Brachytherapy (HDR and LDR)

Brachytherapy is the placement of radioactive sources in or just next to a tumor. The word brachytherapy comes from the Greek “brachy” meaning “close or short distance.” During brachytherapy, the radioactive sources may be left in place permanently or only temporarily, depending upon your cancer.

There are two main types of brachytherapy – intracavitary treatment and interstitial treatment. With intracavitary treatment, the radioactive sources are put into a space near where the tumor is located, such as the cervix, the vagina or the windpipe.With interstitial treatment, the radioactive sources are put directly into the tissues, such as the prostate.  These procedures may require anesthesia, a surgical procedure and a brief stay in the hospital.  Patients with permanent implants may have a few restrictions at first and then can quickly return to their normal activities. Temporary implants are left inside your body for minutes, hours or days. While the radioactive sources are in place, you will stay in a private room.  During the time when radiation is present in your system, doctors, nurses and other medical staff will continue to take care of you, but they will take special precautions to limit their exposure to radiation.

High-dose-rate (HDR) brachytherapy involves the remote placement of the powerful radiation source, accurately directed by your radiation oncologist and team, into the tumor for several minutes through a tube called a catheter, it is usually given in multiple doses once or twice daily, or once or twice weekly.  Your doctor and team will control this treatment from outside the treatment room, monitoring you as the therapy is being given. Devices called high dose-rate remote after loading machines allow radiation oncologists to deliver a brachytherapy treatment quickly, in about 10 to 20 minutes. You may be able to go home shortly after the procedure.

Low-dose-rate (LDR) brachytherapy involves the longer placement of the temporary (several days) or permanent radiation source into the tumor area.  Most patients feel little discomfort during brachytherapy.  If the radioactivesource is held in place with an applicator, you may feel discomfort from the applicator. There are medications that can relieve this discomfort. If you feel weak or queasy from the anesthesia, ask your radiation oncologist formedication to make you feel better.

Depending on the type of brachytherapy you receive, you may need to take some precautions after you leave your treatment, particularly if you plan to be around young children or pregnant women. Because temporary implants are removed after treatment, these radiation safety precaution apply mainly with permanent implants.  Ask your radiation oncologist or radiation oncology nurse about anything special you should know.

Brachytherapy may be used alone or in conjunction with external radiation treatments. Your radiation oncologist will advise you of the sequencing of these treatments that is appropriate for you.