Brachytherapy, also known as sealed source radiotherapy or internal radiotherapy is a type of radiotherapy in which a small radiation source
Brachytherapy, also known as sealed source radiotherapy or internal radiotherapy is a type of radiotherapy in which a small radiation source is placed inside the body, in proximity to the area requiring treatment.
Brachytherapy has many different uses and can be performed to treat different parts of the body. The most common types of brachytherapy include:
● Brachytherapy for cervical cancer
● Brachytherapy for breast cancer
● Brachytherapy for prostate cancer
● Brachytherapy for uterine cancer
● Brachytherapy for skin cancer
This treatment can be performed alone or in conjunction with other procedures such as chemotherapy, external radiotherapy or cancer surgery.
Brachytherapy has several advantages over other types of radiotherapy or cancer treatments. The brachytherapy procedure allows doctors to treat just certain specific areas affected by cancer. Given the fact that brachytherapy has less side effects than external radiotherapy, the time between each radiation dose is shorter, leaving less time for surviving cancer cells to grow. Also, brachytherapy can effectively treat many types of cancer and its success rate is comparable to cancer surgery or external radiotherapy.
Brachytherapy treatment is recommended for patients suffering from the following types of cancer:
● Eye cancer
● Brain cancer
● Breast cancer
● Bile duct cancer
● Cervical cancer
● Endometrial cancer
● Head and neck cancer
● Lung cancer
● Esophageal cancer
● Pancreatic cancer
● Prostate cancer
● Skin cancer
● Rectal cancer
● Vaginal cancer
Brachytherapy treatment can be used alone or with cancer surgery, radiotherapy or chemotherapy.
Certain contraindications related to age, weight and lifestyle may exist, but these are heavily dependent on the brachytherapy treatment’s goal and the area affected by cancer.
An examination from a doctor and a radiation oncologist is necessary before brachytherapy treatment. The oncologist will then set up a treatment plan, taking several details into consideration. Patients may also be required to have X-rays or CTs before the brachytherapy procedure can begin.
The procedure is performed differently, according to the type of cancer the patient suffers from and the desired outcome. Usually, general or local anaesthesia is first administered to the patient.
The radiation implant can also be placed differently:
● It can be placed in a body cavity – the implant containing radioactive material can be placed in the windpipe
● It can be inserted into tissue – an incision is created into the area which needs to be treated and the implant is inserted into it. This technique is usually performed to treat prostate cancer or breast cancer.
There are three different types of brachytherapy, depending on the amount of the treatment length and dose of radiation administered:
● High dose rate brachytherapy
With this technique, the radioactive implant is placed inside the body for a very short period of time, usually around 15-20 minutes. Patients usually undergo this procedure a couple of times every day for up to a week.
● Low dose rate brachytherapy
Patients need to stay in hospital during this procedure. A low dose of radiation is continuously released for a longer period of time – it ranges from a few hours to a few days.
● Permanent brachytherapy
The radioactive implant may be placed inside the body permanently – this is usually performed on patients suffering from prostate cancer.
Local or General anesthetic
Patients may experience some pain and swelling, depending on the brachytherapy technique used and the area treated. Nausea and vomiting are common side effects of general anaesthesia.
Risks and complications associated with brachytherapy depend on the treated area.
Brachytherapy side effects can include:
Brachytherapy success rates depend on the area where the cancer is located and its spread – success rates for patients suffering from prostate cancer range from 71 to 95%, 5 years after the procedure.
Patients undergoing permanent brachytherapy will emit low doses of radiation from the treatment area so it is advised to limit time spent with children and pregnant women.