Targeted Treatment for Secondary Cancer - Non-Invasive Treatment for Oligometastatic Disease

When cancer spreads to a limited number of sites, advanced precision treatments can deliver life-changing results. As a leading UK radiation oncologist specialising in stereotactic radiotherapy (aka stereotactic radiation therapy) for oligometastatic disease, I offer cutting-edge treatment options that target and eliminate cancer metastases with remarkable accuracy and minimal side effects.

Stereotactic radiotherapy can be used when any cancer type has spread, as a secondary cancer, to a few areas. Alongside systemic therapy, it can be used as a local therapy for metastatic lung cancer, metastatic prostate cancer, colorectal cancer, metastatic kidney cancer. SABR aims to completely remove the cancer spots (metastatic lesions). It is a local therapy, meaning it non-invasively targets the metastatic lesions where they are with accurate high-dose radiation.

What is Stereotactic Radiotherapy?

Stereotactic radiotherapy is an advanced form of external radiotherapy that delivers highly focused, intense doses of radiation with pinpoint precision. This treatment for cancer spread clears the cancer spot while minimising damage to surrounding healthy tissues. Unlike conventional radiotherapy, stereotactic body radiation therapy can be completed in just 1-5 sessions, making it convenient and effective for patients with metastatic disease by reducing your time in hospital and on the treatment couch!

Different Types of Stereotactic Radiotherapy

Stereotactic Ablative Radiotherapy (SABR), also known as Stereotactic Body Radiotherapy, is a radiation treatment specifically designed to treat a tumour (tumor) outside the brain. The terms are often used interchangeably, with SABR being more commonly used in the UK. This precision approach effectively eliminates cancer cells while preserving healthy tissue near the treatment area.

For brain metastases (a metastasis being a brain tumour which is actually a cancer that has spread from somewhere else in the body), Stereotactic Radiosurgery (SRS) delivers concentrated radiation precisely to the brain metastases. Despite its name, this is not a surgical procedure—it's an advanced form of radiation therapy requiring no incisions.

Fractionated Stereotactic Radiotherapy (SRT treatment) divides the treatment into multiple sessions, which can be beneficial for treating larger a brain tumour (brain tumour) or those near sensitive structures.

Stereotactic Radiotherapy for Oligometastatic Disease

Oligometastatic disease refers to cancer that has spread from its original site to a limited number of locations (typically 1-5 sites). Research has shown that patients with oligometastatic cancer can achieve long-term disease control or even cure with aggressive local treatments such as stereotactic body radiation therapy. It's also known as SBRT treatment.

Cancer spread that happens some time after the primary tumour was treated can be referred to as metachronous metastases and can occur with any cancer type including cervical cancer, bowel cancer and advanced prostate cancer.

I specialise in treating metastases in various locations:

Stereotactic Body Radiation Therapy for Lung Metastases

Stereotactic ablative radiotherapy lung cancer treatment has revolutionised how we manage lung metastases above and beyond conventional systemic treatment and radiation therapy. Using advanced technology like CyberKnife, I can deliver precise radiation that tracks the movement of pulmonary metastases during normal breathing, ensuring accuracy while minimising damage to healthy lung tissue.

Stereotactic body radiotherapy lung cancer treatment has demonstrated excellent local control rates of over 90% for selected patients, making it comparable to surgery but without the associated risks and recovery time.

Stereotactic Radiotherapy for Brain Metastases

Brain metastases require particularly careful treatment. Stereotactic radiotherapy brain treatment allows me to target multiple brain tumours simultaneously with exceptional precision. Treatment given in a single treatment is called stereotactic radiosurgery.

Stereotactic brain radiotherapy and fractionated stereotactic radiotherapy brain metastases treatments preserve cognitive function while effectively controlling cancer. This approach offers a non-invasive alternative to brain surgery with comparable outcomes. Stereotactic radiosurgery is often given before systemic therapy such as immunotherapy.

Gamma Knife Stereotactic Radiosurgery is available in London, and SRS can also be given with CyberKnife or Linac-based radiosurgery. Before deciding on the best treatment for you, we'll discuss Gamma Knife radiosurgery and other treatment options.

Stereotactic Radiotherapy Bone Metastases

For patients with bone metastases causing pain or at risk of fracture, stereotactic radiotherapy bone metastases treatment can provide rapid pain relief and tumour control. This approach is particularly valuable for spinal metastases where conventional surgery might carry significant risks.

