Brachytherapy

Brachytherapy uses radioactive implants such as seeds, pellets, wires or plates that are put near or inside the tumour. A high dose of radiation is given to the tumour, but nearby healthy areas get much less.

You may have a general anaesthetic or spinal anaesthetic (an injection of painkillers into your spine) for brachytherapy. This depends on how the treatment is given and the area of the body being treated.

The implants are left in place to give the correct dose of treatment. Depending on the type of brachytherapy, this may take a few minutes or a few days. Some types of implants are designed to be left in the body permanently.

Your team will explain any safety measures you need to follow during your treatment. This may include being alone in a single treatment room at times while treatment is given.

Brachytherapy is mainly used to treat prostate, cervical or womb cancer. It is sometimes used to treat other cancers such as cancer of the vagina, vulva, oesophagus (gullet), lung and rectum.

Brachytherapy

Brachytherapy uses radioactive implants such as seeds, pellets, wires or plates that are put near or inside the tumour. The radioactivity only affects tissue that is very close to the implant. This means the tumour is treated, but healthy areas around it get much less radiotherapy. Areas of the body that are further away are not affected at all.

The implants are left in place to give the correct dose of treatment. Depending on the type of brachytherapy, this may take a few minutes or a few days. Some types of implants are designed to be left in the body permanently.

Your team will explain your treatment plan. This may also involve external beam radiotherapy or other treatments such as chemotherapy, hormonal therapy or targeted therapy. Brachytherapy is mainly used to treat cancers in the prostate, cervix and womb. It is sometimes used to treat other cancers, such as cancer of the vagina, vulva, oesophagus (gullet), lung and rectum.

For my first brachytherapy treatment, I was put under an anaesthetic and sedated. I couldn't feel from my waist down and I drifted into a deep sleep during the prep.

Danielle


Radiation safety during brachytherapy

Your treatment is planned to give you the amount of radiation needed to treat the cancer safely and effectively. Your team are also careful to protect people around you from radiation. Safety measures may be slightly different in different hospitals. Your team will explain what to expect.

During your treatment in hospital you may be looked after in a single treatment room. This depends on the type of brachytherapy you have. You may need to be alone in the room at times. Tell your team if you are worried about this so they can help.

As soon as the implants are removed from your body, there is no risk to people around you. You are not radioactive.

For some types of brachytherapy, the implants are not removed (for example, permanent seed implants or SIRT – see below). The radiation from each implant is absorbed by the area of the body closest to it. It is safe for you to be around most other people. As a precaution, you may have to avoid close contact with children or pregnant women for a time. Your team will explain this and any other safety measures to you. They will give you information about your treatment to carry with you at all times.


Brachytherapy for prostate cancer

There are two ways of giving brachytherapy for prostate cancer. We have more about both these treatments in our information about prostate cancer.

Permanent seed implants

Permanent seed implant treatment is sometimes known as low-dose-rate (LDR) brachytherapy. Small radioactive seeds are put into the prostate under a general anaesthetic or spinal anaesthetic (an injection of painkillers into your spine). The seeds are not removed. They are left inside the body permanently and release radiation slowly. The seeds become less radioactive over several months.

High-dose-rate (HDR) brachytherapy

HDR brachytherapy is given under a general or a spinal anaesthetic. Thin hollow needles are put through the skin and into position in the prostate.

The ends of the needles outside the body are connected to a treatment machine. The machine sends a radioactive pellet into each needle. It keeps the pellets in the needle in the prostate for up to an hour to give the treatment. When the treatment has finished, the pellets return to the machine. Sometimes 2 or 3 treatments are given over 24 hours. When all the treatment is finished, the needles are removed.


Brachytherapy for cancers of the cervix, womb, vulva and vagina

Hollow tubes are placed into the vagina. One end of each tube sits inside the vagina or womb. The other end sits outside the body between the legs. You may have a general anaesthetic or spinal anaesthetic (an injection of painkillers into your spine) if a tube is placed in the womb.

The end of the tubes outside the body are connected to a treatment machine. The machine sends a radioactive pellet into each tube. It keeps the pellets in the tubes in the vagina or womb to give the treatment. When the treatment has finished the pellets return to the machine.

This type of brachytherapy can be given as:

  • high-dose-rate treatment
  • low-dose-rate treatment
  • pulsed-dose-rate treatment.

These methods all work equally well. The type you have depends on the system your hospital uses.

High-dose-rate treatment is given over a few minutes. You have several treatments over several days or weeks. If you stay in hospital and your treatments are close together, the tubes may be left in place. They will only be removed after your last treatment. If you go home between treatments, the tubes are removed before you leave the hospital.

Low-dose-rate and pulsed-dose-rate treatments take longer. You are usually in hospital for 12 to 24 hours, or sometimes for a few days. The tubes stay in place during this time and are removed after the treatment.

We have more information about treating cervical cancer, womb cancer, vulval cancer and vaginal cancer.

The brachytherapy only took six minutes. Overall it was a good experience. I didn't feel any pain and I was very relaxed. The procedure was painless and recovery was ok.

Danielle

The radiology staff who performed the brachytherapy were amazing. Very kind, supportive and very gentle. They really made me feel looked after.

Daloni


Other cancers and brachytherapy

Plaque brachytherapy

Eye cancer (ocular melanoma) may be treated using a small radioactive disc called a plaque. The plaque is placed near the cancer using a small operation. It is usually done under a general anaesthetic. But sometimes a local anaesthetic is used. The plaque is left in place, usually for 1 to 4 days. You have another small operation to remove it after the treatment.

We have more information about treating eye cancer.

Brachytherapy using caesium or iridium wires

This can be used to treat cancers including lip, breast and vaginal cancer. Very thin radioactive needles, wires or tubes are inserted into the body while you are under a general anaesthetic.

Your healthcare team will give you more information if you are offered this treatment.

Brachytherapy using an endoscope

An endoscope is a thin, flexible tube with a camera on the end. It can be used to look inside areas such as the nose, throat, airways or rectum.

Brachytherapy can be given using an endoscope to put a thin tube next to tumours in these areas. A machine then sends radioactive pellets into the tube. It keeps the pellets in the tubes in place to give the treatment. After the treatment the pellets return to the machine.

Your healthcare team will give you more information if you are offered this treatment. We have more about treating cancer of the nasopharynx, oesophagus (gullet), lungs and rectum.

Selective internal radiotherapy treatment (SIRT)

This type of brachytherapy may be used to treat some types of liver cancer. For example, it may be used to treat cancer that spreads to the liver from the bowel. Tiny radioactive beads are injected into the bloodstream. They stick permanently in small blood vessels in and around the liver tumour. The beads give off radiation which damages the cancer cells. They also block the blood vessels to the tumour. This stops the blood supply to the tumour, so it does not get the oxygen and nutrients it needs.


We have more information about SIRT.

Back to Internal radiotherapy explained

Radioisotopes

Radioisotope therapy uses radioactive liquid to destroy cancer cells. This can be given as a drink, capsule or injection.