Brachytherapy

Cancer treatment entails the application of brachytherapy, a technique through which radiation therapy comes close to the patient’s tumor. The method does not involve subjecting the entire human body to radiation; rather, it is about accurate implantation of minute radiation sources such as seeds, capsules, and ribbons inside or near the neoplasia. This makes it possible to deliver a treatment that is directed to only that part of the body where it is most needed.

Indications of Brachytherapy

Brachytherapy is used in conjunction with radiotherapy to boost the treatment. Below are the conditions under which brachytherapy is commonly used.

Prostate Cancer: Brachytherapy is commonly used to treat localized prostate. It works by placing radioactive seeds straight into the prostate gland for the purpose of focusing radiation onto the tumor. Using brachytherapy spares the healthy tissues from minimizing too much radiation exposure as the higher concentration of therapy focuses on the tumor.

Gynecological Cancers: Gynecological cancers are a group of cancers like cervical, vaginal and uterine cancer, where brachytherapy is usually used. [HTML] In this form of therapy radioactive sources such as applicators or specialized devices are introduced into the tumor or neighboring areas. Instead of hitting nearby normal tissues this method allows for the exact delivery of radiation to the sick part only.

Breast Cancer: For some selected cases of breast cancer, brachytherapy might be used as a method for partial breast irradiation. In this instance, a radioactive source is put directly inside the surgical cavity or within a balloon-type catheter inserted in the breast tissue. This technique makes sure that radiation focuses on the zone with the highest chances of reoccurrence while causing minimal damage to healthy tissues of the breast.

Head and Neck Cancers: Some head and neck cancer cases such as oral cavity tumors among others can use Brachytherapy as their treatment modality. The process involves inserting radioactive sources also known as applicators directly into the tumor or neighboring tissues [HTML]. This type of treatment helps deliver high-dose radiation to the localized area, hence saving non-targeted organs such as salivary glands.

Skin Cancer: Certain forms of skin cancer, such as squamous cell carcinoma can use brachytherapy in treatment. Radiotracer sources are positioned directly on or into the affected area. In order to reduce exposure to healthy tissues, brachytherapy provides targeted radiation to cancer cells in the skin.

Eye Melanoma: For the treatment of uveal melanoma, which is an eye cancer that affects the choroid, ciliary body and iris, brachytherapy is widely used. A radioactive plaque or source is placed near the tumor, either at one eye’s surface or inside it directly. It focuses on the tumor while minimizing injury to other healthy eye structures.

Team involved in Brachytherapy.

As Brachytherapy is a in-patient procedure the treatment requires collaboration with various medical experts. These include radiation oncologist, radiation therapist, medical physicist, dosimetrist, nurse and a surgeon or anesthesiologist (whenever required).

Types of Brachytherapy

There are three main types of brachytherapy:

Low-dose rate (LDR) implants: LDR is brachytherapy that involves keeping radiation sources within the body for an extended duration, often ranging from up to seven days. Admittance into a hospital is usually done during such a period. After therapy, the sources of radiation, as well as the catheter or applicator, are usually removed by the healthcare providers.

High-dose rate (HDR) implants: The doctor inserts a high intensity radiation source temporarily in a patient during HDR brachytherapy process which lasts between 10 to 20 minutes at any given session. The treatment can be administered several times daily over 2 to 5 days or alternatively once a week for 2 to 5 weeks based on specific cancer type. Between treatments, the catheter or applicator can remain in the same place or be inserted beforehand in each session. 

Permanent implants: In the case of permanent brachytherapy, radiation sources such as seeds or capsules are used and they get implanted alongside tumor, in a manner that they will always remain within or near the body. With time the sources of radiation reduce and become inactive. Initially there is need to ensure that nobody else is exposed to the radiation especially children and pregnant women while subsequent play backs are characterized by less risk as the radiation becomes weaker allowing resumption back to normal activities.

It should also be pointed out here that the specific form of brachytherapy depends on different factors that are brought about by the nature and location of cancer disease process, treatment objectives and status of a patient. Consequently, the decision to use one technique against another is made by a doctor involving a team of radiotherapists after considering the prevailing individual situations and treatment specifics.

Materials used for Brachytherapy

Depending on the type of treatment, suitable radioactive material such as iodine, palladium, cesium is used. These materials are encapsulated with a non-radio metallic capsule which is called seed. This enclosure makes the radiation source stationary when placed into the patient’s body.

Using a delivery mechanism, the radioactive seeds are directly inserted into the tumor. This procedure is utilized for permanent implants.

Needles, catheters, or specialized applicators are used for temporary implantation. The radiation sources are added once the precise position of the device has been verified which is referred to as "after loading." The radiation oncologist may place the delivery device and then manually insert and remove the material. Alternatively, the oncologist could insert the material using a computer-controlled remote after loading device. 

Procedure:

Before the procedure, one may receive an IV line for anesthesia to keep you sleeping or sedated. Depending upon the procedure, the patient may go home or stay at the hospital.

During temporary brachytherapy, one may hear clicking sounds as the machine delivers radioactive material to the site of the tumor. The patient is given the opportunity to communicate with the medical team via a microphone. Sometimes visitors are allowed during some treatments.

Some treatments require hospitalization and may cause some discomfort due to catheters or applicators. You will receive medication to control pain.

After Treatment

You may need to limit close contact if you have permanent brachytherapy. With temporary implants, all the radioactive material is removed before going home.

You will be given individualized home care instructions. Most people can return to their normal routines soon. However, there may be some long-term side effects to deal with. Follow-up exams will help monitor your progress and answer your concerns.

Conclusion

To achieve successful brachytherapy, a smooth collaboration between interprofessional medical teams is crucial. Brachytherapy plays a key role in ensuring that the patient receives a low dose of radioactive material if it is administered with the utmost care and coordination.

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