RADIATION ONCOLOGY OF
Brachytherapy
Brachytherapy, also commonly referred to as radiation implants, is a specialized type of radiation treatment where a radioactive particle is placed either directly into or in very close proximity to a cancer. Treatments can be delivered over a short period of time with a very strong radiation source (called High Dose Rate), or they can be delivered slowly over a much longer period of time with a lower strength radiation source (called Low Dose Rate). Radiation implants can also be delivered using a temporary procedure where we place a radioactive source that will be removed after a specific period of time, or a permanent procedure, where the radioactive source is placed and it will remain in your body forever.
Radiation implants are one of the most effective types of radiation treatment, but they are only appropriate for certain cancer types. The most common cancers treated with implants:
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Gynecologic cancers (ie, cervical, uterine, vaginal, and vulvar cancers)
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Prostate cancer
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Select recurrent cancers
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Skin cancer
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Sarcomas
What makes brachytherapy such an effective treatment option, is that when we place radioactive sources into or right next to a cancer, the highest dose of radiation is whatever is closest to that radiation particle. Also, most of the radioactive sources we use do not have the ability to deliver radiation beyond a few inches. So, implants allow us to deliver very high doses of radiation directly to a tumor, but more importantly a very low dose and in some cases zero radiation dose, to the normal parts of our body that are right next to it.
Common Implant Types:
Permanent Seed Brachytherapy
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Radioactive seeds are placed directly into a tumor.
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The seeds will stay forever, but will lose their strength over time.
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Sometimes requires a small surgery to place the seeds.
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Commonly used option for prostate cancer, some gynecologic cancers, and many other recurrent cancers.
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The success of this type of treatment depends highly on the experience of the physician providing it.
High Dose Rate Brachytherapy
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A single or series of catheters are placed into or very close to a cancer.
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The catheters are then connected to a computerized machine called an afterloader.
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A radioactive source is then placed in each of the catheters for a specified amount of time, and then everything is removed.
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Sometimes requires a small surgery to place the seeds.
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Commonly used option for most gynecologic cancers, breast cancer, and skin cancers.
Implantable Mesh Brachytherapy
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A specialized radiation that can be used in combination with surgery for select recurrent cancers in the abdomen.
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The mesh is coated on one side with radiation shields, and the other side with radioactive sources, so that it can deliver radiation primarily in one direction (this helps protect the bowel from any injury)
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A complex procedure aimed for people who have previously received radiation and have developed a reoccurence of their cancer
Low Dose Rate Brachytherapy
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Radiation is delivered slowly over several days to weeks
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This slower delivery can be advantageous since it is often better tolerated by our normal body tissues
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Ideal treatment option for re-irradiation, which we perform using permanent seed implants
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Previously used often for gynecologic implants, but this has fallen out of favor due to lack of proven benefit and reports of unnecessary side effects