Brachytherapy is a form of internal radiation therapy in which seeds, ribbons, or capsules containing a source of radiation are inserted in, in or near a tumor in your body. Brachytherapy is a local treatment that only targets a particular part of the body. It is commonly used to treat head and neck, breast, cervix, prostate, and eye cancers.
Before you begin brachytherapy, you will have a 1- to 2-hour meeting with your doctor or nurse to schedule your treatment. You will have a physical examination at this time ask about your medical history, and maybe have imaging scans. The type of brachytherapy that is best for you will be addressed by your doctor, its advantages and side effects, and how you can take care of yourself during and after treatment. Then you will decide if you should have brachytherapy.
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Most brachytherapy, which is a thin, stretchy tube, is placed in place via a catheter. Often, via a larger system called an applicator, brachytherapy is placed in place. The manner in which brachytherapy is placed in place depends on your cancer form. Before you begin treatment, your doctor will insert a catheter or applicator into your body.
Brachytherapy placement strategies include:
The radiation source is put inside it once the catheter or applicator is in operation. For a few minutes, for several days, or for the remainder of your life, the radiation source can be kept in place. Depending on the type of radiation source, the type of cancer, where the cancer is in your body, your health, and other cancer treatments you’ve received, how long it stays in place.
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There are three types of brachytherapy:
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The catheter will be removed until you have finished treating yourself with LDR or HDR implants. Some things to expect here:
You might need to restrict behaviors that require a lot of work for a week or two. Ask your physician what kinds of things are appropriate for you and which ones you should avoid.
The radiation source in your body can emit radiation for a while with brachytherapy. If the dose of radiation you receive is very high, certain protective precautions might need to be taken. Such steps can cover:
Your visitors will also need to follow safety measures, which may include:
When you leave the hospital, you will still need to obey safety precautions, such as not spending any time with other individuals. When you go home, the doctor or nurse will discuss with you any safety precautions you may take.
Brachytherapy is used to treat several types of cancer, including:
Brachytherapy may be used on its own or in combination with other therapies for cancer. For example, after surgery, brachytherapy is often used to kill any cancer cells that may remain. Along with external beam radiation, brachytherapy can also be used.
Brachytherapy side effects are unique to the region being treated. Since brachytherapy in a small treatment area focuses on radiation, only that area is affected.
In the treatment area, you might feel tenderness and swelling. Tell your doctor what can be expected from your treatment for such side effects.
You should visit a doctor who specializes in treating cancer with radiation before you start brachytherapy (radiation oncologist). To help your doctor decide your care plan, you can also undergo scans.
Prior to brachytherapy, procedures such as X-rays, computerized tomography (CT) or magnetic resonance imaging (MRI) can be performed.
Treatment with brachytherapy means injecting radioactive material near the cancer into the body.
Where the doctor puts the radioactive material in your body depends on several factors, including the cancer’s location and magnitude, your general health, and your goals for treatment.
Within a body cavity or in body tissue, the placement may be:
The brachytherapy device can be installed by hand by the radiation therapy team or it may use a computerized system to help position the device.
Imaging equipment, such as a CT scanner or an ultrasound system, may be used to ensure that the equipment is positioned where it is most effective.
In the treatment area, devices that transmit interstitial radiation include cables, balloons and tiny seeds the size of rice grains. For the injection of brachytherapy instruments into body tissue, a variety of methods are used.
Needles or special applicators can be used by the radiation therapy team. These long hollow tubes, such as seeds, are filled with brachytherapy devices and inserted into the tissue where the seeds are released.
In certain cases, during surgery, narrow tubes (catheters) can be inserted and then filled during brachytherapy sessions with radioactive content.
To direct the devices into place and to ensure that they are placed in the most successful positions, CT scans, ultrasound or other imaging techniques can be used.
During brachytherapy, what you’ll feel depends on your particular care.
Radiation, as with high-dose-rate brachytherapy, may be offered in a brief treatment session or it can be left in place for a period of time, as with low-dose brachytherapy. The source of radiation is sometimes permanently located in your body.
During brachytherapy, you shouldn’t feel any discomfort, but if you feel uncomfortable or have any questions, be sure to tell your caregivers.
You won’t give off radiation or be toxic until the radioactive material is removed from the body. You’re not a threat to other citizens, and you can continue with the normal things.
Radioactive material is inserted in your body by hand or by computer. During surgery, brachytherapy devices can be placed that may require anesthesia or sedation to help you stay still during the operation and to decrease pain.
During low-dose brachytherapy, you can typically stay in a private room in the hospital. There is a slight risk that it might damage other people because the radioactive material remains inside the body. Visitors will be limited for this purpose.
In the hospital, kids and pregnant women shouldn’t visit you. Others can visit once a day or so, briefly. You will always be given the treatment you need by your health care staff, but the amount of time they spend in your room could be limited.
