Brachytherapy

Brachytherapy is when your doctors treat the cancer by inserting radioactive material directly into the affected area. A high dose of radiation is given to the tumour, but healthy tissue only gets a small amount of radiation.

Brachytherapy is usually used to treat prostate cancer, cervical and womb cancer. It’s also used to treat other cancers such as head and neck cancers.

How it’s given depends on the type of cancer being treated:

  • Prostate cancer - small radioactive seeds are inserted either directly into the tumour or into a catheter in the prostate.
  • Cervical and womb cancer – applicators are placed inside the womb or vagina. Radioactive material is inserted inside the applicators.
  • Mouth, cervical, breast and other cancers - very thin radioactive needles, wires or tubes are inserted into the tumour. This is done under a general anaesthetic.
  • Secondary liver cancer - radioactive beads are inserted into the blood vessels using a catheter.

What is brachytherapy?

Brachytherapy gives a high dose of radiotherapy directly to the tumour, but only a low dose to normal tissues. It’s mainly used to treat cancers in the prostate gland, cervix and womb. It may also be used to treat some other cancers, such as head and neck cancers. Brachytherapy may be given as well as external radiotherapy.


Brachytherapy for prostate cancer

There are two ways of giving brachytherapy for prostate cancer.

Permanent seed brachytherapy

This is sometimes known as low-dose rate (LDR) brachytherapy. It uses small radioactive ‘seeds’ that are inserted into the tumour so that the radiation is released slowly. The seeds are not removed and the radiation gradually fades away over about six months.

All the radioactivity from the seeds is absorbed by the prostate, so it’s safe for you to be around other people. But as a precaution, you should avoid long periods of close contact with children and women who are, or could be, pregnant. Your specialist will give you more information about the precautions you should take.

High-dose rate (HDR) brachytherapy

This involves placing thin plastic or metal tubes into the prostate gland. A radioactive material is then inserted into the tubes by a machine. The radioactive material is left in the tubes for a set period of time and then withdrawn. After the treatment, the tubes are removed and no radioactive material is left in the prostate gland.


Brachytherapy for cervical and womb cancer

Brachytherapy for cervical or womb cancer is given through special hollow tubes called applicators. These are inserted into the womb or vagina.

During treatment, a machine is used to place the radioactive material inside the applicators. After the treatment, the radioactive material is withdrawn back into the machine and the applicators are removed.

The brachytherapy may be given as either a high-dose or low-dose rate treatment. With both treatments, the same dose of radiotherapy is given but over different times:

  • High-dose rate treatment is given over a short period of time (for example, 10–15 minutes). It is given as one short burst or several short bursts over a few days.
  • Low-dose rate treatment is used less often. It is given over a longer period of time, usually over 12–24 hours.

You’ll be cared for in a single room while you’re having brachytherapy. Special precautions will need to be taken to prevent other people being exposed to radioactivity while the machine is giving you your treatment. Your hospital team will give you more detailed information about these precautions.

Image-guided brachytherapy (IGBT)

If you have high-dose rate treatment for cervical cancer, you may have IGBT. IGBT makes the radiotherapy treatment very accurate. It uses CT scans or MRI scans to pinpoint exactly where the cancer is before each treatment session. This makes it possible to shape the radiation dose to match the shape of the tumour and to avoid organs such as the bowel and bladder.

Sometimes, additional applicators may be used to boost the dose of radiotherapy to a particular area.

Your oncologist can tell you whether IGBT is a suitable treatment for you. They can arrange for you to have IGBT at another treatment centre if it’s not possible for you to have it at your local one.

Although you are alone as it’s being delivered, the staff are watching and listening all the time. I had three sessions lasting six minutes each, with no pain and no immediate side effects.

Lynda


Brachytherapy for mouth, cervical, breast and other cancers

Brachytherapy using caesium or iridium wires

This can be used to treat a number of different cancers, including cancers of the mouth, lip, cervix and breast. Very thin radioactive needles, wires or tubes are inserted while you’re under a general anaesthetic in an operating room.

If you need to have this type of treatment, your healthcare team will discuss this with you and give you detailed information about it.


Brachytherapy for secondary liver cancer

Selective internal radiotherapy treatment (SIRT)

SIRT is a specialised type of brachytherapy. It’s suitable for some types of secondary liver cancer, for example those that have spread to the liver from the bowel (colon or rectum). It uses tiny radioactive beads (microspheres) to treat the cancer.

SIRT is only available in some hospitals, so you may have to travel for this treatment if it is suitable for you.

Before having the treatment, a test called an angiogram is done. A fine tube (catheter) is put into a blood vessel in your groin area and passed into a blood vessel taking blood to the liver (hepatic artery). This shows where the SIRT beads would travel through the bloodstream and allows the doctor to close off any blood vessels that would take the SIRT beads to other parts of the body.

When you have the treatment, you will have another angiogram and the SIRT beads will be injected into the catheter. They get stuck in the small blood vessels around the tumour. The radiation given off by the SIRT beads damages the cancer cells and stops them growing. It also damages the blood vessels to the tumour so that it can’t get the nutrients it needs. You may need to stay in hospital overnight after your treatment.

The amount of radiation given off by the beads is small and lasts for about 10–14 days. During this time, you will be told about any safety precautions you need to take and to drink plenty of fluids. The beads remain in the liver permanently and are harmless.

Depending on how effective it is, the treatment can sometimes be repeated.

We have more information about SIRT.

Back to Internal radiotherapy explained

Radioisotopes

Radioisotope therapy targets cancer cells with a radioactive liquid.