Internal radiotherapy

Internal radiotherapy is used only for certain types of cancer, such as prostate cancer, some gynaecological cancers, thyroid cancer, cancer in the liver, and some head and neck cancers. It delivers a high dose of radiation directly to the tumour, limiting the dose to surrounding tissues. Types of internal radiotherapy include brachytherapy, radionuclide therapy and selective internal radiation therapy (SIRT).

Your doctor may recommend internal radiotherapy alone or in combination with external radiotherapy. You may have internal radiotherapy as an inpatient or outpatient, depending on the type of treatment you have.

Topics on this page:


Planning treatment

Planning for internal radiotherapy is different from planning for external treatment and will depend on whether you have brachytherapy, radionuclide therapy or selective internal radiation therapy.

Planning and treatment procedures for internal radiotherapy may vary between hospitals. Your treatment team can give you specific information.

Initial appointment

The radiation oncologist will explain the treatment process and tell you whether you will have treatment as an inpatient or outpatient. You will have tests and scans to help your treatment team decide where to place the implants and to determine the correct dose to deliver to the tumour. These tests may include an ultrasound, an MRI scan and a CT scan.

The oncologist will explain possible side effects and give you information about safety precautions you might need to take after treatment, as you may be radioactive for a short time when you return home.

Further appointments

You will usually see other specialists who are part of your treatment team. For example, you may see an anaesthetist if you will need anaesthetic during radiotherapy.


Brachytherapy

The radioactive sources are placed inside the body close to or inside the tumour. These sources are called implants. The type of implant used depends on the type of cancer and may include seeds, needles, wires or capsules.

How are the implants placed inside the body?

The way the implants are placed inside the body varies. Generally, one or more applicators will be inserted into or near the tumour for the implants to pass through and into the body. Applicators come in different shapes and sizes and are not radioactive.

The process of inserting the applicators and placing the implants inside them is often done in a dedicated room called a brachytherapy suite. In some hospitals, it is carried out in an operating theatre, which means you will need to stay in hospital for the day or overnight.

While you are under either a local or general anaesthetic, the doctor will use an x-ray machine or ultrasound scanner to guide the applicators into position. The placement of the applicators will depend on the type of cancer. For example, for prostate cancer, they will be inserted into the prostate gland; for gynaecological cancers, they will be placed into the vagina or uterus.

Once the applicators are in place, the implants will be put into or near the tumour through the applicators, either manually by the doctor or through a special machine.

The applicators will be removed from your body when treatment is finished. The implants may also be removed or they may remain in place permanently without causing any harm or discomfort.

How long will the implants be in place?

Implants can be temporary or permanent depending on the dose of radiation required.

Temporary implants – Some implants remain in place for 1–6 days before being taken out along with the applicator.

You will stay in hospital during this time, usually in an isolated room or a room away from the main ward.

In other cases, the implants deliver radiation over a few minutes during multiple sessions as an outpatient. The applicator may be left inside you between sessions, or it may be inserted and removed each time.

Permanent implants – Seeds or pellets about the size of a grain of rice are put inside special needles and implanted into the body. They release small amounts of radiation over weeks or months. The implants are left in place permanently to gradually decay, and the needles are removed.

Will I be radioactive?

Brachytherapy will cause you to be radioactive for a short time, depending on whether the implants are temporary or permanent.

Temporary implants – While the implants are in place, some radiation may pass outside your body. For this reason, hospitals take safety precautions to avoid exposing staff and your visitors to radiation. Staff will explain any restrictions before you start treatment.

  • You will be alone or in a dedicated treatment room within or close to the main hospital.
  • Hospital staff will only stay in 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.

Once the implants are removed, you are not radioactive and there is no risk to other people.

Permanent implants – These will cause you to be radioactive for a short time after they are inserted. The radiation level drops over a period of weeks or months until no radiation is detected by tests. The radiation is not usually harmful to people around you, so it is generally safe to go home. Your treatment team will advise you of any precautions to take.

Will the implants be painful?

You should not have any severe pain or feel ill during brachytherapy. If the implants are being held in place by an applicator, you may feel some discomfort, but your doctor can prescribe medicine to help you relax and relieve any pain.  

Once the applicator is removed, you may be sore or sensitive in the treatment area for some time. In some cases, you may have to limit physical and sexual activity for a period of time. Your doctor will advise you about this.

Read more

Radionuclide therapy

Radionuclide or radioisotope therapy is when radioactive material is taken by mouth as a capsule or liquid or given by injection to target cancer cells. Different radionuclides are used to treat different cancers.

The most common radionuclide therapy is radioactive iodine, which is taken as a capsule and used for thyroid cancer.

Radionuclide therapy may require a short stay in hospital. During this time, you will be radioactive and in a room on your own. The radioactive material that is taken up by the cancer cells decays and becomes less radioactive each day.