During low-dose rate brachytherapy, you do not experience discomfort. It can be uncomfortable to keep silent and stay in your hospital room for days. Inform the health care team if you experience any pain.
The radioactive substance is extracted from your body after a specified period of time. You’re free to have visitors without restrictions once brachytherapy treatment is complete.
After brachytherapy, your doctor can prescribe scans to decide if the treatment was successful. Depending on the form and position of your cancer, the types of scans you receive will depend.
Most commonly, brachytherapy is used to treat prostate cancer. It can also be used to treat gynecological cancers such as cancer of the cervix and uterus, as well as breast cancer, lung cancer, rectal cancer, cancer of the eye, and cancer of the skin.
The use of an implant allows for a higher dose of radiation in a small area than would be necessary with traditional externally administered radiation treatments. This can be more successful in killing cancer cells while minimizing damage to normal tissue surrounding them.
How long does the implant stay in the body?
The implants may be temporary or permanent. If the implants will be removed but then put in again later, the catheter is often left in until the treatment is finished. The catheter is then removed when the implants are taken out for the last time. The way you will receive brachytherapy depends on a number of factors, including where the tumor is, the stage of the cancer, and your overall health.
How is brachytherapy delivered?
A physician who specializes in radiation therapy, called a radiation oncologist, uses a needle or catheter in most brachytherapy procedures to insert the encapsulated radioactive material directly on or near a tumor within the body. In certain cases, a radioactive substance, such as the rectum, vagina, or uterus, is placed in a body cavity. For any of those operations, the patient is sedated.
How do doctors know if the radioactive material is going to the right place?
During brachytherapy preparation and delivery, radiation oncologists rely on imaging techniques such as CT scans and ultrasound to ensure that the encapsulated material is positioned with accuracy.
Does brachytherapy require a hospital stay?
It depends on your cancer and the type of brachytherapy you are receiving: Low Dose Rate (LDR) or High Dose Rate (HDR). Usually, LDR brachytherapy does not require an overnight hospital stay. HDR brachytherapy can include a hospital stay for you.
What’s the difference between low dose rate brachytherapy and high dose rate brachytherapy?
With brachytherapy with a low dose rate (LDR), doctors inject tiny radiation-containing seeds into or around the tumor while the patient is under anesthesia. Usually, LDR brachytherapy requires a little over an hour and does not require a stay in the hospital overnight. The seeds are usually permanent, but they cause little to no discomfort and after several weeks or a few months, their radioactivity decreases. In certain cases, the implants are removed after several days, such as when treating eye tumors.
In high dose rate (HDR) brachytherapy, doctors normally offer concentrated radiation bursts within a short period of time. A variety of plastic catheters (tubes) are inserted into or around the tumor, with the patient under anesthesia. The catheters are connected to a system that in the form of radioactive pellets, provides accurate doses of radiation. For skin cancer, HDR brachytherapy uses electronically generated radiation that is provided at the skin surface without need for catheters.
How does brachytherapy compare with other forms of radiation treatments?
Brachytherapy has been shown to be as effective as traditional external beam radiation therapy and surgery for many cancers when used properly. In patients whose cancer has not spread or metastasized, it is best used. In several ways, brachytherapy, like stereotactic body radiation therapy, is paired with external-beam radiation therapy to achieve the best results.
How often is brachytherapy treatment given, and how long do the sessions last?
For LDR brachytherapy, for a prolonged period of time, the radiation sources have to stay inside or next to the cancer. Because of this, care is typically administered over a span of one week and includes a hospital stay.
Treatment is offered in one or two brief (around 15 minutes) sessions for HDR brachytherapy, delivering radiation directly to the tumor. The catheters are removed after the final procedure and you will return home.
How long does the brachytherapy radiation stay in the body?
Your body may give off a small amount of radiation for a short while after treatment. You will be asked to remain in the hospital if the radiation is contained in a temporary implant and will have to restrict your contact with visitors. You may not be permitted to be visited by pregnant women and children. Your body can no longer give off radiation until the implant is removed.
For a couple of weeks to months, permanent implants give off small doses of radiation as they eventually avoid giving off radiation. Usually, the radiation does not move far, so the risk of others being exposed to radiation is very small. Still, you might be asked to take precautions such as staying away from small children and pregnant women, particularly right after treatment.
What side effects may occur as a result of brachytherapy?
Swelling, bruising, bleeding, or pain and irritation at the site where the radiation was applied can be side effects of brachytherapy. Brachytherapy may lead to short-term urinary symptoms, including incontinence or urination pain, when used for gynecologic or prostate cancer. Diarrhea, constipation and some rectal bleeding may also contribute to brachytherapy for these cancers. Occasionally, prostate brachytherapy can cause erectile dysfunction.