Additional Treatment Sites

My expertise extends to treating metastases in other critical locations:

• Liver metastases: Precise targeting while protecting surrounding healthy liver tissue
• Adrenal metastases: Non-invasive treatment for these often challenging locations. The MR-linac is particularly helpful here.
• Lymph node metastases: Effective control of isolated lymph node disease

Advanced Technologies for Stereotactic Radiotherapy

I offer the complete spectrum of advanced technologies for stereotactic radiotherapy, allowing me to select the optimal approach for each patient's specific oligometastatic presentation:

Linac-Based Stereotactic Radiotherapy

Modern linear accelerator (Linac) systems equipped with advanced imaging and motion management capabilities provide excellent stereotactic radiotherapy delivery. Linac-based stereotactic radiosurgery and stereotactic radiotherapy represent the foundation of precision radiation treatments, offering:

• Volumetric Modulated Arc Therapy (VMAT): Continuous radiation delivery while the machine rotates around you, creating highly conformal radiation dose distributions
• Image-Guided Radiotherapy (IGRT): Daily imaging ensures precise targeting of the radiotherapy beams for each treatment session
• Motion Management: Techniques to account for breathing and other movement
• Efficiency: Treatments typically completed in 15-30 minutes per session

For many oligometastatic presentations, conventional Linac-based stereotactic radiotherapy provides the optimal balance of precision, efficiency, and effectiveness. I carefully evaluate each case to determine when this approach is most appropriate.

CyberKnife: The Gold Standard for Precision Stereotactic Radiotherapy

CyberKnife is an advanced stereotactic radiotherapy system that uses robotic technology to deliver radiation with extraordinary precision. As one of the UK's leading experts in CyberKnife treatment, I offer unparalleled experience in using this technology for oligometastatic disease.

What Makes CyberKnife Unique?

Unlike conventional stereotactic radiotherapy systems, CyberKnife features a compact linear accelerator mounted on a highly flexible robotic arm, allowing radiation delivery from potentially thousands of different angles. This distinctive capability enables:

• Unmatched Geometric Precision: The robotic delivery system achieves submillimetre accuracy, targeting metastases while meticulously avoiding critical structures—even when they're just millimetres away
• Real-Time Tumour Tracking: CyberKnife's advanced imaging systems continuously track tumour position during treatment, automatically adjusting the radiation beam to compensate for movement
• Treatment During Free Breathing: Patients breathe naturally throughout treatment as the system intelligently tracks and follows tumour motion—eliminating the need for uncomfortable breath-holding or restrictive immobilisation
• Non-Coplanar Beam Delivery: Radiation can be delivered from virtually any angle, creating treatment plans that simply aren't possible with conventional systems
• Customised Patient Experience: Treatment takes place on a comfortable cushion with no clamps or restrictive frames, enhancing patient comfort during longer treatment sessions

Ideal Oligometastatic Targets for CyberKnife

CyberKnife stereotactic radiotherapy excels in treating:

• Lung metastases: Respiratory tracking allows precise targeting during normal breathing
• Brain metastases: Frameless radiosurgery offers patient comfort with surgical precision
• Spinal metastases: Sub-millimetre accuracy protects the adjacent spinal cord
• Complex-shaped metastases: Multi-angle delivery conforms dose to irregular tumours
• Metastases near critical structures: Steep dose gradients minimise radiation to sensitive areas and therefore side effects.

CyberKnife's exceptional precision and motion management capabilities make it particularly valuable for treating moving targets like lung metastases and tumours adjacent to critical structures where even slight patient movement must be accounted for.

MR-Linac: Revolutionary Precision in Stereotactic Radiotherapy

The MR-Linac represents the pinnacle of stereotactic radiotherapy technology, combining a high-field MRI scanner with a state-of-the-art linear accelerator in a single system. As one of the few oncologists in the UK with access to this groundbreaking technology, I can offer treatment capabilities that simply aren't available at most cancer centres.

What is the MR-Linac?

The MR-Linac integrates a 1.5 Tesla MRI scanner with a powerful linear accelerator, allowing for real-time, crystal-clear imaging during radiation delivery. This "see-as-you-treat" approach represents a quantum leap forward in stereotactic radiotherapy precision.

Is a MR Linac the same as stereotactic radiotherapy? No—the MR-Linac is an advanced delivery system that takes stereotactic radiotherapy to unprecedented levels of accuracy and adaptability. It's not just about seeing the tumour; it's about responding to what's happening in real-time during each treatment session.

