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Internal radiotherapy safety

Nurse and patients talking about cancer

This page tells you about the safety procedures you need to follow when you have internal radiotherapy. There is information about

 

Why safety procedures are needed

Hospitals follow particular safety guidelines while you have a radioactive implant in place. They also follow similar guidelines for a few days after you have treatment with a radioactive drink or injection. This is so that the hospital staff and your friends and family are not exposed to the radiation. Each hospital has slightly different routines but the same safety rules apply across the UK. 

You usually have an appointment in the radiotherapy unit or ward, or the nuclear medicine department, a few days before your internal radiotherapy treatment. The staff will explain the treatment to you. You can also ask the nurses, medical staff, or nuclear medicine practitioners any questions that you have. It may help to make a list of your questions so that you don't forget something important. Or you can print out the questions for your doctor and add your own questions to the list.

 

Effect of the radiotherapy on you

If you have a radioactive implant in your body, areas close to the implant get a high dose of radiation. But further away from the implant, the levels of radiation are low. The implant is put close to the tumour, or into the area where a tumour has been removed, so it gets a high dose of radiation. The rest of the body gets a much lower dose and it is normally not enough to harm you.

If you have a radioactive liquid, such as iodine, your urine, sweat or poo (faeces) give out a low amount of radiation for a few days. The radiation levels gradually fall as the radioactivity breaks down.

 

Safety procedures

When you are admitted to the ward the nurses and physicists will go over the radiation safety procedures with you. They include the following

  • You will probably be nursed in a special side room, away from the main ward for 1 or 2 days – you might be able to keep the door open if you like
  • You may be nursed on your own or with someone else having similar treatment
  • Lead screens may be put on either side of your bed to block any radiation from reaching visitors or hospital staff
  • The doctors and nurses looking after you will only stay in your room for short periods at a time
  • Staff will wear badges that monitor their exposure to radiation and make sure they keep to a safe level
  • Staff and visitors will be told to stay a little way away from your bed – the further away they are, the less exposure they have to the radiation
  • The nurses may use an instrument called a scintillation counter to monitor radiation levels in anything taken out of the room, such as bed linen (the faster the counter clicks, the more radiation there is)
  • You will only be allowed to have a limited number of visitors
  • Visitors will be asked to stay only a short time and may need to sit some distance away from you or talk to you from the doorway
  • Children under 16 and pregnant women are not allowed to visit
  • You will be able to bring books, magazines, some electronic devices, etc into the room
  • Your possessions may be monitored by the scintillation counter before you leave and the hospital may keep them for a few weeks until the radiation level is low enough
  • There should be a TV for you to watch
  • If you had a radioactive drink, your urine may be slightly radioactive for a few days – you may be asked to use the toilet sitting down and to wear gloves when you wipe yourself
  • After a radioactive drink, for a few days you may be asked to flush the toilet twice each time you use it.

These safety measures are only needed while your radioactive implant is in place or for a few days after treatment with a radioactive liquid.

There are one or two internal radiotherapy treatments that these precautions don't apply to, such as

  • Radioactive strontium
  • Radioactive phosphorus

You have these treatments as an outpatient because the radioactivity gets absorbed very quickly by the cancer cells in the body. Also, the type of radiation produced (beta particles or electrons) is quickly absorbed by normal body tissues, so people around you are not exposed to radiation.

 

Safety for visitors

The further away visitors and staff stand from you or your bed, the less radiation they are exposed to. This is because the levels of radiation fall very quickly as you move away from the radioactive source.

You may be able to have your door open so that people can stop and chat as they pass by. This depends on the type of treatment you have. Hopefully you won't feel too cut off during the few days you are having your treatment.

 

Your feelings about the precautions

The radiotherapy safety measures can add to the fears you may already have about your treatment. People are different in the way they handle their worries. Some find it easier to know everything about their treatment, while others like to know as little as possible.

If you would like explanations, the staff on the ward will be happy to talk to you. It often helps to bring your fears and worries into the open by talking to the staff or your family and friends.

 

After internal radiotherapy treatment

Some people worry that they will stay radioactive once the treatment has finished. They think they might be a danger to their family and friends. But if you have had a temporary radioactive implant, all the radiation disappears as soon as the implant is removed. You are then not a risk to anyone around you. 

If you have a permanent implant (with radioactive seeds) you may give off a low level of radioactivity for a few days after the seeds are put in. Your doctor or nurse will tell you about this. They will advise you on how to restrict your activity until the radiation cannot be detected outside the body. You may be asked to stay in hospital for a few days, or avoid close contact with pregnant women or children, or asked to avoid public transport. 

If you have had a liquid radiotherapy treatment it usually takes a few days for the radioactivity to fade away. The hospital staff will make sure that the radioactivity is at a safe level for your friends and family before you go home. After you leave hospital you may be given some safety steps to follow for a while when you get home, for instance if you will be in contact with children or pregnant women. The staff will explain these to you, but if you are worried or don't understand, do ask them to explain again.

The safety measures are there to protect you, your family and the hospital staff. If you would like more information about internal radiotherapy, contact the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday. They will be happy to help and answer any questions.

 

Coping with isolation

Being looked after in a single room can feel lonely. Some people find it frightening. It can help to talk to your nurses about your worries. They can reassure you.

For radioactivity using implants, taking in some of your personal things can make the room feel more homely. Books, photographs and an ornament or two can brighten it up. You can also take in a mobile phone, laptop, electronic tablet or music player to make the time pass more enjoyably.

For radiotherapy using radioactive liquids you will not be able to take many personal items into the treatment room. This is because the items may become contaminated with radioactivity from your sweat. Wards, nuclear medicine departments and radiotherapy departments have limited storage space for contaminated articles. So, personal effects are restricted to limit the number of items that need to be stored until the radioactivity has fallen to a safe level.

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Updated: 30 April 2014