Any radioactive material not taken up by the cancer cells will be passed out of your body, mostly in urine, but also in sweat, saliva and faeces. Your treatment team will advise you to drink plenty of water and pass urine regularly to help reduce the amount of radioactive material in your body.

The level of radiation will be measured regularly during your hospital stay. You will be able to go home once the level is considered low enough for you to be around other people.

You may need to take some safety precautions for a short while after you get home, such as limiting close contact with other people and being careful to avoid exposing others to bodily fluids, such as urine, faeces, saliva and sweat. Your radiation oncologist, medical physicist or nurse will discuss these precautions with you.

Read more about radioactive iodine treatment for thyroid cancer in Understanding Thyroid Cancer.

    Understanding Thyroid Cancer

  • 761 kB

Printed copies are available for free - Call 13 11 20 to order

Instructions for downloading and reading EPUB files

Apple devices

The iBooks application must be installed on your Apple device before you can read the EPUB.
Different ways to download an EPUB file to your Apple device:

  • email EPUB files to yourself and transfer the attachment to iBooks.
  • copy EPUB files into DropBox (or a similar service) and use the DropBox app to send them to iBooks.
  • open EPUB files directly from Mobile Safari and open them in iBooks, where they are saved automatically by downloading the EPUB from the website.

Need more help? Visit: http://support.apple.com/kb/HT4059

Kobo

To download an EPUB file to your Kobo from a Windows computer:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • select “Open folder to view files” to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

To download an EPUB to your Kobo from a Mac:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • open your “Finder” application.
  • select “Kobo eReader” from the listed devices to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
Need more information? Visit: http://www.kobo.com/help/koboaura/response/?id=3784&type=3

Sony Reader

To download an EPUB file on your Sony Reader™:

  • ensure you have already installed the Reader™ Library for PC/Mac software
  • select the eBook you want from our website and click the link to download it.
  • connect the Reader™ to your computer.
  • open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.

Need more help? Visit: https://au.readerstore.sony.com/apps_and_devices/

Amazon Kindle 2nd Generation devices

EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:

  • download the PDF directly onto your computer.
  • connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
  • open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
  • safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.

Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit http://www.amazon.com/gp/help/customer/display.html/ref=help_search_1-1?ie=UTF8&nodeId=200767340&qid=1395967989&sr=1-1
For more information on accessing a PDF on your Kindle™, visit www.amazon.com/manageyourkindle, log in to your account and click on Personal Document Settings.
Need more help? Visit https://www.amazon.com/gp/help/customer/display.html?nodeId=200375630

Android and PC

You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.

Read more

Instructions for downloading and reading EPUB files

Apple devices

The iBooks application must be installed on your Apple device before you can read the EPUB.
Different ways to download an EPUB file to your Apple device:

  • email EPUB files to yourself and transfer the attachment to iBooks.
  • copy EPUB files into DropBox (or a similar service) and use the DropBox app to send them to iBooks.
  • open EPUB files directly from Mobile Safari and open them in iBooks, where they are saved automatically by downloading the EPUB from the website.

Need more help? Visit: http://support.apple.com/kb/HT4059

Kobo

To download an EPUB file to your Kobo from a Windows computer:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • select “Open folder to view files” to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

To download an EPUB to your Kobo from a Mac:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • open your “Finder” application.
  • select “Kobo eReader” from the listed devices to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
Need more information? Visit: http://www.kobo.com/help/koboaura/response/?id=3784&type=3

Sony Reader

To download an EPUB file on your Sony Reader™:

  • ensure you have already installed the Reader™ Library for PC/Mac software
  • select the eBook you want from our website and click the link to download it.
  • connect the Reader™ to your computer.
  • open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.

Need more help? Visit: https://au.readerstore.sony.com/apps_and_devices/

Amazon Kindle 2nd Generation devices

EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:

  • download the PDF directly onto your computer.
  • connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
  • open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
  • safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.

Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit http://www.amazon.com/gp/help/customer/display.html/ref=help_search_1-1?ie=UTF8&nodeId=200767340&qid=1395967989&sr=1-1
For more information on accessing a PDF on your Kindle™, visit www.amazon.com/manageyourkindle, log in to your account and click on Personal Document Settings.
Need more help? Visit https://www.amazon.com/gp/help/customer/display.html?nodeId=200375630

Android and PC

You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.


Selective internal radiation therapy (SIRT)

SIRT or radioembolisation is a way of delivering high doses of internal radiotherapy to treat tumours in the liver. The treatment uses tiny pellets called microspheres, which contain a radioactive substance. The pellets are injected into a thin tube called a catheter, which is inserted into the main artery (hepatic artery) that supplies blood to the liver.