Unparalleled Advantages for Oligometastatic Treatment

The MR-Linac offers several game-changing benefits for patients with oligometastatic disease:

• Superior Soft Tissue Visualisation: MRI provides exceptional soft tissue contrast, allowing me to clearly distinguish between tumour and healthy tissue in areas where CT imaging struggles, such as the liver, pancreas, and abdominal lymph nodes.
• Real-Time Adaptive Treatment: Unlike any other radiotherapy system, the MR-Linac allows me to adapt your treatment plan during each session based on what I can see happening inside your body at that moment—accounting for daily changes in tumour position, shape, and surrounding anatomy.
• Motion Management: For tumours that move with breathing or digestive processes, the MR-Linac provides continuous monitoring and adjustment, ensuring radiation hits the target with sub-millimetre precision even when internal movement occurs.
• Reduced Treatment Margins: The exceptional visualization allows me to reduce the "safety margin" around tumours, meaning less healthy tissue receives radiation—particularly crucial for metastases near critical organs.
• Treatment of Previously Challenging Cases: Some oligometastatic sites that were traditionally difficult to treat with stereotactic radiotherapy become accessible with MR-Linac technology due to its superior imaging capabilities.

Ideal Oligometastatic Sites for MR-Linac Treatment

Cancer spread from any cancer type, including metastatic breast cancer, metastatic NSCLC, metastatic prostate cancer, metastatic colorectal cancer can be treated on the MR-Linac.

While the MR-Linac excels in treating many types of metastases, it offers particular advantages for:

• Liver metastases: Superior soft tissue contrast allows clear visualization even without invasive fiducial markers.
• Pancreatic metastases: Precise targeting in this challenging location with daily adaptation
• Abdominal and pelvic lymph nodes: Clear distinction between nodes and surrounding structures
• Adrenal metastases: Excellent visualization of these small glands surrounded by critical structures
• Recurrent tumours in previously treated areas: Adaptive planning enables safe re-treatment

The MR-Linac represents not merely an evolution but a revolution in stereotactic radiotherapy. Having access to both this technology and CyberKnife means I can select the optimal approach for each patient's specific oligometastatic presentation.

Personalising your stereotactic radiotherapy plan

The first step in planning your radiotherapy will be to do a radiotherapy planning CT scan. For treatment with the MR-linac, and for some CyberKnife or conventional Linac treatments, you'll also need an MRI scan. You'll meet a radiographer/radiation therapist at this scan appointment who will position you on the scanner in the same position you'll be in for treatment.

I then work with medical physicists on your scans to personalise a highly accurate radiotherapy plan to make sure it's the best treatment for you.

Stereotactic Radiotherapy vs Other Treatments

Stereotactic Radiotherapy vs Conventional Radiation Therapy

While conventional external beam radiotherapy treats larger areas over many sessions (typically 20-30), stereotactic radiotherapy delivers higher doses to precisely defined targets in fewer sessions. This concentrated approach results in higher biological effectiveness against cancer cells with fewer side effects. While conventional radiotherapy is given daily over a number of weeks, stereotactic radiotherapy is usually given in 1 to 5 treatments.

Stereotactic Radiosurgery and Stereotactic Radiotherapy

Stereotactic radiosurgery and stereotactic radiotherapy represent two approaches on the same precision treatment spectrum. Stereotactic radiosurgery typically refers to single-session treatments (particularly for brain metastases), delivering an intense dose in one session. Stereotactic radiotherapy generally involves 2-5 treatment sessions, which can be advantageous for larger tumours or those near sensitive structures.

Stereotactic radiosurgery and stereotactic radiotherapy share the same fundamental principles of extreme precision and dose concentration. Both approaches require specialised equipment, meticulous planning and highly experienced health professionals (such as the radiographer/radiation therapist) to achieve optimal results. I have extensive experience with both techniques and can recommend the most appropriate approach based on your specific situation.

Stereotactic Radiotherapy Success Rates

Stereotactic radiotherapy success rates for oligometastatic disease are impressive across different anatomical sites. For lung metastases, stereotactic radiotherapy success rates lung cancer patients show local control rates exceeding 90% at two years. Similar excellent outcomes are seen for liver, bone, and adrenal metastases when treated with appropriate doses.

Selected patients with limited metastatic cancer show significant improvements in progression-free survival and, in selected cases, overall survival. Multiple clinical studies have demonstrated that aggressive treatment of oligometastatic disease with stereotactic ablative radiotherapy or stereotactic body radiotherapy can substantially improve outcomes and quality of life.

The success of stereotactic radiotherapy depends on several factors:

• Tumour characteristics: Size, location, and number of metastases
• Primary cancer type: Some cancers respond better than others
• Treatment planning: Precision of target delineation and dose prescription
• Delivery technology: Advanced systems like CyberKnife, MR-Linac, or modern Linacs
• Physician expertise: Experience in treating oligometastatic disease

As a specialist focused on stereotactic radiotherapy for oligometastatic disease, I carefully evaluate each patient's situation to determine the most effective approach for achieving optimal outcomes.

