Brachytherapy for Cancer
Brachytherapy is a treatment for cancer. Implants are used that attack the tumor from inside the body. This treatment can help slow the growth of a tumor. It can help relieve pain and other symptoms caused by the tumor.
How brachytherapy works
This treatment uses small implants (also called sources). They are placed into the tumor or nearby tissue. Sources give off radiation. With low-dose rate (LDR) brachytherapy, the implants stay in the body for hours or days and then are removed. With high-dose rate (HDR) brachytherapy, the implants stay in the body for several minutes and then are removed. With permanent brachytherapy, implants that give off a low dose of radiation are used. They are not removed. With time, the radiation lessens, then stops completely.
Possible side effects of brachytherapy
Brachytherapy can kill healthy cells in addition to cancer cells. This can lead to side effects, such as fatigue. Many side effects affect only the area where the radiation is given. For instance, if the breast is treated, skin on the breast may become red and dry. Your doctor can tell you more about what side effects you may expect.
Preparing for the implant procedure
Prepare as you have been told. Tell your doctor about all medications you take. This includes over-the-counter drugs. It also includes herbs, and other supplements. You may need to stop taking some or all of them before the procedure. You may need to stop taking aspirin and NSAIDs. These can cause bleeding problems. Also, follow any directions you’re given for not eating or drinking before the procedure.
The implant procedure
The type of cancer you have, its location, and other factors will determine your treatment schedule. You may go home after treatment. Or you may stay in the hospital for one or more nights.
Before the procedure begins: An IV line is put into a vein in your arm or hand to give fluids and medications. To keep you free of pain during the procedure, you will be given anesthesia. This medication makes you numb, drowsy, or completely asleep.
During the procedure: A delivery device, such as a needle, is placed into the cancer site. The device may be passed through a nearby opening in the body, such as the vagina or rectum. Or, an incision may be made in the skin. Implants are then passed through the delivery device into or near the cancer site. The implants are placed by hand or machine. X-rays, ultrasound, or another imaging test may be used to ensure correct placement.
With LDR, the implants and delivery device stay in place for hours to days. You remain in the hospital during this time.
With HDR, the implants are put in once a day for several minutes, then removed. The implant tube may be removed after each treatment session. Or it may remain in place. You may go home between treatments. Or you may stay in the hospital until all treatment sessions are done.
With permanent brachytherapy, the implants are put in place and not removed. Very low doses of radiation are given, and the radiation stops over time.
After the procedure: You will recover from the procedure, then go to your hospital room. Or you will be released to go home. If you are able to go home, have an adult family member or friend drive you.
If you go home
Follow any instructions you are given for caring for yourself between treatments. These may include:
Take any prescribed medication exactly as directed.
Care for your bandage and implant site as instructed.
If you have an implant tube left in place, follow your healthcare provider’s instructions for taking care of it.
Follow your doctor’s instructions about not putting weight or pressure on the implant site.
Follow any radiation precautions you are given.
Brachytherapy involves doses of radiation. If you are given special precautions by your healthcare team, be sure to follow them closely.
With LDR, the implants are removed before you go home. Once they are removed, you are not radioactive and do not pose a danger to others. In most cases, you are unlikely to need special precautions.
With HDR, the implants are in your body only a short time. But the radiation dose is high. Between treatment sessions, you may be given some precautions to help keep others safe. Follow these closely.
With permanent brachytherapy, the implants stay in your body. At first, they give off a very low dose of radiation. This is unlikely to affect others. But depending on the type of implant used, you may be advised to avoid close contact with small children and pregnant women. Follow your healthcare team’s instructions carefully.
When to call your healthcare provider
Call the doctor if you have any of the following:
Fever of 100.4ºF (38ºC) or higher, or as directed by your health care provider
Wheezing, shortness of breath, or trouble breathing
Nausea or vomiting
Pain that doesn’t go away, especially if it’s always in the same place
New or unusual lumps, bumps, or swelling
Diarrhea that doesn’t improve with time
Any other signs or symptoms indicated by your doctor
Checking your progress
During the course of your treatment, you’ll have routine visits with your doctor. These allow your doctor to check your health and response to the treatment. After treatment ends, you and your doctor will discuss your treatment results. You’ll also discuss whether you need additional cancer treatments.
Risks and complications
Risks and complications of brachytherapy for cancer include:
Discomfort from remaining in one position
Temporary side effects in the area being treated (digestive issues, etc.)
Failure to affect tumor growth
Damage to healthy tissue and organs
Another cancer later on due to radiation exposure
Risks of anesthesia
March 21, 2017
Radiation Therapy Techniques in Cancer Treatment, Up To Date
Gersten, Todd, MD,Image reviewed by StayWell medical illustration team.