Radiation from the microspheres damages the blood supply of the tumours. This means they are unable to get the nutrients they need and they shrink. Each pellet gives out radiation to a small area. Normal liver cells should only receive a small amount of radiation and there should be few side effects.

To plan for SIRT, you may need to stay in hospital for a night. Once the pellets are in place, they deliver radiotherapy continuously for 10–14 days. After treatment has finished, the pellets will remain in your body permanently without causing any harm or discomfort.

Read Cancer Council’s booklet Understanding Cancer in the Liver for more information about SIRT.

Printed copies are available for free - Call 13 11 20 to order

Instructions for downloading and reading EPUB files

Apple devices

The iBooks application must be installed on your Apple device before you can read the EPUB.
Different ways to download an EPUB file to your Apple device:

  • email EPUB files to yourself and transfer the attachment to iBooks.
  • copy EPUB files into DropBox (or a similar service) and use the DropBox app to send them to iBooks.
  • open EPUB files directly from Mobile Safari and open them in iBooks, where they are saved automatically by downloading the EPUB from the website.

Need more help? Visit: http://support.apple.com/kb/HT4059

Kobo

To download an EPUB file to your Kobo from a Windows computer:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • select “Open folder to view files” to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

To download an EPUB to your Kobo from a Mac:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • open your “Finder” application.
  • select “Kobo eReader” from the listed devices to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
Need more information? Visit: http://www.kobo.com/help/koboaura/response/?id=3784&type=3

Sony Reader

To download an EPUB file on your Sony Reader™:

  • ensure you have already installed the Reader™ Library for PC/Mac software
  • select the eBook you want from our website and click the link to download it.
  • connect the Reader™ to your computer.
  • open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.

Need more help? Visit: https://au.readerstore.sony.com/apps_and_devices/

Amazon Kindle 2nd Generation devices

EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:

  • download the PDF directly onto your computer.
  • connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
  • open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
  • safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.

Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit http://www.amazon.com/gp/help/customer/display.html/ref=help_search_1-1?ie=UTF8&nodeId=200767340&qid=1395967989&sr=1-1
For more information on accessing a PDF on your Kindle™, visit www.amazon.com/manageyourkindle, log in to your account and click on Personal Document Settings.
Need more help? Visit https://www.amazon.com/gp/help/customer/display.html?nodeId=200375630

Android and PC

You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.

Instructions for downloading and reading EPUB files

Apple devices

The iBooks application must be installed on your Apple device before you can read the EPUB.
Different ways to download an EPUB file to your Apple device:

  • email EPUB files to yourself and transfer the attachment to iBooks.
  • copy EPUB files into DropBox (or a similar service) and use the DropBox app to send them to iBooks.
  • open EPUB files directly from Mobile Safari and open them in iBooks, where they are saved automatically by downloading the EPUB from the website.

Need more help? Visit: http://support.apple.com/kb/HT4059

Kobo

To download an EPUB file to your Kobo from a Windows computer:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • select “Open folder to view files” to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

To download an EPUB to your Kobo from a Mac:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • open your “Finder” application.
  • select “Kobo eReader” from the listed devices to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
Need more information? Visit: http://www.kobo.com/help/koboaura/response/?id=3784&type=3

Sony Reader

To download an EPUB file on your Sony Reader™:

  • ensure you have already installed the Reader™ Library for PC/Mac software
  • select the eBook you want from our website and click the link to download it.
  • connect the Reader™ to your computer.
  • open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.

Need more help? Visit: https://au.readerstore.sony.com/apps_and_devices/

Amazon Kindle 2nd Generation devices

EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:

  • download the PDF directly onto your computer.
  • connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
  • open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
  • safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.

Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit http://www.amazon.com/gp/help/customer/display.html/ref=help_search_1-1?ie=UTF8&nodeId=200767340&qid=1395967989&sr=1-1
For more information on accessing a PDF on your Kindle™, visit www.amazon.com/manageyourkindle, log in to your account and click on Personal Document Settings.
Need more help? Visit https://www.amazon.com/gp/help/customer/display.html?nodeId=200375630

Android and PC

You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.


This information was last reviewed in June 2016
View who reviewed this content
View our editorial policy

Support services

Coping with cancer?
Ask a health professional or someone who’s been there, or find a support group or forum

Need legal and financial assistance?
Pro bono legal and financial matters, no interest loans or help with small business

Looking for transport, accommodation or home help?
Practical advice and support during and after treatment

Cancer information

Deciding on specialist care
How to find and choose a surgeon, oncologist or other specialist

Patient rights and responsibilities
What you can reasonably expect from your health care professionals

View our publications
Guides and fact sheets for people with cancer, their families and friends

SHARE
TOP BACK TO TOP