radiotherapy centre - Modern MRI machine

SBRT vs. Traditional Radiotherapy: Which Is More Effective?

Typically, when people enter a radiotherapy centre for treatment to remove prostate cancer, the course prescribed can sometimes involve as many as 39 doses of radiation over several weeks.

This is a long treatment, but typically if caught early enough has a 90 per cent chance of stopping the cancer from spreading further if not outright destroying it.

However, the length of the treatment along with the fatigue that can often arise as a side effect has led researchers to explore the possibility of using a more intense radiotherapy treatment such as stereotactic body radiotherapy (SBRT), and a major study by the Institute of Cancer Research has provided promising results.

The PACE study, conducted on 874 men with low or medium-risk prostate cancer tested SBRT in a course of five treatments over two weeks against conventional radiotherapy in both its 20-dose and 39-dose pathways over four weeks or 7.5 weeks respectively.

Both treatments were highly effective, with 94.6 per cent of traditional radiotherapy patients being cancer-free after five years. However, what was surprising is that a percentage point more of the patients on SBRT were declared the same.

This is a relatively small increase, but what it highlighted is the potential to use a shorter treatment that is more effective, more convenient and less overall exposure to radiation over the five doses compared to the higher number of doses.

This suggests that it could potentially become the standard radiotherapy treatment for early-stage prostate cancer patients going forward, although there are some patients for whom a long-term radiotherapy treatment would be more suitable.

Prostate radiotherapy can exacerbate urinary issues in people who already have them, and whilst it would be a shorter-term treatment, there will be people who would rather not deal with the irritation, although in the case of SBRT, these symptoms only last a few weeks.

Ultimately, time and further study will tell, but this could potentially be a game changer and ensure people get the treatment they need sooner.

Radiotherapy Centre - Examination by doctor urologist of prostate gland photo concept

Where Prostate Cancer Rates Are The Highest Globally

Prostate cancer is one of the more common cancers, but if detected early enough, men who suffer from it can have a very good chance of survival. Accessing a radiotherapy centre can often be a crucial factor in enabling them to do so.

However, the rates vary widely between countries, with Austria far from being among the worst affected. There are various reasons for this, not least ethnicity, as the majority of Austrians are white. Research in various countries has shown that, for example, black men are far more likely to suffer the disease.

World Cancer Research Fund International (WCRFI) data published in 2020 showed that the highest rates were in the French overseas territories of Guadeloupe and Martinique. Migration from those Caribbean countries to France may partly account for the fact that it was ninth on the list.

Caribbean countries featured heavily among the highest rates, reflecting the ethnic divide, with the top ten also including Barbados, St Lucia and the Bahamas. These countries all had rates of more than 98 per 100,000 men, compared with the global average of 30.7.

However, that was not the full picture; the third-highest rate was in Ireland, while Estonia and Sweden were also in the top ten, showing that European countries with mostly white populations were second-worst affected. High incidence rates in European countries may arise from secondary influences like obesity and high dairy consumption rates.

Another notable fact is that prostate cancer rates vary widely between European countries; EU and EFTA stats in 2018 had put Sweden slightly ahead of Ireland, with these being among five countries with over 200 cases per 100,000 that year.

Yet, at the opposite end of the scale, the rate was only 63.6 in Romania and 83.7 in Poland. The overall average was 151.2, with Austria well below this at 130.4.

However, the difference between the cancer incidence rate and mortality was the most notable finding of the WCRFI figures. No European country was in the top ten for death rates from the disease. Instead, Zimbabwe had the highest death rate, joined in the top ten by Zambia and the Ivory Coast. The other seven in this list were Caribbean nations.

In these countries, the mortality rates ranged from 29.5 per 100,000 in the Ivory Coast to 41.7 in Zimbabwe, compared with a global figure of 7.7. 

What this indicates is that the most deadly combination is that of a population more demographically prone to the disease and poorly resourced in terms of its cancer treatment facilities. This would certainly apply to a country like Zimbabwe, where controversial agricultural reforms in the 2000s brought the economy to its knees.

The WCRFI noted how the cancer survival rates for various forms of the disease can vary between countries, with higher-income nations benefitting from better screening and treatment services.

