Brachytherapy for Cancer

Brachytherapy is internal radiation therapy. It uses small radiation implants to treat cancer. These implants impact the tumor from inside the body. This treatment can kill cancer cells and help slow the growth of a tumor. It can also help ease pain and other symptoms caused by the tumor.

How brachytherapy works

This treatment uses small implants that give off radiation. These implants are also called sources. The sources are placed into the tumor or nearby tissue. Sources give off radiation. There are different types of brachytherapy:

• Low-dose-rate (LDR) brachytherapy. The implants stay in the body for hours or days and then are removed. You stay in the hospital during this time.

• High-dose-rate (HDR) brachytherapy. The implants stay in the body for a few minutes and then are removed. Follow up treatments may be daily or weekly for several weeks depending on the type of cancer

• Permanent brachytherapy. Implants remain in your body the rest of your life. But the radiation gets weaker every day until it is gone.

Possible side effects of brachytherapy

Brachytherapy can kill healthy cells in addition to cancer cells. This can lead to side effects such as severe tiredness (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 healthcare provider can tell you more about what side effects you may expect.

Getting ready for the procedure

Your healthcare provider will tell you what to do to get ready for the procedure. Follow the directions closely. Tell your provider about all medicines you take. This includes over-the-counter and prescription medicines. It also includes herbs, vitamins, and other supplements. You may need to stop taking some or all of them before the procedure. For instance, you may need to stop taking aspirin because it can cause bleeding problems. Follow all directions you’re given for not eating or drinking before the procedure.

The 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 1 or more nights.

• Before the procedure begins: Depending on how the implant is placed, a small tube called an IV (intravenous) line may be put into a vein in your arm or hand. This is to give you fluids and medicines. To keep you pain-free during the procedure, you may be given anesthesia. This medicine makes you numb, drowsy, or completely asleep.

• During the procedure: A device to carry the implant to the correct place is placed into the cancer site. This can be a needle, small tube (catheter), or a special applicator. The device may be passed through a nearby opening in the body, such as the vagina or rectum. Or a small cut (incision) may be made in the skin. Implants are then passed through the 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 make sure they are placed correctly.

  • LDR brachytherapy. The implants and device stay in place for hours to days. You stay in the hospital during this time.

  • HDR brachytherapy. The implants are put in 1 to 2 times a day for several minutes, then removed. The device 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.

  • 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 all directions you are given for caring for yourself between treatments. These may include:

• Taking any prescribed medicine exactly as advised.

• Caring for your bandage and implant site as advised.

• If you have a tube left in place, following your healthcare provider’s instructions for taking care of it.

• Following your provider’s directions about not putting weight or pressure on the implant site.

• Following all radiation safety measures you are given.

Radiation safety steps

Brachytherapy involves doses of radiation. If you are given special precautions by your healthcare team, be sure to follow them closely.

• LDR brachytherapy. The implants are removed before you go home. Once they are removed, you are not radioactive and don't pose a danger to others. In most cases, you are not likely to need special precautions.

• HDR brachytherapy. The implants are in your body only a short time. But the radiation dose is high. Between treatment sessions, you may be given some safety measures to help keep others safe. Follow these closely. When the delivery device and radiation sources are removed there is no risk of exposure to others.

• Permanent brachytherapy. The implants stay in your body. At first, they give off a very low dose of radiation. This is not likely to affect others. But depending on the type of implant used, you may be told to not have close contact with small children and pregnant people. Follow your healthcare team’s instructions carefully.

When to call your healthcare provider

Call your healthcare provider if you have any of the following:

• Fever of 100.4ºF ( 38ºC) or higher, or as advised by your provider

• Trouble focusing

• Ongoing fatigue

• 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 abnormal lumps, bumps, or swelling

• Abnormal bleeding

• Diarrhea that doesn’t get better with time

• Any other signs or symptoms as advised by your provider

Checking your progress

During the course of your treatment, you’ll have routine follow-up visits with your healthcare provider. These allow your provider to check your health and your response to the treatment. After the treatment ends, you and your provider will discuss your treatment results. You’ll also discuss whether you need additional cancer treatments. 

Risks and possible complications

Risks and possible complications of brachytherapy for cancer include:

• Fatigue (tiredness)

• Discomfort from having to stay in one position

• Short-term (temporary) side effects in the area being treated (digestive issues, etc.)

• Infection

• Failure to affect tumor growth

• Damage to healthy tissue and organs

• Another cancer later on due to radiation exposure

• Risks of anesthesia