Internal radiotherapy for nasopharyngeal cancer
This page tells you about internal radiotherapy for nasopharyngeal cancer. You can find the following information
Internal radiotherapy for mouth or nasopharyngeal cancer
Internal radiotherapy isn't used as often as external radiotherapy for nasopharyngeal cancer. You are most likely to have internal radiotherapy if your cancer has come back after treatment.
Internal radiotherapy (brachytherapy) means the radiation source is inside your body. The radiation source is a metal substance that gives off the radiation. It may be positioned within the cancer or very near to it. This way, the tumour gets a high dose of radiation, without damaging the surrounding tissue.
Types of internal radiotherapy
The radioactive sources can be placed alongside the tumour (called intracavitary radiotherapy). Or radioactive implants can be put into the cancer and surrounding tissues (called interstitial radiotherapy).
With intracavitary radiotherapy you have a thin tube (a catheter) put into your mouth or up your nose. It has a radioactive source inside. The doctor leaves it in place for a few minutes. You usually have up to 6 treatments, with at least 2 days rest in between treatments. After each treatment you can go home.
For interstitial radiotherapy you have tubes or radioactive seeds put directly into your tumour. They stay in place for anything from a few minutes to a few days. Seed type implants are left in place permanently. The amount of radiation is very small and can only travel a short distance.
If you have internal radiotherapy there are certain safety precautions that you and anyone visiting you will need to take. There is more information about these in our main radiotherapy section.
You can view and print the quick guides for all the pages in the treating nasopharyngeal cancer section.
Internal radiotherapy (brachytherapy) means the radiation source is inside your body. The radiation source is a metal object that gives off the radiation. It may be positioned within the cancer or very near to it. This way, the tumour gets a high dose of radiation, without damaging the surrounding tissue.
Internal radiotherapy isn't used as often as external radiotherapy for nasopharyngeal cancer. You are most likely to have internal radiotherapy
- If your cancer has come back after earlier treatment with external beam radiotherapy
- As a booster dose at the end of a course of external radiotherapy
The benefits of using internal radiotherapy for nasopharyngeal cancers are
- Nearby structures such as the brain, spinal cord and eyes don’t receive high doses of radiation
- You can give high doses to tumours, that can’t be treated any more with external radiation (salvage brachytherapy)
Intracavitary radiotherapy delivers a high dose of radiation as close to the cancer as possible. Intracavitary means the treatment is placed in a cavity near the tumour. To reach a tumour in the nasopharynx, you have a thin tube (catheter) put into your mouth or up your nose. Your doctor uses an anaesthetic spray to numb your mouth, throat or nose. This makes it more comfortable when the catheter goes in.
The catheter is then connected to a brachytherapy machine, which contains a radioactive metal ball. The doctor leaves the room. The metal ball leaves the machine and travels into the catheter. It releases a dose of radiation. It lasts for a few minutes. Afterwards the doctor comes back in and detaches the catheter from the machine.
You usually have up to 6 treatments with at least 2 days rest in between treatments. After each treatment you can go home. If you have a long way to travel, your doctor may suggest you stay in during your treatment period.
For this procedure you are under a general anaesthetic. The doctor places a number of hollow, thin tubes directly into your tumour. To make sure they are in the right position you may have an X-ray.
The implants stay in place from a few minutes to a few days. If the implants are a booster treatment after external radiotherapy, they may stay in for 2 days. If the implants are your only treatment. they may stay in for between 3 to 5 days.
For the actual treatment, the radiographers connect the tubes to a brachytherapy machine. This machine contains a radioactive metal ball which travels out of the machine. It enters the tubes and releases high doses of radiotherapy directly to your tumour. You can have up to two treatments a day.
They do not last long but you have to be alone when you have the treatment. The radiographers watch you from outside the room during the treatment, on a closed circuit television screen.
You then have another general anaesthetic and have the tubes taken out. You are likely to feel sore for up to 2 or 3 weeks after you have had the implant removed.
Having implants in can be uncomfortable. They can make eating and talking difficult. You may need a soft or liquid diet while the implants are in place.
Radioactive implants are sometimes used to treat head and neck cancers. They are put into the cancer and surrounding tissues. They are small radioactive gold pellets, which are the size and shape of a grain of rice. Once the doctor has put them into the tumour, they stay there forever.
They contain a small level of radiation which eventually loses its strength over a few weeks. The radiation can only travel a short distance and the tumour gets nearly all the radiation dose, with very little effect of surrounding tissues and organs. It is not a risk to you or anyone around you.
The doctor places these pellets in the tumour when you are under a general anaesthetic. You have to stay on the ward in a isolated room for the first night following the procedure. This is because the radioactivity in the pellets is at its strongest and other people can't be exposed to the radiation.
Afterwards you are free to go home and your doctor usually calls you back after 6 weeks to have a CT scan. This is to check the pellets are still in place and haven't moved.
Your doctor also gives you a card to carry for a certain amount of time. The is to be shown to your dentist or any hospital staff when you have a procedure. Let your next of kin know about the card and procedure incase you end up in hospital, and are unable to give the information yourself. This is to alert the staff that you have these pellets in you, before you have any other procedure.
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