Brachytherapy for cervical cancer

Brachytherapy is a type of internal radiotherapy that gives treatment directly to the cervix and the area close by. It is usually given after external radiotherapy. Tubes (applicators) are placed into your womb or vagina. The radiotherapy is given through the tubes.

If you have not had a hysterectomy, you will have intrauterine brachytherapy. Your doctor will place applicators into your vagina, through your cervix and into your womb while you are under a general or spinal anaesthetic.

If you have had a hysterectomy, you will have vaginal brachytherapy. One or two applicators will be placed in your vagina. You will not need an anaesthetic if only one applicator is used. But if two applicators are used, you will have a general anaesthetic.

When the applicators are in place they are connected to a machine. The machine places a radioactive capsule into the applicators to give the planned dose of radiation.

Brachytherapy can be given as high-dose-rate, low-dose-rate or pulsed-dose-rate treatment. These all work equally well but take different lengths of time. The type you have will depend on the system your hospital uses.

Internal radiotherapy

Internal radiotherapy is called brachytherapy. It gives radiation directly to the cervix and the area close by. It is usually given after external radiotherapy.

You have one or more hollow tubes, called applicators, put into your womb or vagina. The radiotherapy is given through these tubes. How you have your treatment depends on whether you have had your womb removed.


Brachytherapy if you have not had a hysterectomy

If you have not had a hysterectomy, you will have intrauterine brachytherapy. You have a general anaesthetic or a spinal anaesthetic first. Your doctor will explain this to you.

Your doctor inserts applicators into your vagina. They pass them up through your cervix into your womb. They may also place applicators alongside the cervix.

The doctor may place padding inside your vagina. This is to help protect your back passage (rectum) and prevent the applicators moving. You will also have a catheter put into your bladder to drain off urine.

The applicators can be uncomfortable, so you may need to take painkillers while they are in.

Brachytherapy
Brachytherapy

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Brachytherapy if you have had a hysterectomy

If you have had a hysterectomy, a doctor may place one or two applicators into your vagina. This is called vaginal brachytherapy.

If your treatment involves just one applicator, you will not need an anaesthetic or sedation. But if you are to have two applicators placed, this will be done under a general anaesthetic.

Vaginal brachytherapy is a simpler treatment than brachytherapy if you have not had a hysterectomy. You do not need any particular preparation for the treatment. It is unlikely to cause any immediate side effects.


How you have your treatment

You will have a scan or x-rays to check the position of the applicators. When it is confirmed that the applicators are in the right position, they are connected to the brachytherapy machine. The machine is operated by a radiographer. It places a radioactive capsule, called a source, into the applicators. The machine then gives the planned dose of radiation.

Internal radiotherapy can be given as high-dose-rate, low-dose-rate or pulsed-dose-rate treatment.  Most centres in the UK use high-dose-rate equipment. These different ways of giving internal radiotherapy all work equally well. The type you have will depend on the system your hospital uses. Your cancer specialist and specialist nurse will explain more so that you know what to expect.

High-dose-rate treatment

This is the most common way of giving brachytherapy to the cervix. You have each treatment over a few minutes. You will have several treatments. How high-dose-rate treatments are given varies from hospital to hospital. Usually, each treatment takes about 10 to 15 minutes.

If you stay in hospital, you will have your treatments over several days. The applicators may be removed between treatments. Or they may be left in place and removed after your final treatment.

If you have your treatment as an outpatient, you go to the hospital three or four times over several days or a week. A nurse will remove the applicators before you go home.

You may have a tube (catheter) put into your bladder to drain urine during high-dose rate treatment. A nurse will take this out before you go home.

Low-dose-rate treatment

If you have this treatment, you will usually be in hospital for 12 to 24 hours. But sometimes it may be given over a few days. Your doctor, nurse or radiographer will tell you more about low-dose-rate treatment.

Pulsed-dose-rate brachytherapy

This treatment is given over the same length of time as low-dose-rate treatment. But the radiation dose is given in pulses rather than as a continuous dose. Your doctor, nurse or radiographer will give you more information.

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