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What is Brachytherapy?

Brachytherapy, also known as internal radiation therapy, is a precise way to deliver radiation. It treats cancer by placing radioactive sources directly in or near a tumor to kill cancer cells and destroy the tumor. Although radiation with brachytherapy can help treat many different cancers, you should talk to your cancer care team to see if it’s best for your specific cancer.
 

Types of Brachytherapy

There are three main ways you may receive brachytherapy. Each type of brachytherapy differs based on how much and how often you receive radiation.

High-Dose Rate (HDR) Brachytherapy

High-dose rate brachytherapy involves placing a high-strength radioactive source in or near a tumor for a short time. We often use the HDR technique to treat gynecological cancer, lung cancer, breast cancer, prostate cancer, and head and neck cancers.

Low-Dose Rate (LDR) Brachytherapy

Low-dose rate brachytherapy, also called seed therapy, involves implanting small, seed-sized radioactive sources inside the tumor. The “seeds” release most of their radiation in the first three months, but their radiation levels decrease over time. They’re mostly inactive within nine months after the implant.

We often use the LDR technique to treat prostate cancer, but it can help certain gynecological cancers, too.

Pulsed-Dose Rate (PDR) Brachytherapy

Pulsed-dose rate brachytherapy delivers short pulses of radiation for a defined period. For example, you may receive a pulse of radiation once every hour for up to 24 hours. We often use the PDR technique to treat gynecological cancer and head and neck cancer.
 

Benefits of Brachytherapy

Brachytherapy has proven to be very effective at treating several types of cancer. Although each patient’s experience is unique, benefits can include:

  • Direct delivery: Brachytherapy delivers radiation directly into the tumor, unlike other types of external radiation that deliver treatment from outside the body (also called external beam radiation).
  • Lower risk of complication: Since radiation is targeted to a specific area, you can receive a high dose of treatment with less impact to surrounding healthy tissues.
  • Fewer treatment sessions: With some cancers, brachytherapy requires fewer treatment sessions than external beam radiation treatment.
  • Faster recovery: In most cases, after you receive outpatient brachytherapy, you go home right after treatment. Many people can even return to normal activities that same day.


What to Expect During Brachytherapy

Just like other cancer treatments, your brachytherapy treatment is unique to you. Your doctor and cancer care team will discuss in detail what you need to know to prepare for your brachytherapy appointments.

With any type of brachytherapy, know that your comfort is our top priority. Your radiation team works hard to reduce any possible discomfort, providing a warm environment and a private, comfortable room. Let them know what you need to improve your experience.

    During HDR brachytherapy, your doctor directs the radioactive source into or near the tumor. Here’s what you can expect:

    1. Receive anesthesia: The type of anesthesia you receive depends on the area that needs treatment. You may get conscious sedation or local, spinal or general anesthesia.
    2. Have applicator placed: An applicator is a device that helps deliver the radiation. Depending on your tumor location, the applicator may go inside a body cavity or tissue. Applicator placement usually happens in the hospital. 
      Take images: After your applicator is in place, your care team takes images of the tumor. These images help them finalize your treatment plan.
    3. Receive radioactive treatment: We connect the applicators to an “afterloader” machine at our Radiation Treatment Center. This machine contains the radioactive source. Your team leaves the room just before your treatment begins. Then, the afterloader delivers the radioactive source through the applicators for several minutes. Once complete, the radiation source returns to the afterloader, and no radiation stays in your body.

    With HDR brachytherapy, most patients can leave right after their procedure and return to normal activities the same day. You will likely need one to five treatment sessions total.

    During LDR brachytherapy for prostate cancer treatment, most patients have a short stay in the hospital. You can expect these steps:

    1. Receive general anesthesia: Your team gives you general anesthesia before the procedure.
    2. Have applicator placed: An applicator is a device that helps deliver the radiation. Depending on your tumor location, the applicator may go inside a body cavity or tissue. Applicator placement usually happens in an operating room.
    3. Receive radioactive “seeds”: Using the applicator, your team places small radioactive “seeds” into the prostate.
    4. Receive continuous radiation: The seeds stay in the prostate and supply most of their radiation gradually over several weeks or months, depending on the type of seeds we use. All radiation should leave your body within three to four months.

    Some radiation remains in your body with LDR brachytherapy. So, you will get instructions from your doctor about how to interact safely with others — especially during the first few months after implant.  
     
    In rare cases, LDR brachytherapy may help treat some types of gynecological cancer. For this cancer, we place radioactive sources into the cervix and uterus. After receiving the “seeds,” you must stay in the hospital for up to 30–40 hours. Then, we remove the “seeds,” and you can return home.

    During PDR brachytherapy, most patients have a short stay in the hospital. You can expect these steps:

    1. Receive general anesthesia: Your team gives you general anesthesia before the procedure.
    2. Have applicator placed: An applicator is a device that helps deliver the radiation. Depending on your tumor location, the applicator may go inside a body cavity or tissue. Applicator placement usually happens in an operating room.
    3. Receive radioactive “seeds” continuously: A machine sends radioactive “seeds” or pellets into the applicator for 10-15 minutes every hour. This radiation process may happen for a few days, and you may need to repeat it in a few weeks.

    Cancer Patient Stories

    Sometimes, it helps to learn from others who’ve had cancer. Read and watch stories from cancer patients who share their experiences with diagnosis, treatment and recovery.

    Radiation Treatment Helps Tom Overcome Prostate Cancer

    When Tom’s biopsies came back positive for prostate cancer, he never thought treatment would be easy. But after a combination of radioactive seeds and six weeks of radiation treatment, he has never felt better.

    Read Tom’s Story