Internal radiotherapy with radioactive metal (brachytherapy)
This page tells you about internal radiotherapy treatment with radioactive metals. There is information about
Internal radiotherapy is known as brachytherapy. There are many brachytherapy techniques used to treat different cancers. These split into 2 main categories; Low Dose Rate (LDR) or High Dose Rate (HDR) brachytherapy.
Brachytherapy uses specialised equipment which is placed as close to the tumour as possible. The equipment can stay inside you for a few minutes, a few days or forever. It depends on the type of treatment you have. You may have to stay overnight in the hospital or attend several outpatient appointments over a few weeks.
Brachytherapy can be given in combination with radiotherapy or by itself.
Each brachytherapy treatment is given using specialist applicators. Every treatment area uses specific applicators. There are different applicators for different areas to be treated. The doctor places the applicator either into or as close to the treatment area as possible.
Radioactive seeds are also used. They are placed in the tumour site and remain there forever as they can’t be removed afterwards. They are tiny and do not cause any problems.
For some brachytherapy procedures, overnight stays may be required until the treatment is completed. The applicators are inserted in the operating room. You either have a general anaesthetic or a spinal epidural (when you have no feeling from below your waist).
If you are coming in once or twice a week, you most likely won’t need an operating procedure. The applicators can be inserted in before you have an outpatient appointment and taken out after the treatment is finished. These are put in by your doctor or radiographer every time.
There are different types of brachytherapy machines. For the treatment, all the machines connect up to the applicators. A radioactive pellet travels out of the machine, into the applicators. While the treatment is happening, there is nothing to feel or to see.
Some machines are in your ward room. One type of machine gives a constant dose of radiation and can be turned off when you have visitors. Some hospitals use a pulsed dose brachytherapy machine (PDR Machines). Every hour or so, your nurse connects you to the PDR machine for your treatment. At other times you are free to have visitors.
A low dose rate treatment usually takes between 12 to 24 hours. This depends on how much external radiotherapy you have had.
You may be attached to a machine which the nurses control. Or you may have seeds inserted into the tumour. These seeds release radiation but after a few days you are not radioactive enough to harm others. When you are highly radioactive you have to be alone in a room with limited visitors.
High dose rate treatment machines give treatments over a shorter period of time. The treatment may last between 10 and 40 minutes.
You are taken into a specialist room and the applicators are connected to the brachytherapy machine. A radioactive pellet leaves the machine and travels into each applicator individually, releasing a dose of radiation. Once the applicators are disconnected from the machine, you are free to be around other people.
Once the radioactive applicators are removed, the radioactivity disappears. You can usually go home the same day, or the next day.
When you have radioactive seeds put into the tumour site, you may need to stay overnight before you can go home and be around other people.
Your doctor, specialist nurse or radiographer will advise you on aftercare and any side effects.
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