All this suggests that those with the means to travel from countries lacking in the necessary treatment facilities such as radiotherapy providers may find centres like ours the best place to get vital, potentially life-saving treatment.

Briefe von Patienten

“Als Resümee bleibt mir ein riesengroßes Danke für ihre Leistungen und die ihrer Mannschaft auszusprechen, die in Summe die Bestrahlungen in sehr guter Erinnerung bleiben lassen.”

Sehr geehrter Herr Dr Kuczer,

ich möchte mich herzlich für die bei Ihnen absolvierte Strahlentherapie bedanken.

Aus der Sicht des Patienten stehen sie als Verantwortlicher naturgemäß im Vordergrund, entscheidend ist jedoch das Gesamtpaket.

Es begann mit unserem ersten Kontakt, wo ich bereits neben Ihrer ausgeprägten Kompetenz auch Ihren angenehmen Humor und Ihre deutlich spürbare Empathie kennen und schätzen lernen durfte.

Auch ihr Kollege, der mir die Goldplättchen eingesetzt hat, ist äußerst kompetent, sehr sympathisch und humorvoll.

Positiv möchte ich auch Ihre stets höfliche, reizende und immer hilfsbereite Sekretärin erwähnen.

Dann war ihr Bestrahlungsteam am Zug und hat aufgrund der professionellen, aber auch entspannten und immer freundlichen und humorvollen Abwicklung zum 100% positiven Gesamtbild beigetragen.

Als Resümee bleibt mir ein riesengroßes Danke für ihre Leistungen und die ihrer Mannschaft auszusprechen, die in Summe die Bestrahlungen in sehr guter Erinnerung bleiben lassen.

Die einzige immer mit kurzer Dauer sporadisch aufgetretene Nebenwirkung der Müdigkeit wird angesichts des realistisch erscheinenden Erreichens eines Erfolges und der beschriebenen positiven und entspannten Behandlungsphase in den bedeutungslosen Hintergrund gerückt.

Nochmals ein großes Danke!

Sie und Ihr Team vermitteln und stellen einem Patienten in meiner Lage genau das im medizinischen und psychologischen Bereich zur Verfügung, was er als Werkzeuge im Kampf gegen die Erkrankung und als Beitrag zur Stärkung und Fortsetzung einer bereits bisher stabilen und optimistischen psychischen Entwicklung braucht.

Ich habe binnen kurzem den besten Eindruck von der hohen Fachkompetenz und dem zwischenmenschlichen Zugang von Dr. Kuczer erhalten.

Daß die Amethyst Radiotherapie mit ihrer technischen Ausstattung auf sehr hohem Niveau steht und die Geräte den Patienten kurzfristig zur Verfügung stehen, unterstreicht für mich die besondere Bedeutung dieser Klinik und trägt wesentlich zu meinem Vertrauen auf die menschenmöglichen Chancen auf Leben und Genesung bei.

Von W.G.Sch.

Gamma knife surgery - Radiosurgery word cloud

When Is Gamma Knife Surgery The Best Option For You?

All over the world, millions of people who have contracted brain cancer will have soon learned there is more hope for extended survival today than ever before, because of the wide range of treatments available.

For those learning about gamma knife surgery, there may be a lot of interest in this option and the circumstances in which it might be used as the best available means of treating a tumour.

Brain tumour surgery has certainly been in the news a lot recently, with news that the former US Open golf champion Gary Woodland has had surgery to remove most of a tumour.

The 39-year-old, who won his major title in 2019, revealed on his X (Twitter) account that he would have the operation on September 18th, having been diagnosed just over three months earlier. He had been seeking to use medication to treat the lesion but had agreed after consultation to undergo the operation.

A subsequent statement on his social media accounts revealed: “After a long surgery, the majority of the tumor has been removed and he is currently resting.” 

No further details of the nature of the operation were provided, but the use of the phrase ‘long surgery’ may be a strong indicator that this was a matter of invasive surgery in which the brain was physically accessed and most of the tumour excised.

A gamma knife operation would not be quite like this. Firstly, it does not actually involve any invasive surgery at all as it involves the focused direction of radiotherapy beams on the specific affected area of the brain.

