- Understanding Radiation Therapy: A Guide for Patients and Families
- What is radiation therapy? When is it used?
- How does radiation therapy work?
- Do the benefits outweigh the risks and side effects?
- How much does radiation treatment cost?
- Who gives radiation treatments?
- Informed consent
- How is radiation therapy given?
- External radiation therapy
- Internal radiation therapy (brachytherapy)
- Systemic radiation therapy
- Preventing and managing side effects
- Skin problems
- Hair loss
- Blood count changes
- Eating problems
- How will I feel emotionally?
- Will side effects limit my activity?
- Are there long-term side effects I should be concerned about?
- Managing side effects of treatment to certain parts of the body
- Radiation therapy to the head and neck
- Radiation therapy to the brain
- Radiation therapy to the breast and chest
- Radiation therapy to the stomach and abdomen
- Radiation therapy to the pelvis
- Follow-up care
- To learn more
Internal radiation therapy (brachytherapy)
What is internal radiation therapy?
Your doctor may recommend internal radiation therapy (which is also called brachytherapy [brake-ee-THER-uh-pee]) as the best way to treat your cancer. This type of radiation does not use radiation beams aimed from a large machine. Instead, the radiation source is usually sealed in a small holder (called an implant). The implant is placed very close to or inside the tumor. It’s placed so that it harms as few normal cells as possible. The radioactive material 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 higher 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 pellets, seeds, ribbons, wires, needles, capsules, balloons, 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.
The implants are kept and carried in special containers that hold the radiation inside so it can’t affect others. You will likely be treated in a special shielded room that also contains the radiation. And the health professionals handling the implants may wear special gear that protects them from exposure once the implants are taken out of the container.
How are implants placed in the body?
Sealed radioactive substances are put into 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 drugs are used to put you into a deep sleep so that you don’t feel pain) or local (where part of your body is numbed). The doctor puts the applicators in using an imaging test (such as an x-ray or MRI) to find the exact place they need to go.
During the actual radiation treatment, the radioactive 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 time, but then put in again later, the applicator is often left in until the treatment is finished (stitches may be used to keep it in place). The applicator is removed when the implants are taken out for the last time.
How long do implants stay in place?
The type of implant you receive and your treatment schedule will depend on the kind 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 temporary implants are left in place from 1 to 7 days. For larger implants, depending on where the implant is, 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) may be left in—they are never taken out. 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 for a few weeks to protect family and friends from the radiation given off by the implants. Be sure to 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 before each treatment.
How will I feel during implant therapy?
You are not likely to have a lot of pain or feel sick while implants are being put in. The drugs (anesthesia) used while they are being placed might make you feel drowsy, weak, or sick to your stomach (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.
What happens after a temporary implant is removed?
In most cases, anesthesia is not needed when the applicator and/or implant is removed. It’s usually done right in your hospital room. The treated area may be sore or tender for some time after treatment, but most people 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.
What happens to permanent implants?
Radioactive materials 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. They usually stay in place and cause no harm, so there’s no need to take them out.
Will I be radioactive during or after internal radiation treatment?
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 the things 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 right after you get the implants. Again, body fluids and the things you use will not be radioactive.
Last Medical Review: 01/24/2013
Last Revised: 01/24/2013