ACS :: Internal Radiation Therapy (Brachytherapy)

Your doctor may recommend internal radiation therapy (also called brachytherapy) as the best way to treat your cancer. Instead of using radiation beams aimed from a large machine, the radiation source is usually sealed in a small holder (called an implant). The implant is placed very close to or inside the tumor. The material is placed so that it harms as few of the normal cells as possible. The material itself may be left in the body for only a short time, or it may be left there permanently. This allows the doctor to give a high dose of radiation to a smaller area than is possible with external radiation treatment.

The main types of brachytherapy are intracavitary radiation and interstitial radiation. Both of these methods involve using radioactive implants, such as metal pellets, seeds, ribbons, wires, needles, capsules, or tubes. During intracavitary radiation, the material is placed in a cavity (space) in the body, such as the uterus. With interstitial radiation, the implants are placed in or near the cancer, but not in a body cavity.

Sealed radioactive substances are placed in body cavities or body tissue with applicators, which are often metal tubes or plastic tubes called catheters. This is done in a hospital operating room. You will get anesthesia, which may be either general (where you are given drugs to put you into a deep sleep) or local (where part of your body is numbed). The applicators are put in by a doctor using an imaging test (such as an x-ray or MRI) to look at the exact area where the radiation needs to go. If the applicators need to stay in, stitches may be used to keep them in place until treatment is over.

During the actual radiation treatment, the implants are put into the body through the applicator(s). Some implants are permanent. They are put in through the applicator and then the applicator is removed. Other implants are left in only for a certain amount of time. For the implants that will be removed after a certain number of minutes, hours, or days, the applicator is usually left in until the treatment is finished. The applicator is then removed when the implants are taken out for the last time.

The type of implant you receive and your treatment schedule will depend on the type of cancer, where it is in your body, your general health, and other treatments you have had. Some implants deliver low doses of radiation. They are left in place for many days or may even be permanent. Others deliver high doses of radiation and are taken out after only a few minutes.

Some low-dose implants are left in place from 1 to 7 days. For larger implants, depending on where the implant is placed, you may have to stay in a hospital bed and lie fairly still to keep it from moving.

Some smaller implants (such as the seeds or pellets used to treat prostate cancer, and some lung cancers) may be left in permanently. Over the course of several weeks they stop giving off radiation. The seeds are about the size of rice grains and rarely cause problems. If your implants are to be left in, you may be able to go home the same day they are put in (or the day after). But you will need to stay in the treatment center until the anesthesia wears off. Sometimes special precautions are needed to protect family and friends from the radiation given off by the implants. Ask your health care team about this.

High-dose-rate (HDR) brachytherapy allows a person to be treated for only a few minutes at a time with a powerful radioactive source that is put in the applicator. The source is removed after only a few minutes. This may be repeated over the course of a few days to weeks. The radioactive material is not left in your body. Sometimes the applicator is left in place between treatments, or it may be put in place before each treatment.

You are not likely to have a lot of pain or feel sick while implants are being put in. The anesthesia used while they are being placed might make you feel drowsy, weak, or nauseated, but these side effects do not last long. If your implant is held in place by an applicator, you may have some discomfort in that area. Ask for medicine to help you relax or to relieve pain if needed. Be sure to tell the nurse if you have any burning, sweating, or other symptoms.

In most cases, anesthesia is not needed when the applicator and/or implant is removed. It is usually done right in your hospital room. The treated area may be sore or tender for some time after treatment, but most patients can return to normal activities quickly. Keep in mind that your body is recovering, and you may need extra sleep or rest breaks over the next few days.

Radioactive material will stop giving off radiation over time. This may take weeks or months. Talk to the doctor or nurse about how long this may take in your case. Once the radiation is gone, the implant(s) are no longer active. Usually they stay in place and cause no harm, and they do not need to be removed.

With internal radiation therapy, your body may give off a small amount of radiation for a short time. If the radiation is contained in a temporary implant, you will be asked to stay in the hospital and may have to limit visitors during treatment. You also may be asked to stay a certain distance away from them. Pregnant women and children may not be allowed to visit you. With sealed implants, body fluids and materials used by the patient are not radioactive.

Permanent implants give off small doses of radiation over a few weeks to months as they slowly stop giving off radiation. The radiation usually doesn’t travel much farther than the area being treated, so the chances that others could be exposed to radiation is very small. Still, your health care team may ask you to take certain precautions such as staying away from small children and pregnant women, especially just after you get the implants.

Need answers? 1·800·227·2345 \| Home \| Community \| Get Involved \| Donate \| \| Site Index \| Search