Secondly, the time taken does not particularly fit the description ‘lengthy’. Although the duration of the procedure can vary, a period of less than one hour is perfectly normal.

Also, while Gary Woodland is ‘resting’ from his surgery and it required someone else to make the social media posts on his behalf – suggesting he may have been under general anaesthetic – this is different from gamma knife operations, where patients can often return to normal activities within a day or two, though regular check-ups will be needed thereafter.

Of course, the specific details of Gary Woodland’s condition are between him and his doctors, but some factors would determine that invasive surgery instead of gamma knife surgery might be required. Some of these could apply in his case, while others would not.

For example, a gamma knife may not be the best solution for those who are very young or very old, although this would not apply to a patient of Gary Woodland’s age.

Other issues favouring different options could include larger or more complex tumours (gamma knife treatment is best for small and well-defined tumours), bleeding disorders or having a metal implant in the head.

Finding the right treatment for brain tumours is important and there will be times when a gamma knife is not the best option. But when it is, it comes with a lot of advantages in enabling you to resume normal activity sooner than invasive surgery would normally allow. 

Keto Food For Ketogenic And Cholesteral Diet, Healthy Nutritiona

The Role of Nutrition in Supporting Cancer Treatment Outcomes

When it comes to treating cancer, surgery, radiotherapy or chemotherapy are most frequently used. 

They are designed to either remove the tumour, kill it or shrink it, so it is no longer at risk of spreading.

However, taking steps to improve the patient’s lifestyle can help them cope with the adverse symptoms of these therapies, as well as make their bodies strong to support their cancer fight. 

Having good nutrition, for instance, is essential, helping to boost the immune system, lower the risk of cancer returning, rebuild tissue, and maintain strength. 

Essentially, cancer patients need to eat extra protein, including meat, fish, eggs, dairy or plant-based proteins. 

One of the biggest side effects of treatment is appetite loss, so it is important for patients to set reminders to eat even if they do not feel like this, as they need to remain strong. 

They might also suffer from a dry or sore mouth or throat, or have trouble swallowing. In this case, swapping to liquid foods, such as gravies, smoothies and soups could help them get their calories in. 

Other side effects can include diarrhoea or constipation, so they need to talk with their nutritionist about how to increase or decrease fibre in their diet.

It is also important to drink plenty of water, particularly on days when appetite is low. 

Other ways to manage food intake while undergoing cancer treatment is to eat smaller meals throughout the day, keep snacks closeby, eat something before bed, have soft or cold foods, consume large meals when feeling well, and only sip liquids during meals to avoid filling up too quickly. 

After the treatment is complete, the symptoms should start to subside, making it easier to eat again. 

It is still important to regain strength and boost mood so patients should continue eating well, making sure there is plenty of fruit and veg in the diet, adding pulses to meals, eating whole grains, choosing low-fat milk options, limiting red meat to three servings a week, and easing off fat, salt, sugar, and alcohol.

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Stereotactic radiation of prostate cancer in 7 instead of 39 sessions

Radiotherapy uses high-energy beams to kill prostate cancer cells. It is a treatment option for nearly all cancer stages, from early-stage tumours to more advanced and metastatic prostate cancer.

Our radiation oncology team at Amethyst Radiotherapy, represents the largest pan-European network of high-tech radiotherapy centres. Our doctors are committed to providing cutting-edge radiation therapy treatments that effectively target cancer while minimising the risk of side effects. One of these innovative methods is hydrogel spacers.

This technique involves the use of an absorbable gel that temporarily creates a gap between the prostate and rectum, significantly reducing the risk of bowel radiation during treatment. Hydrogel spacers also improve tumor targeting, reducing the total number of treatment sessions from 39 to 7.

This means that you can complete your treatment in 2.5 weeks instead of 8 weeks. The method is used for localised prostate cancer and is performed on an outpatient basis every 2nd working day. A treatment takes about 10 minutes and is painless.

Attached is the example of the first patient we treat using this method. You can see the dose by the very precise color that surrounds the prostate, as well as the white color of the spacer gel that pushes the rectum away from the prostate.

