Types of brachytherapy
Depending on the type of cancer and your radiation oncologist’s recommendation, the radioactive sources may be placed in your body for a limited time or permanently.
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In temporary brachytherapy, you may have one or more treatment sessions to deliver the full dose of radiation prescribed by the radiation oncologist. The radioactive source is inserted using applicators such as thin plastic tubes (catheters) or cylinders. The source is removed at the end of each treatment session. The applicator may be removed at the same time, or left in place until after the final session.
Temporary brachytherapy is mostly used for prostate cancers and gynaecological cancers (such as cervical and vaginal cancers).
While the radioactive source is in place, some radiation may pass outside your body. For this reason, hospitals take certain safety precautions to avoid exposing staff and visitors to radiation. Staff will explain any restrictions before you start brachytherapy treatment.
In some cases, the treatment will be high-dose-rate brachytherapy and it will be given for a few minutes at a time during multiple sessions. The radiation therapists will leave the room briefly during the treatment, but will be able to see and talk to you from another room. You may be able to have this treatment as an outpatient.
In other cases, the radioactive sources will deliver low-dose-rate or pulsed-dose-rate brachytherapy over 1-6 days. During this time, you will be an inpatient and will stay alone in a dedicated treatment room within or close to the main hospital ward.
For low-dose-rate or pulsed-dose-rate brachytherapy, hospital staff will only come into the room for short periods of time, and visitors may be restricted – children under 18 and pregnant women are usually not allowed to enter the room. You can use an intercom to talk with staff and visitors outside the room.
If you have temporary brachytherapy, once the source is removed, you are not radioactive and there is no risk to other people.
In permanent low-dose-rate brachytherapy, radioactive seeds about the size of an uncooked grain of rice are put inside special needles and implanted into the body while you are under general anaesthetic. The needles are removed, and the seeds are left in place to gradually decay.
As the seeds decay, they slowly release small amounts of radiation over weeks or months. They will eventually stop releasing radiation, but they will not be removed. Low-dose-rate brachytherapy is often used to treat early-stage prostate cancers.
If you have permanent brachytherapy, you will be radioactive for a short time after the seeds are inserted. The radiation is usually not strong enough to be harmful to people around you, so it is generally safe to go home. However, you may need to avoid close contact with young children and pregnant women for a short time – your treatment team will advise you of any precautions to take. You will normally be able to return to your usual activities a day or two after the seeds are inserted.
For the first few weeks after the seeds were implanted, I thought this is a doddle. Then suddenly, I started getting this really urgent need to urinate. That gave me a few weeks of disturbed sleep, but the urgency gradually eased off and I thought this is pretty good. Now after three years, there’s no sign of the cancer and I’ve had no long-term side effects.
Dr Madhavi Chilkuri, Radiation Oncologist, Townsville Cancer Centre, The Townsville Hospital, and Dean, RANZCR Faculty of Radiation Oncology, QLD; Polly Baldwin, 13 11 20 Consultant, Cancer Council SA; Patricia Hanley, Consumer; Prof Michael Hofman, Nuclear Medicine and Molecular Imaging Physician, Peter MacCallum Cancer Centre, VIC; Leanne Hoy, Cancer Nurse Consultant, GenesisCare, VIC; Sharon King, Accredited Practising Dietitian, TAS; Dr Yoo Young (Dominique) Lee, Radiation Oncology Consultant, Princess Alexandra Hospital, QLD; Dr Wendy Phillips, Senior Medical Physicist, Department of Radiation Oncology, Royal Adelaide Hospital, SA; Katrina Rech, Radiation Therapist and Quality Systems Manager, GenesisCare, SA. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
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