My doctor wants me to have brachytherapy

contributed by Susan L. Daron, R.N., BSN, OCN, Cancer AnswerLine nurse

Brachytherapy is a procedure in which radioactive material sealed in needles, seeds, wires or catheters is placed directly into or near a tumor; also called internal radiation, implant radiation or interstitial radiation therapy.

What is brachytherapy?

Brachytherapy radiation is used to treat a variety of cancer types, but is most common in prostate, breast and gynecological cancers (cancers of the uterus, cervix and vagina).

Brachytherapy is sometimes a preferred method of treatment, depending on your physician's advice, because of its precision. Rather than using a machine such as a linear accelerator outside of the body to direct radiation through healthy tissue to get to the cancerous cells, brachytherapy radiation is implanted inside the body either temporarily or permanently, depending on the type and location of the cancer.

And because of its precision, certain cancer patients may get a higher dose of radiation with brachytherapy, which could kill the cancerous cells faster. Brachytherapy may reduce patients' side effects times too, because the brachytherapy radiation doesn’t have to penetrate normal, healthy tissue like it does from external radiation sources.

Like with any radiation, there are side effects which may result from brachytherapy, and those side effects largely depend on the area being treated. Please consult your doctor for additional information about these disadvantages, as it is cancer-specific and site-specific.

As mentioned, brachytherapy has two types, temporary and permanent. Unfortunately, the patient cannot choose one over the other. That decision is made by the doctor, depending on the type of tumor. The radioactive material is placed in the body under the guidance of CT scans, MRI or ultrasound.

According to the American Cancer Society, the type of implant you receive and your treatment schedule will depend on the kind of cancer, where it is in your body, your general health, and other treatments you have had.

With temporary brachytherapy, the radiation source is placed inside the body with a special applicator or catheter and then removed. Temporary brachytherapy can be administered at a low-dose rate over 20 to 50 ours or at a high-dose rate over 10 to 20 minutes per session.

This applicator or catheter usually comes out before the patient leaves, and the patient must return several times for another dosage. Patients who receive temporary brachytherapy will not be radioactive once the radiation source is removed.

With permanent brachytherapy, the radiation source is implanted into the body through seeds or pellets. These seeds give out small amounts of radiation for weeks to months, and patients need to take the following precautions:

Avoid pregnant women and children.
Strain urine to catch any seeds that may have inadvertently passed for the first week to 10 days. (Only for certain types of cancer.)
Wear a condom during sex to catch seeds. (Again, only for certain types of cancer.)

When the seeds or pellets stop giving off radiation, they usually do not cause any further problems. So although they are “permanent,” they are not harmful when the activation period is over and therefore are not removed.

Those who are undergoing or plan to undergo brachytherapy radiation will receive detailed instructions from their heath team about what to expect and other precautions to take.