Radiation techniques available at Amethyst Radiotherapy include:

Image guided VMAT radiation therapy

Volumetric modulated arc therapy (VMAT) is one of the most advanced techniques of external radiotherapy. It involves the use of a linear accelerator machine that rotates around the patient while he lies down. The machine precisely delivers radiation doses to the tumor site while limiting the amount of radiation received by the healthy tissues surrounding it.

Stereotactic Body Radiotherapy (SBRT)

Amethyst Radiotherapy is among the few private centres in Europe offering SBRT radiotherapy, and the only one in Austria. SBRT is a cutting-edge radiotherapy technique that can comprise the radiotherapy treatment into a few sessions, by delivering higher radiation doses safely and efficiently. SBRT is an efficient treatment option both for metastasis/lymph nodes as well as for small PET positive relapses for patients that had radiotherapy previously.

Author: Dr. David Kuczer
Literature: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31131-6/fulltext

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Radiotherapy Benefits Patients with Metastatic Prostate Cancer

Radiotherapy Benefits Patients with Metastatic Prostate Cancer

… and using VMAT and image guidance technology makes it well tolerated

By Amethyst Radiotherapy

New research has shown how radiotherapy combined with others standard treatments for advanced prostate cancer can extend life while avoiding significant side-effects.

This was the finding of the STAMPEDE international study shows benefits from radiotherapy for prostate cancer, conducted by a combination of British-based researchers. This backs up previous data presented to the 2018 European Society of medical Ongology Congress.

Combining radiotherapy to the prostate and hormone therapy can raise survival rates among men with advanced prostate cancer by an additional 11 %, which amounts to two extra years of life on average.

This will be good news for men visiting our Amethyst radiotherapy centre in the Vienna Private Clinic Cancer Center , as the life-extending benefits do not stop there. Especially by using VMAT and Image guidance technology therapy can be applied with a highly focused precision allowing healthy organs to stay unharmed a lot better so therapy will be tolerated well and to maintain the best possible quality of life next to improving life expectancy.

For example, the research found that 65 per cent of men who had recently been diagnosed with prostate cancer that had spread to the bones and lymph nodes and received radiotherapy on top of hormone treatment survived for at least five years. This compares with a five-year survival rate of 53 per cent of those who did not have radiotherapy.

Chief investigator of the STAMPEDE trial Professor Nick James acknowledged that the original 2018 findings had been “surprising”. He added: “Previous thinking was that if the cancer had spread then the horse had bolted and there was no point in shutting the stable door by treating the original disease site.”

Furthermore, he said, the findings suggest prostate cancer sufferers will not be alone in benefitting, commenting: “This could potentially benefit people with other cancers that have spread to other parts of the body too.”

According to the World Cancer Research Fund, there were more than 1.4 million cases of prostate cancer globally in 2020, with 375,000 deaths. The cancer is the fourth most common cancer overall and the second most common for men.

Medical Advisory Dr. David Kuczer

 

 

 

 

 

 

Long-term benefit of radiotherapy confirmed in advanced prostate cancer – The Institute of Cancer Research, London (icr.ac.uk)

Prostate cancer statistics | World Cancer Research Fund International (wcrf.org)

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How Radiotherapy Relieves Cancer Pain

How Radiotherapy Relieves Cancer Pain

The vast majority of people who have booked appointments at our Radiotherapy Clinic  in the Vienna Private Clinic Cancer Center  have done so in order to take advantage of a highly targeted, specialist treatment that helps to remove lesions and tumours before they can cause harm through growing and spreading.

The stereotactic radiosurgery, for example, is a highly effective targeted radiotherapy treatment that uses a range of focused beams of radiation to destroy tumours with little damage to surrounding tissue.

However, besides treatment, radiotherapy has a number of other purposes, one of which is less about a curative treatment and more focused on palliative care and relieving the pain that can come from more advanced stages of cancer.

Whilst primarily used for helping relieve the pain associated with bone cancer, it can be used to help with the management of other types of cancer induced pain.

How Cancer Causes Pain

To understand how radiotherapy helps with pain relief, it is important to know the reasons why cancer can cause people pain.

