What is internal radiotherapy?

Internal radiotherapy (or brachytherapy) gives a high dose of radiotherapy to the top of the vagina (where the womb was). It is given by placing hollow tubes (applicators) in the vagina. A machine, operated by a radiographer, delivers a radioactive source that gives off radiation into the correct place through the tubes. The machine gives you the exact dose your cancer specialist has prescribed. After treatment finishes, a nurse removes the tubes and you can go home.

You may have several short bursts of treatment, which is called high-dose rate or fast treatment. Or you may have one long, slow treatment called low-dose rate or slow treatment. Slow treatment is only rarely used.

You can have internal radiotherapy on its own or at the end of your external radiotherapy treatment. Internal radiotherapy can be given in different ways. They work equally well.

Women who still have their womb may be advised to have a different type of internal treatment. It involves putting a tube into the womb as well as the vagina. It is done under a general anaesthetic, or sometimes a spinal anaesthetic. Your doctor or nurse can explain more.

High-dose rate (fast treatment)

This is the most common way of giving internal radiotherapy after surgery to treat womb cancer. You can usually have it done as an outpatient. Your doctor will carefully put a hollow plastic or metal tube (applicator) into your vagina. You won’t usually need any anaesthetic to have this done. But let your nurse or doctor know if you’re worried or have any discomfort. They can help to reassure you or give you painkillers if you need them.

You’ll probably have a CT scan or x-ray to check the position of the applicators. After this, a radiographer will attach a flexible tube to the applicator. This is connected to the machine that delivers the radioactive source into the applicators.

The radiographer and nurse will leave the room and switch on the treatment machine. They will still be able to see you and hear you, so if you need anything they can stop the machine and come back in again.

The treatment only lasts a few minutes, and a nurse will gently remove the applicators when it’s over. You’ll need to come back and have it on different days for between 2–4 treatments. You can usually have it as an outpatient.

Low-dose rate (slow treatment)

Slow treatment is only rarely used. It is given in the same way as the fast treatment, but much more slowly. It can be given over 12–24 hours, or over a few days. You will usually have your treatment in a room of your own or with another woman who’s having similar treatment. Being in your own room means other people aren’t exposed to unnecessary radiation.

You’ll need to need to stay lying down in bed while the applicators are in place. This helps them stay in the correct position. Having the applicators in and not being able to move around can be uncomfortable, but you’ll be given regular painkillers. Let your nurse or doctor know if you’re in any pain. You’ll also have a catheter (tube) inserted into your bladder because you won’t be able to get out of bed to pass urine.

The radioactive source can be withdrawn from the applicators back into the machine to allow nurses or doctors to come in without being exposed to radiation. The nurses will regularly check the applicators, give you painkillers and make sure you’re comfortable. You’ll have a nurse call system at hand to allow you to contact them at any time.

You can also have visitors (except pregnant women or children), but only for a short time so that you can continue with the treatment. The machine adds on the time that you’re not being treated, so you’ll still get the same dose. A nurse will discuss this with you beforehand so you know what to expect.

It’s a good idea to take in plenty to read, and an MP3 player or radio to keep you occupied. There will be a television in the room that you can watch. If you get anxious or worried during the treatment, tell the nurse or doctor how you’re feeling so that they can give you more support.

When your treatment finishes, your nurse will gently remove the applicators and catheter and you will be able to go home.

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