Brachytherapy with Varian Bravos™

What Is Brachytherapy?

Brachytherapy, also known as internal radiation therapy, is a precise form of radiation therapy that treats cancer by placing radioactive sources directly into or near a tumor in an effort to kill cancer cells and destroy the tumor.

Types of Brachytherapy

There are three main techniques used to administer brachytherapy:

• High-Dose Rate (HDR) Brachytherapy
  High-dose rate brachytherapy involves temporarily placing a high-strength radioactive source in or near a tumor.
  HDR brachytherapy is usually performed on an outpatient basis (you won't need to stay overnight at the hospital). You will typically need one to five treatment sessions. The HDR technique is often used to treat gynecological, lung, breast, prostate, and head and neck cancers.
• Low-Dose Rate (LDR) Brachytherapy
  Low-dose rate brachytherapy, also called seed therapy, involves placing small (seed-sized) radioactive sources inside a tumor. The "seeds" release most of their radiation in the first three months, then their radiation levels gradually decrease so that they're practically inactive within nine months of implant. LDR is most commonly used to treat prostate cancer, but in rare instances it may be used to treat certain gynecological cancers as well.
• Pulsed-Dose Rate (PDR) Brachytherapy
  Pulsed-dose rate brachytherapy delivers short pulses of radiation (for example, once an hour) over a period of time, up to 24 hours. PDR is often used to treat gynecological and head and neck cancers.

Benefits of Brachytherapy

Unlike other forms of radiation therapy, which deliver radiation from outside the body, brachytherapy delivers radiation directly into the tumor. This enables you to receive a high dose of treatment with minimal impact on your surrounding healthy tissues.

Brachytherapy has proven to be highly effective at treating several types of cancer. Although individual experiences may vary, benefits can include:

• Less risk for complications. Since the radiation is targeted to the exact area in need of treatment, surrounding areas are left untouched.
• Fewer treatments needed. With certain cancers, brachytherapy requires fewer treatment sessions than external beam radiation treatment.
• Quicker recovery. In most cases, brachytherapy can be performed on an outpatient basis. This means you can go home immediately after treatment and many people find they can go back to their normal activities the same day.

What to Expect During Brachytherapy

You are a unique individual, and your treatment plan will be tailored to fit your specific needs. The descriptions below can give you an idea of what you can expect during different procedures, but your doctor will discuss in detail what you need to know to prepare for your brachytherapy.

What to Expect During High-Dose Rate (HDR) Brachytherapy

Your comfort is a top priority, and you can rest assured that our radiation team will take all necessary steps to minimize any possible discomfort. During HDR brachytherapy, your doctor uses a technique to direct a radioactive source directly into or near the tumor. Depending on the area being treated, you’ll receive some type of anesthesia (local, conscious sedation, spinal or general) before the applicator is placed. After the applicator is inserted, your care team will take images to help optimize treatment.

Once the applicators are set and the treatment plan is finalized, the applicators are connected to an "afterloader" machine that contains the radioactive source. Your medical team will leave the room to begin treatment.

The afterloader will deliver the radioactive source through the applicators for several minutes. Once complete, the source of radiation is returned to the afterloader — no radiation is left inside your body.

Most patients are able to leave immediately after their procedure and can return to their normal activities that same day.

What to Expect During Low-Dose Rate (LDR) Brachytherapy

LDR brachytherapy is most commonly used to treat prostate cancer and typically involves general anesthesia and a short hospital stay.

After taking all the necessary steps to minimize discomfort, your medical team places small radioactive "seeds" into the prostate. The seeds remain in the prostate and supply most of their radiation gradually over several weeks or months, depending on the type of seeds used. Within nine months, the radiation should be gone.

Since some radiation remains in your body with this type of treatment, your doctor will give you instructions about how to interact safely with those around you during the first few months after implant.

In rare instances, LDR may be used to treat some cases of gynecological cancer. This specific treatment technique involves placing radioactive sources into the cervix and uterus. After the procedure, you'll be asked to stay in the hospital for up to 30 to 40 hours. After that time, the sources are removed, and you can return home.