When tumors grow, they can start to press against other parts of the body, such as nerves, organ tissue and bones. Another mechanism is when the tumor grows into a tissue (e.g. bone) and by that destroys it and causes there painful inflammation.

With bone cancer, this destruction can lead to fractures and breaks, which can cause agonising pain that compounds the pain caused by cancer in the first place, which can reach the point of being unbearable at more advanced stages. If the destructed bone is within the spine, breaks could even cause paralysation, which is a much feared result from bone metastases and therefore needs swift treatment in order to be avoided.

What Radiotherapy Can Do For Your Relief

Radiotherapy works to reduce pain in similar ways to how it can help reduce or remove cancer at less advanced stages.

It reduces the size of cancer tumours, which stops them from pressing against nerves and other parts of the body, and can in some cases make these tumours more viably treated.

For tumours that press on the spinal cord or have started to obstruct the airway, these can provide significant relief or even become a vital part of treatment.

It can help to heal destructed bones and so prevent bone fractures and palsy.

It can also be used if a cancer is ulcerating and thus causing bleeding by healing cancer caused  ulceration and stop the bleeding.

However, it cannot always be used and targeted radiotherapy in the process of pain relief must be mindfully  used by an experiences radiation oncologist in order to achieve the necessary relief.

This is also managed by using lower doses and fewer sessions of treatment  in palliative radiotherapy than would be used in curative settings since the purpose is to shrink the tumour rather than completely excise it.

It can also be used in combination with other medications and treatments to help relieve pain as well, depending on the type of cancer and how it reacts to different treatments.

Palliative treatment is not intended to cure the cancer, but it is commonly effective at reducing symptoms and allowing a better quality of life as well as a longer life expectancy for people in the advanced stages of cancer.

Medical Advisory Dr. David Kuczer

 

 

 

 

 

 

Source: Amethyst Radiotherapy

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How Prostate Cancer Can Be Identified And Effectively Treated

How Prostate Cancer Can Be Identified And Effectively Treated 

By Amethyst Radiotherapy Vienna

Prostate cancer is a disease that kills thousands of men in Austria every year, but the rate at which it does so is less than in most European nations.

That is because the disease is not necessarily a death sentence, and the countries in which it is detected and treated earlier will have higher survival rates.

Eurostat provided the most recent statistics on mortality rates for prostate cancer in 2018. The chart of EEA countries (including the UK, which was still in the EU then, plus non-EU nations like Norway and Switzerland) saw Austria having the 11th lowest rate out of the 31 listed.

The Austrian mortality rate was 29.4 per 100,000 men, which compared favourably with neighbours like Germany and Switzerland, but was worse than Italy.

Overall, the lowest death rate was 18.9 in Luxembourg, with the highest being Estonia at 50.9, followed by Sweden at 50.4.

Needless to say, a key factor in survival can be having treatment at an experienced radiotherapy clinic like the Amethyst radiotherapy  in the Vienna Private Clinic Cancer Center , but first it is important to spot symptoms and get a swift diagnosis. As with any cancer, the sooner it is identified and treated, the better the chances of survival.

Writing for Targeted Oncology, US-based radiotherapy oncologist John Sylvester noted that many of the common symptoms that can indicate a problem needing investigation, such as urinary problems or blood in urine, are not always present.

For this reason, he said early screening, especially for those at high risk such as men from certain ethnic groups or those with a family history of prostate cancer, can save lives.

Dr Sylvester went on to note that while surgery can work for some patients, it is not the only option and that treatment options “become more limited” once the prostate itself has been removed. Moreover, he noted, research has shown that “combining radiotherapy with brachytherapy provides a better chance of preventing local cancer from metastasizing”.

So by getting checked out early, patients may find that they can tackle prostate cancer swiftly and effectively without having to resort to life-changing surgery.

Medical Advisory Dr. David Kuczer

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Why Oligometastatic Prostate Cancer Is Now More Treatable

Why Oligometastatic Prostate Cancer Is Now More Treatable

… and using stereotactic radiotherapy makes it well tolerated and highly effective

By Amethyst Radiotherapy Vienna

Prostate cancer is one of the most common forms of cancer in men and incidences of it are rising. Across Europe, 30 million men alive now will receive a diagnosis of the disease in their lifetime, with 75,000 dying each year.

