Brachytherapy is a radiation therapy designed to treat cancer. It uses a form of energy known as ionizing radiation to destroy cancerous cells. Brachytherapy tends to be used to treat diseases of the prostate gland, uterus, cervix, and head, and neck. However, it can also be used to treat other cancers, including skin and lung cancers.
A team of medical professionals are involved in administering brachytherapy treatment. A specialist doctor, known as a radiation oncologist, will determine whether brachytherapy is a suitable treatment, which areas of the body require treatment, and the amount of radiation that needs to be administered.
He or she will also determine the techniques that need to be used to administer the prescribed dose of radiation and whether the dosage administered will be tolerated by the tissues surrounding the tumor. Brachytherapy is advantageous as it enables doctors to use a higher than usual dose of radiation to treat cancer. This high dose of radiation directly targets the tumor, while only a small amount of radiation impacts the healthy tissues.
The medical team involved in carrying out brachytherapy may perform preparations before administering the treatment. These preparations may include blood tests, imaging tests, and bowel preparation. Before brachytherapy treatment begins, a general anesthetic and sedative may be used.
Brachytherapy can be temporary or permanent. In permanent brachytherapy, radioactive material contained within tiny pellets is inserted into or near to the tumor using a delivery device. These pellets remain in place permanently, and their radioactivity will fade over time. Their presence in the body will cause no ill-effects. However, as the pellets are made from metal, they may set off metal detecting devices at airports. In temporary brachytherapy, small applicators, such as needles and catheters (tiny tubes), are inserted into the tumor, and radioactive material is administered through these applicators.
Following determining the positioning of the delivery device or applicator, radiation is administered. A radiation oncologist may administer and remove the radioactive material manually through a delivery device. Alternatively, the radiation oncologist may administer and remove the contaminated content using a remote afterloading machine that is controlled by computers. In this instance, the individual receiving treatment will be kept in a shielded treatment room, and the doctor will monitor the equipment from outside of this room.
Radiation may be administered at a high dose rate over ten to 20 minutes per treatment session or at a low dose rate over 20 to 50 hours per treatment session. High dose rate brachytherapy is performed as an outpatient procedure, with radiation being administered in short bursts. Low dose rate brachytherapy is usually performed as an inpatient procedure, with pollution being administered at a continuous rate over one or two days. Medical imaging can be used to position the radioactive material correctly. Once treatment has been completed, both the source of the radioactive material and the delivery device are withdrawn.
Side effects are associated with both temporary and permanent brachytherapy. Tenderness and swelling may be felt in the area that has been treated yet will resolve itself in the days following completion of the cancer treatment. Normal activities can be resumed within days or weeks of receiving brachytherapy, with the total recovery time varying between individuals. In a small number of individuals, brachytherapy may cause long-term side effects. These side effects result from damage or disruption to the tissues surrounding the tumor that has been treated. As these long-term side effects are only usually mild, the benefit of treatment tends to outweigh the risk of experiencing these side effects.
Following treatment, individuals who have received temporary implants need not concern themselves with regards to the risks of exposing others to radiation. This is because they will be free from sources of radiation following leaving the hospital. Those who have received permanent brachytherapy may be advised not to come into close contact with children or pregnant women shortly after treatment. However, the amount of radiation left within the body is low and will decrease over time.