Internal Radiation Therapy (Brachytherapy)

Internal radiation therapy, also called Brachytherapy, refers to methods of radiation delivery in which radioactive material is implanted directly into or near a tumor. Brachytherapy allows the doctor to give a higher total dose of radiation in a shorter period of time than is possible with external treatment. It concentrates the radiation in the tumor and lessens damage to normal tissue near the cancer. This can be the best way to treat certain types of cancer, and it can also be an alternative to surgery. Sometimes brachytherapy is done in conjunction with external radiation therapy, in which case the brachytherapy delivers a “boost” (higher dose) to help destroy the main mass of tumor cells.

The radioactive material is sealed in a metal seed and placed directly into or near the cancer site. Interstitial brachytherapy involves placing radiation seeds directly placed into the tumor or tissue at risk using a needle applicator. Intracavitary brachytherapy involves the use of special applicators or small tubes (catheters) that are placed within body cavities that are near the tumor. These devices are then ‘loaded’ with radioactive sources.

Types of Brachytherapy

High Dose Rate (HDR) brachytherapy is most commonly an outpatient procedure where very effective high-dose radioactive sources are removed after only a few minutes. The doctor places a catheter in or near the tumor, and then directs the procedure remotely from outside the treatment room. A computer sends a radioactive source through the catheter to the treatment site. In some cases, several treatments may be required.

Low Dose Rate (LDR) brachtherapy can be either temporary or permanent. Advanced ROS offers permanent LDR brachtherapy, an outpatient procedure where the radioactive sources are left in place permanently. Because the seeds are emitting radioactivity, safety precautions are necessary to reduce exposure to family members. The seeds become less and less radioactive each day until the radiation diminishes to an undetectable level.

How will I feel during the procedure?

You are not likely to feel pain or become ill during treatments. If your implant is held in place by an applicator, the treatment area may be sensitive for some time after treatment. If anesthesia is needed to place the implant, you might feel drowsy for a short time. Anesthesia is generally not required when the implant is removed and most implants can be taken out immediately after the treatment.

Will I become radioactive?

Even though the effects of radiation are powerful, you will not become permanently radioactive. If a permanent implant procedure is used, as with prostate seed brachytherapy, your body may give off a small amount of radiation for a short time.

What are the benefits of brachytherapy?

Brachytherapy has been proven to be comparably effective in the treatment of many kinds of cancer and patients often suffer fewer side effects compared to when external radiation therapy or surgery is used. The benefits vary depending on the patient and the type of brachytherapy, although as a minimally invasive treatment method, the benefits of avoiding surgery are universal. These include a quicker recovery time, less time spent in the hospital, and a reduced risk of postoperative infection.

The benefits of using brachytherapy in the treatment of early stage prostate cancer are quite pronounced. This usually involves an outpatient procedure for either LDR permanent seed implantation or HDR brachytherapy to the prostate gland. Prostate brachytherapy has been shown to have ten-year survival rates comparable to radical prostatectomy surgery and has fewer side effects, including a much lower incidence of impotence and incontinence.