How Brachytherapy Is Used for Cancer Treatment

Brachytherapy is a form of radiation therapy that involves delivering radiation directly to or near a tumor, targeting cancer cells from within the body rather than externally. This localized approach makes it possible to treat the tumor while reducing the risk of radiation exposure to nearby healthy tissue. 

Internal radiation therapy can be used to treat various types of cancers, including breast, prostate, gynecologic, skin, rectal, and head and neck cancers. If you or a loved one was recently diagnosed with cancer that will be treated with radiation, it’s helpful to learn more about this type of radiotherapy.

How is Brachytherapy Administered? 

The type of cancer you have will influence how you receive brachytherapy treatment. Typically, brachytherapy involves using a catheter (a small, flexible tube) to place small radiative seeds, also called pellets, in the area to be treated. If a catheter isn’t used, it can also be delivered through needles (small, rigid tubes) or an applicator (a larger, hollow device).

Before starting treatment, your doctor will insert the catheter or applicator into your body. Your care team may use imaging techniques such as CT scans, MRI scans, or ultrasound to guide the placement of these devices.

Where does the radiation go in the body?

The radioactive pellets can be placed directly into the tumor through the applicator, called interstitial brachytherapy, or they can be placed within a body cavity or a cavity that has been surgically created, called intracavity brachytherapy. The type that’s right for you depends on the type of cancer and whether the tumor is still present when brachytherapy is administered.

Is the radiation left inside of the body?

The radiation source can either be temporary or permanent. How long it remains in place depends on several factors, including the type of radiation source used, your specific type of cancer, the location of the cancer in your body, your overall health, and any other cancer treatments you have undergone. 

Do you have to stay in the hospital for brachytherapy treatment?

Brachytherapy may not always require a hospital stay, but some patients might need to stay overnight for recovery after their procedure. In some cases, staying in the hospital is necessary if treatments are spread out over several days. If you are allowed to go home the same day, it's a good idea to have someone available to drive you, particularly if you received pain medications or anesthesia.

The Difference Between High-Dose Rate Brachytherapy and Low-Dose Rate Brachytherapy

Once the catheter is in place, brachytherapy can be administered in just a few minutes. It can be left in the body permanently or it can be put in place for just a few minutes and then removed. The difference is based on the dose of radiation in the pellets.

• High-dose-rate (HDR) brachytherapy involves placing the radiation source for only 10 to 20 minutes at a time, after which it is removed. Treatments may occur twice a day for 2 to 5 days or once a week for 2 to 5 weeks, depending on the type of cancer. During this treatment, a catheter or applicator may remain in place or be inserted before each session. Patients may either stay in the hospital throughout treatment or make daily trips to the hospital for the radiation application.
• Low-dose rate (LDR) brachytherapy: The radiation source is left in place for 1 to 7 days, requiring most patients to stay in the hospital during this period. Once treatment is completed, your doctor will remove the radiation source and the catheter or applicator.
• Permanent brachytherapy: A type of LDR brachytherapy, which involves radioactive implants remaining in the body for the rest of a person's life. This is most commonly used for prostate cancer. The radiation weakens over time and eventually, the radiation will go away. Initially, you may need to limit your contact with others and take specific safety precautions. It is particularly important to avoid spending time with children or pregnant women during this period. 

Benefits of Brachytherapy for Cancer Treatment

While internal radiation can only be used in some situations, brachytherapy offers benefits to patients that are harder to achieve with external beam radiation therapy, including: 

• Precision and conformity: Using advanced planning software and imaging techniques, radiation doses can be tailored to fit the size and shape of the tumor, allowing for highly targeted treatment.
• Reduced risk of side effects: By confining the radiation to the tumor, surrounding healthy tissue is spared, which results in fewer patient side effects.
• Shorter treatment times: Unlike conventional external beam radiation therapy treatments, which can take weeks to complete, a brachytherapy course typically lasts 1 to 5 days. This efficiency allows patients to return to their daily lives sooner.
• Cost-effectiveness: The shorter treatment duration, the ability for outpatient procedures, and lower investment and maintenance costs contribute to reduced expenses for providers and patients.  

What Types of Cancers Are Treated With Brachytherapy? 

Brachytherapy is a treatment option for several types of cancer, including:

• Gynecologic cancers, such as uterine, cervical, and vaginal cancer - pellets are placed in a tube that is inserted into the vagina where it’s left for a period of time while the radiation treats the cancer.
• Prostate cancer - can be high-dose or low-dose brachytherapy.
• Skin cancer - typically uses a high-dose treatment that places the radioactive seeds next to the area that needs treatment. It may be used for patients whose skin cancer is in an area that can’t be removed easily with surgery.
• Breast cancer - typically performed after surgery for early-stage breast cancer to kill any remaining cancer cells.
• Rectal cancer - a tube is placed in the area allowing high-dose rate radiation to be delivered.
• Head and neck cancers - Because there are many delicate structures in the head and neck area, brachytherapy may be used to deliver radiation directly to the affected area.

When brachytherapy is recommended, it’s usually for patients whose cancer has not spread outside of its point of origin. That’s because internal radiation treats a very localized area of the body. Some patients will receive both internal radiation and external beam radiation therapy as part of the overall treatment plan.

Side Effects Associated With Brachytherapy

The side effects of brachytherapy can vary depending on the area being treated and the dosage received. Most side effects tend to improve after the radiation has left the body. However, some patients may experience delayed or long-term side effects. Possible side effects include:

• Fatigue
• Nausea and vomiting
• Difficulty urinating or pain when urinating especially if given in the pelvic area for men or women
• Erectile dysfunction for men
• Urinary incontinence
• Bowel issues, such as constipation or diarrhea

Additionally, patients may experience pain, tenderness, or swelling in the treatment area. It is important to discuss any potential side effects with your radiation oncologist to understand what to expect. 

Radiation Oncologists in Portland and Vancouver

When diagnosed with cancer you need a complete team of experts who will not only provide the most advanced treatment but also offer the care and concern that every patient needs as they go through cancer treatment. Radiation therapy is commonly included in the treatment plan, including brachytherapy. 

Our radiation oncologists work with our surgeons and medical oncologists to develop a plan that’s best for you. Our cancer centers are located throughout the Portland-Vancouver metro area, caring for patients throughout Northern Oregon and Southern Washington.