Definition and Overview
Also known as internal radiotherapy, brachytherapy is a type of cancer treatment that involves placing radioactive materials directly into or near the tumor to shrink or destroy it as opposed to external radiotherapy, where radiation energy is delivered from outside the body.
Brachytherapy has a very long history beginning in the 1900s. However, its popularity declined through the years due to the possible side effects of long-term exposure to radioactive materials especially among operators. Fortunately, advanced technologies now allow them to administer these materials remotely and with the least contact possible.
Who should undergo and expected results
Brachytherapy has been shown to be effective in treating different types of cancer but not limited to prostate, cervical, uterine, eye, vaginal, and rectal cancers. It offers the following benefits to the patient:
Shorter treatment time. When compared to external radiation therapy, internal radiotherapy can be completed in less than seven days instead of weeks.
It is more effective. Many experts believe that brachytherapy is more effective than external radiation therapy due to its precision as radiation is applied directly to the tumor. This means that the radiation no longer has to pass through several tissues or organs that can delay the effects of the procedure. Also, with brachytherapy, radiation can be given in high doses which can further shorten treatment time.
Reduced side effects. Due to its precision or accuracy, internal radiotherapy is less likely to damage healthy tissues that surround the tumor and allows patients to keep their affected organ in some cases. For people with prostate cancer, for example, brachytherapy can cure the disease without the need to surgically remove the prostate glands.
It works with other forms of cancer treatment. Brachytherapy can be combined with other cancer treatment methods including chemotherapy and surgery. It may also be carried out as part of palliative care (symptom management).
How the procedure works
The treatment program begins with thorough planning. In this stage, the patient works with his oncology team to ascertain:
- The stage, prognosis, location, and type of cancer
- The overall health condition of the patient
- Procedures that may have to be performed before or alongside brachytherapy
- Dose, placement, and duration of the treatment
These may be determined through a series of tests such as imaging scanners (MRI, CT, or PET) and blood tests, as well as a review of the patient's oncological records.
During the actual treatment, a team prepares the patient. He is sent to a special room dedicated to the procedure. Given the nature of the treatment, this room is radioactive and special gear needs to be worn, especially by the medical team. They review the treatment plan and provide an overview on how the actual procedure will occur, including how the materials will enter the body and their rate of radiation.
The patient lies on the table and is connected to applicators, or tools that are used to deliver the radioactive materials. They may be made of metal or plastic including catheters. The applicators are connected to an offloading machine, which contains the radioactive materials. The machine also has settings so the team can customize the treatment for the patient based on the agreed-upon treatment plan.
Depending on the kind of brachytherapy performed, the machine may receive the materials back or the delivery is only one way. After the procedure, the applicators are removed, and the patient is allowed to recovery and is checked for any side effect.
Possible risks and complications
Brachytherapy, when done right, doesn't pose serious health risks to the patient or even the people near him. In permanent brachytherapy, the emission is so low that the person doesn't become "radioactive." However, the inactive seeds may react to magnets like metal detectors found in airports. In rare cases, the seeds may move to other organs, but since they are inactive, they are less likely to cause complications or damage.
Follow-up care, however, remains important not only to monitor the risks and complications but also to evaluate the effectiveness of the treatment and the progress of the disease.
- Brachytherapy. RadiologyInfo.org. http://www.radiologyinfo.org/en/info.cfm?pg=brachy.
- Radiation therapy and you: Support for people with cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/coping/radiation-therapy