The number of diagnoses in the EU and EFTA has doubled since 1995, with the causes of this being uncertain. By 2018 more than a fifth of cancer cases in men were of the prostate, highlighting the need for oncologists to respond.

Curiously, the levels of prostate cancer varied markedly between countries, with Romania lowest at just 63.6 per 100,000 to Sweden’s rate of 211.6. The average figure was 151.2.

In comparison, Austria had a much lower rate of 130.2, but this was still over double that of Romania and higher than neighbours Hungary and Slovakia, though less than Italy, Switzerland, Slovenia, the Czech Republic and Germany.

Even with Austria in the lower half of this grisly table, many men will want to get private stereotactic cancer treatment. The good news is that the capacity of oncologists to treat some forms of the disease has become significantly more advanced in recent years.

This will be good news for men visiting our Amethyst radiotherapy centre in the Vienna Private Clinic Cancer Center , as our oncologist looks back to more than 20 years of experience in high precision stereotactic radiotherapy. Especially by additionally using VMAT and Image guidance technology therapy can be applied with a highly focused precision allowing healthy organs to stay unharmed a lot better so therapy will be tolerated well and to maintain the best possible quality of life next to improving life expectancy. By high precision is meant the resolution of 1 pixel which equals 0.8 mm. And using VMAT reduces dose exposure of adjacent healthy organs within a perimeter of 3 – 5 mm around the tumor to only a fraction of the treatment dose.

As Cure Today reports, this is certainly true with oligometastatic prostate cancer. The term refers to an intermediate form of the disease where it has progressed beyond a localised cancer but is not yet a fully-emerged metastatic disease.

Speaking to the journal, retired US-based urologist Mark Samberg said his diagnosis in 2020 meant his career brought both advantages and disadvantages – the latter being that he knew how such situations often ended for patients. The positive was he knew the “right questions to ask” and understood aspects of his condition.

This included the fact that he was diagnosed as being in the oligometastatic phase, something most patients would not know existed.

However, that was true of oncologists too until the mid-1990s. That is when oncologists Samuel Hellman and Ralph Weichselbaum proposed such a state could exist. Their research focused on prostate cancer because of its high prevalence.

The understanding that has grown since then of oligometastases has enabled more tailored treatment to be carried out, including radiotherapy, as well as other treatments like chemotherapy.

Dr. Neha Vapiwala, professor and vice chair of education, radiation oncology, at the University of Pennsylvania in Philadelphia said oligometastes are usually detected by scans showing metastes in five regions.

“We might be able to intervene with treatment that’s more aggressive, targeting the handful of lesions that are seen, usually in addition to the normal systemic therapy we would give,“ he observed, adding that this could help lower the “tumour burden” and extend the survival time of the patient.

The report also noted that improvements in screening technology mean oligometastic prostate cancer is now easier to identify at an early stage.

Meanwhile latest reports on metastases directed radiotherapy in oligometastatic disease showed that this novel treatment option allows to postpone the use of male hormone depleting therapy (ADT). This allowing  patients to continue their usual sexual life quality.

While Austria may be better off than most of its neighbours when it comes to prostate cancer occurrence, there will still be many men who have it and some will be in an oligometastic stage. That is why it may be good to know that if this is the case, the capacity to treat it with radiotherapy and other means is greater than it was just a few years ago.

Medical Advisory Dr. David Kuczer

 

 

 

 

 

 

PROSTATE CANCER (efpia.eu)

Oncologists Can Now Better Detect and Treat Oligometastatic Prostate Cancer, Leading to Improved Survival (curetoday.com)

Metastasis-Directed Therapy for Prostate Cancer Increases PFS, Time off Hormones

— Radiotherapy led to “dramatic” slowing of progression, increased time with normal testosterone

Salvage Nodal Radiotherapy as Metastasis-Directed Therapy for Oligorecurrent Prostate Cancer Detected by Positron Emission Tomography Shows Favorable Outcome in Long-Term Follow-Up

Metastasis-directed Therapy Without Androgen Deprivation Therapy in Solitary Oligorecurrent Prostate Cancer