Stereotactic Radiotherapy Side Effects

What are the side effects of stereotactic radiotherapy? Compared to traditional radiation treatment, most patients experience minimal side effects due to the high precision of treatment and sparing of healthy tissues. Possible effects include:

• Fatigue: Temporary tiredness that typically resolves within weeks
• Local reactions: Mild skin changes or inflammation near the treatment site
• Site-specific effects: Depending on the treatment location (e.g., temporary cough with lung treatment, nausea with abdominal treatments)

Stereotactic body radiotherapy side effects are generally well-tolerated and managed with supportive care. Serious side effects are rare when treatment is planned and delivered by experienced specialists.

What to Expect During Stereotactic Radiotherapy

Your treatment journey will include several steps:

1. Initial Consultation: We'll discuss your specific case and treatment options
2. Treatment Planning: Detailed imaging and customised treatment design
3. Treatment Delivery: Short sessions (typically 30-60 minutes each)
4. Follow-up Care: Regular monitoring to assess response and address any concerns

Most patients continue normal daily activities throughout treatment, with minimal disruption to their routine.

Why Choose Dr James Wilson for Stereotactic Radiotherapy?

As one of the UK's leading radiation oncology specialists in stereotactic radiotherapy for oligometastatic cancer, I offer several distinct advantages:

• Dual Technology Expertise: I am one of the few oncologists in the UK with expertise in both CyberKnife and MR-Linac technologies, allowing me to select the optimal system for your specific metastases
• Comprehensive Experience: I specialise in treating oligometastatic disease across all body sites (lung, brain, bone, liver, adrenal, lymph nodes) and from all primary cancer types
• Technology-Agnostic Approach: Unlike specialists limited to a single technology, I can recommend the truly best treatment approach for your individual case without bias
• Personalised Treatment Planning: Every treatment plan is meticulously customised to your specific situation, considering tumour location, size, and your overall health status
• Rapid Access: I understand the urgency of treating oligometastatic disease and offer prompt assessment and treatment initiation
• Research-Informed Practice: My treatment approaches incorporate the latest clinical evidence, ensuring you receive cutting-edge care based on the most current research

When a oligometastatic cancer patients have an appointment in my clinic, they always see me personally, not a doctor-in-training. My clinics run to time, and I share detailed treatment letters and reports with you on the same day as your appointment. I remain accessible throughout your treatment journey to address any questions or concerns.

Where Can I Get Stereotactic Radiotherapy UK?

While stereotactic radiotherapy is available at several UK centres, access to the most advanced technologies and expertise in treating oligometastatic disease is limited. I provide treatment at leading London private hospitals equipped with state-of-the-art technology including CyberKnife and MR-Linac systems.

For patients not based in London, I can arrange accommodation during treatment and coordinate with your local healthcare team for seamless care.

Stage 4 Cancer and Stereotactic Radiotherapy

What is Stage 4 Cancer?

What is stage 4 cancer? Stage 4 cancer means the cancer has spread from its original site to distant parts of the body. This spread, known as metastasis, is what defines cancer as being "stage 4" or "metastatic." When cancer cells break away from the primary tumour and travel through the bloodstream or lymphatic system to form new tumours in other organs or tissues, this represents the most advanced stage of cancer.

What does stage 4 cancer mean for treatment options? While stage 4 cancer presents significant challenges, it's important to understand that modern treatment approaches have evolved dramatically. Today's advanced therapies can often control stage 4 cancer for extended periods, allowing patients to maintain good quality of life.

Is Stage 4 Cancer Terminal?

Is stage 4 cancer terminal? While stage 4 cancer is serious, it should not automatically be considered terminal. Selected patients with stage 4 cancer can live for years with proactive treatment. The outlook varies significantly based on the cancer type, its specific characteristics, your overall health, and the treatments available.

Is stage 4 cancer a death sentence? Absolutely not. Modern oncology has transformed how we approach metastatic disease. Treatments like stereotactic radiotherapy for oligometastatic disease can effectively target and eliminate cancer that has spread to limited sites, potentially extending life significantly.

Can Stage 4 Cancer Be Cured?

Can stage 4 cancer be cured? While complete cures for widespread stage 4 cancer remain challenging, certain presentations—particularly oligometastatic disease—may be amenable to potentially curative approaches. Oligometastatic disease represents a specific scenario where cancer has spread but only to a limited number of locations (typically 1-5 sites).

