongside radiotherapy, a specialist may prescribe anti-convulsant drugs to control the seizures as part of the overall treatment.

The team here at Amethyst Radiotherapy have been featured on the website of Austrian broadsheet newspaper Die Presse, showcasing the leading private radiotherapy clinic, based in Vienna, which provides a wide range of different radiation oncology services.

Centre director Paul Stuchetz spoke to the news source, explaining how Amethyst helps patients achieve the best possible courses of treatment to tackle their illness and detailing how the team works tirelessly to support people throughout their journey, with integrative cancer treatment at the heart of all they do.

Further information on radiation as a treatment option is also provided, with in-depth explanations as to how the external beam radiation device can be used to treat a range of different cancers, including prostate cancer, where it has seen particular success.

Linear accelerator (or Linac) radiotherapy uses high-energy X-rays and speeds up electrons to conform them to tumour shapes and sizes. When aimed at cancers, invasive cells are destroyed, but healthy ones go untargeted.

To find out more about such treatments, get in touch with the Amethyst Radiotherapy team today.

Anyone who is prescribed a course of radiotherapy treatments from a specialist centre can feel comforted that they are receiving a proven treatment that is over a century old and is still evolving and improving in its efficacy.

From the very start of radiotherapy’s development as a potential treatment for cancer, the effectiveness of radiation was never in doubt, because the underlying therapeutic principle largely predates the discovery of radiation itself.

Replacing Chemicals And Electricity

The therapeutic action of radiotherapy is to burn away the tissue that is exposed to radiation, which means that its targeted use can effectively destroy unwanted cells.

The main developments from this discovery in 1896 by Leopold Freund, Eduard Schiff, Emil Grubbe and Victor Despeignes paved the way for progressively better targeted, safer and more effective forms of treatment.

However, the underlying therapeutic action was much older than this, even if the tools used to destroy the malignant tissue were far less accurate and far more dangerous.

Early 1800s: Electrotherapy

One main form of treatment which inspired the development of radiotherapy once radiation was discovered was electrotherapy.

Unlike modern electrotherapy, which tends to use small electrical currents to stimulate recovery or enhance the effects of certain chemotherapy treatments, the field of electrotherapy up until the early 19th century was rather more experimental.

Up until Golding Bird, who helped rehabilitate the field of electrotherapy in the same way that Henri Coutard would radiotherapy in the 1930s, electrotherapy was another treatment that was often extremely dangerous with somewhat dubious benefits.

It was used to stimulate skin tissue and potentially burn away unwanted cancerous cells, and this method of action still sees some use today in the treatment of varicose veins.

Early 1900s: Escharotics

One of the earliest forms of treatment for killing unwanted tissue was poisonous and caustic substances called escharotics. However, these substances are not only extremely dangerous, scarring and in some cases outright mutilating, they can cause permanent, potentially life-threatening damage.

They were popular in early medical practice up until the early 1900s because, without the knowledge of how tumours survive, the tumour did appear to be burned away, along with a significant chunk of healthy tissue, making it appear to be effective even if the tumour very often grew back.

Escharotics have been largely discredited by mainstream medical practice since, and many of the substances used are illegal to sell because of the significant amounts of damage they can cause.

Even the few forms of cancer that can be treated topically such as basal cell carcinoma are typically treated with less damaging and more effective topical solutions than caustic chemical burns.

1896: Discovery of radiation

As early as 1896, doctors knew that radiation could provide the same ablative effect, even if they did not quite understand why.

Victor Despeignes accidentally discovered the therapeutic effects of radiotherapy when trying to treat a patient with late-stage stomach cancer.

Whilst he ultimately did not survive and Mr Despeignes only opted for radiotherapy under the mistaken belief that cancer was caused by parasites, it inadvertently proved a principle that would be more effectively demonstrated by Mr Freund and Mr Schiff, and mark a seismic shift in the history of medicine.

1933: Stereotactic frame & electrotherapy

Interestingly, the first use of the stereotactic frame to treat a human patient involved electrotherapy.

In 1933, Martin Kirschner published a paper wherein he detailed his use of a treatment for trigeminal neuralgia by using a stereotactic frame to make an incision large enough to feed an electrode to the trigeminal nerve, burning it away and reducing the pain.

