What is brachytherapy?

Brachytherapy radiation treatment is given from within the body using devices that are placed directly into or near the cancer. These devices are called implants. Tiny radiation sources are fed into the devices to deliver the dose from within for a calculated amount of time.

Brachytherapy lets your health care provider use a higher total dose of radiation over a shorter time than is possible with external beam radiation therapy. The radiation dose is focused on the cancer cells. It does less damage to the nearby normal cells.

Brachytherapy implants may be short-term (temporary) or long-lasting (permanent).

Temporary brachytherapy
Temporary implants are removed after the treatment has ended. The implants may be hollow needles, hollow tubes or balloons filled with fluid. The implants are inserted into or near the cancer for a short time, then removed. Either high-dose or low-dose brachytherapy may be used:

  • High-dose rate (HDR) brachytherapy: The implants stay in the body for several minutes and then are removed.
  • Low-dose rate (LDR) brachytherapy: The implants stay in the body for hours or days and then are removed.

Permanent brachytherapy
The implants are put in place and not removed. Very low doses of radiation are given, and the radiation stops over time. This type is also called low-dose rate brachytherapy or seed implantation. It uses implants called pellets or seeds. These implants are very small, about the size of a grain of rice. Your health care provider inserts the seeds directly into a tumor with thin, hollow needles. The seeds are left in place after the radiation has been used up. Their small size causes little or no pain. With time, the radiation lessens, then stops completely.

Brachytherapy is used especially for prostate cancer. It may also be used to treat vaginal, cervical or uterine cancer, breast cancer, eye cancer, or head and neck cancers.

Radiation is delivered internally to the area where the cancer is over a certain amount of time. In the case of prostate cancer, your radiation oncologist will place the radiation source directly into the prostate. How long it remains depends on the size of the cancer and your overall health.

Treatment Overview

What happens during brachytherapy?

The type of cancer you have, its location and other factors will determine your treatment schedule. How long brachytherapy lasts will depend on the type of treatment given.

Before the procedure: Right before the brachytherapy starts, you may need anesthesia medicine to keep you free from pain while the implants are placed in your body. This will depend on the size and number of implants, as well as the location of the insertion site. Anesthesia makes you numb, drowsy or completely asleep. An IV line is put into a vein in your arm or hand to give fluids and medicines.

During the procedure: A delivery device, such as a needle, is placed into the cancer site. The device may be passed through a nearby opening in the body, such as the vagina or rectum. Or an incision may be made in the skin. Implants are then passed through the delivery device into or near the cancer site. The implants are placed by hand or machine. X-rays, ultrasound or another imaging test may be used to make sure of correct placement. Here's what happens depending on the type you have:

  • High-dose rate (HDR) brachytherapy: The implants are put in once a day for several minutes, and then removed. The implant tube may be removed after each treatment session, or it may stay in place. You may go home between treatments or you may stay in the hospital until all treatment sessions are done.
  • Low-dose rate (LDR) brachytherapy: The implants and delivery device stay in place for hours to days. You stay in the hospital during this time.
  • Permanent brachytherapy: The implants are put in place and not removed. Very low doses of radiation are given, and the radiation stops over time.

Benefits and Risks

What are the benefits of brachytherapy?

The benefit of brachytherapy is that the device is small and can be less invasive than other cancer treatments. In addition, treatment time is usually shorter because the radiation is more concentrated and safely given at one time.

Using brachytherapy can also save nearby healthy tissue from being affected by radiation.

What are the risks of brachytherapy?

Like many cancer treatments, brachytherapy can come with risks. Because brachytherapy sends radiation to the cancer, the risk of having another cancer later due to radiation exposure is possible.

Anesthesia is used when the device is placed near or at the cancer, so this form of treatment comes with the general risks of anesthesia. These risks include cognitive dysfunction, hyperthermia and breathing problems.

Brachytherapy may not always have a successful outcome treating cancer.

Side Effects

What are the side effects of brachytherapy?

Brachytherapy side effects often depend on where the therapy is given and the dose. Risks and possible complications include:

  • Extreme tiredness (fatigue)
  • Pain from staying in 1 position
  • Temporary side effects in the area being treated. For example, head and neck brachytherapy can cause sores in the mouth and throat. Brachytherapy to the pelvis can cause urinary or digestive issues, such as urinary frequency or diarrhea.
  • Failure to affect tumor growth
  • Damage to healthy tissue and organs
  • Having another cancer later due to radiation exposure
  • Risks of anesthesia

Management & Support

To control discomfort during treatment, you may use an ice pack on the affected area. You’ll likely be prescribed a pain medication or given instructions on over-the-counter pain medications to use.

Follow all provider instructions carefully. You may want to ask your provider what kind of diet to follow. You can also make an appointment with an oncology dietitian to create a diet plan during treatment.

There are many other services you may want to take advantage of while going through cancer treatment