For patients with oligometastatic disease, aggressive local treatments like stereotactic radiotherapy combined with systemic therapy can sometimes achieve long-term disease control or even cure. This represents a paradigm shift in how we view stage 4 cancer treatment.

Is stage 4 cancer curable? For select oligometastatic patients with limited metastatic spread, curative approaches may be possible. Each case requires individual assessment, but it's important to know that stage 4 cancer can sometimes be controlled for very long periods or even eliminated with the right combination of treatments.

Can You Survive Stage 4 Cancer?

Can you survive stage 4 cancer? Yes, many patients survive and thrive for years after a stage 4 diagnosis. Survival rates in clinical trials continue to improve with advanced treatments like stereotactic radiotherapy and new systemic therapies. Has anyone survived stage 4 cancer? Absolutely—many patients not only survive but maintain good quality of life following appropriate treatment.

How long can you live with stage 4 cancer? Survival varies widely depending on cancer type, specific characteristics, and treatment response. Many patients live for years or even decades with stage 4 cancer that is well-controlled. With treatments like stereotactic radiotherapy for oligometastatic disease, we can often achieve long-term control of metastatic sites.

Can Stage 4 Cancer Be Treated?

Can stage 4 cancer be treated? Yes, there are numerous effective treatment options for stage 4 cancer. Modern approaches typically combine systemic therapies (treatments that work throughout the body) with local treatments targeting specific metastases.

Is stage 4 cancer treatable? Absolutely. Treatment options may include:

• Systemic Therapies: Cancer immunotherapy, targeted therapy, or chemotherapy to address cancer throughout the body
• Stereotactic Radiotherapy: Precise, high-dose radiation to eliminate specific metastases
• Surgery: Removal of accessible tumours in select cases
• Combination Approaches: Carefully sequenced treatments tailored to your specific situation

Can Immunotherapy Cure Stage 4 Cancer?

Can immunotherapy cure stage 4 cancer? Immunotherapy has revolutionised the treatment of many cancers, enabling the body's immune system to recognise and attack cancer cells. For some patients, immunotherapy can produce remarkable and durable responses.

When combined with stereotactic radiotherapy, immunotherapy may offer even greater benefits. Research suggests stereotactic radiotherapy can create an "abscopal effect," where radiation to one tumour site triggers immune responses that affect cancer cells throughout the body.

The Oligometastatic Opportunity

For patients with stage 4 cancer that has spread to limited sites (oligometastatic disease), stereotactic radiotherapy offers a particularly valuable treatment option. This approach can:

• Eliminate visible metastases with high precision
• Delay the need for systemic therapy or extend its effectiveness
• Potentially achieve long-term disease control
• Maintain quality of life with minimal side effects

How serious is stage 4 cancer? While undoubtedly serious, the outlook for many stage 4 cancer patients has improved dramatically. For those with oligometastatic disease, stereotactic radiotherapy provides a powerful tool to target and potentially eliminate visible metastases while preserving quality of life.

Next Steps for Stage 4 Cancer Patients

If you've been diagnosed with advanced cancer, accessing expert assessment for stereotactic radiotherapy could significantly impact your treatment journey. As a specialist in treating oligometastatic disease with advanced stereotactic techniques, I can help determine if this approach might benefit your specific situation.

Can you recover from stage 4 cancer? Many patients achieve excellent outcomes with the right combination of treatments. The first step is a comprehensive assessment to understand your specific situation and develop a personalised treatment plan.

Patient Success Stories

Here are experiences from patients who have benefited from treatment with Dr James Wilson.

"A very appealing combination of detailed knowledge and experience, but down-to-earth manner. Very friendly, and warm. I felt he really cared. His explanations of treatment plan were very clear, without any sense of condescension. I felt confident that my radiotherapy treatment was meticulously planned and executed." — Doctify review

"Whilst I wouldn't wish cancer on my worst enemy, if you have it try and see Dr Wilson. Not only is he an extremely well qualified Clinical Oncologist, he's also a thoroughly decent human being. He explained all the available treatment options in a way that was easy to understand and he patiently answered all my questions honestly. Dr Wilson always made me feel that I was dealing with someone who's at the very top of his game." — Doctify review

Take the Next Step

If you've been diagnosed with oligometastatic disease, access to expert stereotactic radiotherapy could significantly improve your outcome. Contact me today to discuss your diagnosis and explore how advanced treatment options can be tailored to your specific needs.

I'm committed to providing you with the highest standard of care, using cutting-edge technology and my extensive experience to achieve the best possible results.