1940s: Gamma Knife development

This principle would later be used by Lars Leksell for his innovative Gamma Knife radiosurgery and serves to highlight just how influential pre-radiation radiotherapy treatments were and how similar their core method of action is.

The main difference, of course, is a matter of scale, effect and invasiveness to a patient.

Surgery was and remains very effective but is also extremely invasive and typically requires a patient to spend several nights in the hospital to recover.

Escharotics may not require incisions but they are invasive and require time to recover from the intense and often unpredictable damage that the materials could cause. This lack of consistency is what led to them being almost universally outlawed.

Electrotherapy was less invasive but in some cases still required an actual incision to provide the same effect of ablation and burning away of unwanted or harmful tissue.

2025: AI in radiotherapy

In early January 2025, researchers explored the potential of using AI to make what had become an already accurate set of treatments even more precise, something that has some benefits for brain lesions and tumours but can be even more important for treating cancers that affect the digestive and reproductive systems.

If someone is prescribed a treatment plan that consists of stereotactic radiosurgery, they can enter the radiotherapy centre confident that they are being treated by one of the most effective, accurate and oldest radiosurgical treatments available.

The principle of stereotactic radiosurgery, as pioneered by Lars Leksell’s Gamma Knife in the late 1940s, is that multiple small beams of radiation that converge on a particular point can have a much greater effect without damaging the surrounding tissue and minimising overall exposure.

This treatment, whilst adjusted and refined over the past half-century, has been consistently used and effective even before there were effective ways to map treatments using MRI and CT scans. 

This naturally leads to a big question; if the Gamma Knife is so effective, why has the stereotactic principle not been widely applied to other forms of radiotherapy treatment outside of the brain and spine?

The answer is complex and one that medical researchers are doing their utmost to try and change.

The Sea Of Life

The almost tautological answer for why the Gamma Knife specifically is not used to treat other parts of the body is that it was only designed for the brain and relies on a very specific set of medical apparatus that has only been used in the head and cannot be used anywhere else.

Part of this is that the frame system that keeps the head in place for a Gamma Knife treatment is based on the Horsley-Clarke frame initially used to create an atlas of various animal brains before being applied to the human head over the course of four decades.

This tool, albeit heavily modified by Mr Leksell and others, is as fundamental and vital to the success of Gamma Knife as the source of radiation itself. This is why the treatment was tested and used before the widespread availability of three-dimensional medical imaging.

It meant that thanks to some rather complex mapping, a series of skull X-rays could be triangulated to position the stereotactic beams in order to treat patients effectively. Once CT scans and MRIs came in, this only made the process even more accurate.

A lot of this can be credited to Mr Leksell’s work himself, who famously said there was no tool too accurate for use on the brain, but whilst an accurate approach is mandatory for obvious reasons, it is also, relatively speaking, easier to achieve.

The skull helps keep everything in place and there is less variation, relatively speaking, with tumour and lesion positions, allowing for consistency and greater accuracy. 

Pair this with the stereotactic frame keeping the head from moving during treatments and it is perhaps understandable how the Gamma Knife started as a highly effective targeted treatment and has only gotten more accurate with time.

By contrast, the rest of the body is far less consistent and mobile. Organs are constantly moving in the body, not just in terms of pulsing, contracting and relaxing, but also shifting positions based on the position of the body.

Organs change shape depending on their use, muscles such as the diaphragm affect their shape, and even posture and the way people lie down can alter the shape, size and position of organs, particularly those in the abdomen.

This is a major problem when planning radiotherapy because the act of breathing creates a moving target that affects treatments, often requiring wider beams and more collateral damage to healthy tissue to ensure that all cancerous cells are destroyed.

There are ways to mitigate some of these issues, such as through the use of frames and casts to at least keep a body part securely in place during treatment, but there are a lot more variations than there are for the brain, requiring not only different treatments but a different treatment philosophy.

There have been attempts to change this over the years, primarily through increasing the speed at which medical images are produced and interpreted, and this could lead to Gamma Knife-like treatments becoming possible with that level of accuracy in the future.

In order for this to be accomplished, however, there needs to be a close to real-time form of three-dimensional imaging of body parts that can be used to plan treatments the same day they are executed, as unlike the brain there is the potential for much greater organ movement.

This concept, known broadly as real-time adaptive radiotherapy, is one that is at least conceptually possible, but it requires a widely-used real-time imaging system that, as of 2024 at least, has not been widely used.