External radiotherapy is very common for many forms of cancer, either alone or in conjunction with surgery or other treatments, however some patients face long delays, even for private treatment.
When people refer to radiotherapy they generally mean external radiotherapy, without realising that there are other forms, as well more advanced types of radiation therapy, with different characteristics and advantages.
There have been many advances in recent years, particularly in the introduction of image guided treatments, but all external radiotherapy systems suffer from two inherent disadavantages.
In many countries radiotherapy capacity has not kept up with rising demand, but centres in Germany, Austria or Switzerland can generally offer radiotherapy almost as soon as you can arrange to be there.
Intraoperative radiotherapy (IORT)
Intraoperative radiotherapy is most commonly used for breast cancer, but also for soft tissue sarcomas e.g. rectum, stomach, pancreas, kidney and gynaecological tumours and for paediatric brain tumours.
Treatment is given in a single dose during open surgery, directly to the tumour bed, rather than through the skin.
This saves radiation burn and damage to intervening healthy tissue.
It can cut weeks from conventional external radiotherapy, by delivering 20-30% of the total required radiation in a single dose for breast cancer or the entire dose for some other cancers.
One of the leading stereotactic radiotherapy systems is Intrabeam® from Carl Zeiss Meditec and another is Mobetron® from IntraOp Medical Corp.
Particle beam therapy
Proton therapy centres use just protons (hydrogen ions) whereas ion beam therapy centres use a range of particles, including protons.
It avoids or reduces many of the distressing side effects of conventional radiotherapy and reduces the risk of new cancers developing in later life.
Particle beam therapy is especially beneficial for children. Children grow by their cells dividing and this process is very susceptible to radiation damage, so radiotherapy is usually ruled out for them.
Particle beam therapy requires fewer daily treatments and can be used in sensitive areas where conventional radiotherapy is impossible.
Radiosurgery beams are of much higher power and greater precision than radiotherapy can offer. As a result treatments can be reduced to as little as a single session of 45-90 minutes.
The leading system is CyberKnife® and we have handled patient enquiries for this system since 2006.
CyberKnife is not suitable for all tumours but it may be the only form of treatment available for some complex tumours in sensitive locations and it can offer an alternative to open surgery.
Visit the CyberKnife page for more details
Here the radiation source is placed in direct contact with the tumour. The advantage is that the radiation takes effect directly in the malignant tissue.
This means that the fall-off of in the radiation dose in the surrounding tissue is much higher than with external radiotherapy.
A further advantage is the significantly lower radiation exposure compared to traditional radiotherapy.
Even with advanced tumours or the recurrence of a tumour following radiotherapy, brachytherapy offers patients considerable advantages.
Low dose rate (LDR)
In Low Dose Rate brachytherapy, e.g. for prostate cancer, small radioactive 'seeds' are implanted which irradiate the tumour over time. They are left in place after treatment.
High dose rate (HDR)
In High Dose Rate brachytherapy small tubes are placed to guide a radioactive source to the target site for a short time. The radiation source is then removed
Brachytherapy allows a higher radiation dose to be administered in the shortest time so treatment is, in general, reduced from six weeks to just one.
Brachytherapy may be used alone or in conjunction with traditional radiotherapy and/or chemotherapy.
Note: MHL (PPM Consult Ltd.) has no contractual or financial relationship with the manufacturers of any of the medical technologies listed on this page.
Specialist treatments < Radiation therapies
MHL Cancer Enquiries
Different types of external and internal radiation therapy and the advanced cancer centres which offer these.
Ion beam therapy typically uses ions of carbon, oxygen or helium instead of protons, allowing a much higher dose of radiation to be delivered safely.
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IORT is not widely available but it can be found in a few specialist centres.
Firstly although X-ray beams can be aimed quite accurately, they damage everything in their path. Intensity is high at the point of entry and tails off until it emerges on the other side.
To reduce the damage to sound tissue and distressing side effects, patients usually have to attend daily over several weeks and beams are fired from many different angles
Inevitably though there is substantial excess radiation, which can also give rise to later cancers and sensitive skin, e.g. in breast cancer treatments may suffer radiation burn.
Secondly the radiation beams are wide compared to radiosurgery or particle beam therapy, so again it is impossible to target fine structures without damaging surrounding tissues.
For larger or more diffuse tumours this comparative disadvantage can be quite minimal, so external radiotherapy may well be the best treatment. It is certainly more economical and more widely available.
Particle beam therapy uses ions (charged atomic particles) instead of X-rays and these stop at the target, delivering a high dose of radiation within the tumour.
Proton therapy has been used for eye treatments for some time, but in recent years the accuracy of scanning techniques and the power of treatments has improved enormously.
As a result awareness is increasing and more proton centres are being opened around the world.
Ion beam centres are much rarer, but a new centre has now opened in Europe in collaboration with the CERN large hadron collider project.
Because of our experience helping proton therapy patients, MHL has been given direct access to their Medical Director for new enquiries.
New ion beam therapy centre in Austria, available to international patients through MHL
Tissues before and after the tumour receive much lower doses than with radiotherapy.
When used for breast cancer, to irradiate the tumour bed after surgery, the effect is similar to intraoperative radiotherapy (see above).
We work with a large number of university hospitals and world-leading specialist cancer centres who offer these and other advanced treatments for cancer patients.
MHL helps you to obtain prompt, expert opinions from top specialists in their respective fields, so that you can make informed decisions.
You can discuss these opinions or recommendations with your doctor or make your own decision on treatment; the choice is yours.
If you proceed you will already have direct contact with your chosen hospital or specialist and they will guide you from there.
We make a single, flat charge for most enquiries, which can cover application to more than one hospital.
If on reflection you want to try somewhere else, we will assist you if we can, at no extra charge.
CyberKnife tracks lung tumours as you breathe