All About Brachytherapy

Brachytherapy is a new, upcoming cancer treatment that many oncologists view as effective and efficient. Brachytherapy can be very successful for cancer patients who have lower stages of cancer, and who want a shorter overall treatment period. However,before a cancer patient decides to go through Brachytherapy, it is important for them to evaluate the benefits, drawbacks, and procedures that are involved with receiving Brachytherapy treatment.

What is Brachytherapy?

Brachytherapy is a type of cancer treatment that uses “seeds, ribbons, or capsules that contain a radiation source that are placed in [a specific] part of the body or near [a] tumor.”1 Brachytherapy is mostly used to treat cancers that do not spread very quickly, or mostly stay limited to one part of the body (such as eye cancer). Brachytherapy is most often performed by a radiation oncologist, because it requires expertise in handling the amounts of radiation that are being put into the body. There are five different types of Brachytherapy cancer treatments: some are based on the location of the radiation in the body, and some types are based on the dosage amount of the radiation.

Types of Brachytherapy (based on location of body part)

There are two types of Brachytherapy that are affected by the location of the body part (where the radiation is placed): intracavity brachytherapy and interstitial brachytherapy.

Intracavity brachytherapy involves placing radiation in a specific opening of the body (such as the windpipe). During the process of intracavitary brachytherapy, a tube or cylinder is often used to deliver the radiation into the opening of the body.

Interstitial brachytherapy is when radiation is placed in body tissue (such as the breasts). Some devices that are used to deliver interstitial radiation into the body tissue are wires, balloons, or tiny seeds. The process of interstitial brachytherapy often involves delivering radiation to the tissue by using needles or special applicators (such as catheters or other narrow tubes).

Types of Brachytherapy (based on dosage levels of radiation)

There are three types of Brachytherapy that are dependent on the amount of radiation that is placed in the body during treatment: Low Dose Rate (LDR) implants, High Dose Rate (HDR) implants, and Permanent implants.

Brachytherapy with LDR implants makes the radiation source stay in the body for a period of 1-7 days. During LDR Brachytherapy, the cancer patient is likely to be in the hospital during the 1-7 days of treatment, and is usually discharged once the radiation oncologist removes the radiation source from the body.

Through the course of Brachytherapy with HDR implants, the radiation source remains in the body for intervals of 10-20 minutes at a time, and then is taken out. The schedule of this type of Brachytherapy varies with the severity of the type of cancer that the patient has. For more severe cancers (for example), the treatment might have to be done twice a day for five consecutive days. With HDR Brachytherapy, the patient has a choice of staying in the hospital for the duration of the treatment, or to make routine visits to the hospital. The patient’s radiation oncologist will recommend which option is better for the patient’s treatment schedule.

Brachytherapy with permanent implants involves the radiation source being in a person’s body for the rest of their life. However, as time goes on, the radiation source gets weaker and weaker. Therefore, many recovered patients may have to make monthly (or sometimes yearly) hospital visits in order to replenish the radiation source in their body with new implants.

The Benefits of Brachytherapy

There are numerous benefits that come with choosing Brachytherapy as the cancer patient’s treatment. One obvious benefit is that there are a variety of Brachytherapy treatments to choose from. Each Brachytherapy treatment (HDR, LDR, intracavity, etc) can be modified to suit a patient’s schedule, needs, and progression of their cancer. Another benefit of Brachytherapy is that the recovery period is often quicker than other forms of cancer treatment (such as normal radiation therapy). A quick recovery period can be desirable for a cancer patient who wants to get back to their normal ways of life quickly (such as professional athletes).

The Drawbacks of Brachytherapy

Along with the numerous benefits, there are many drawbacks of Brachytherapy that need to be considered before a cancer patient chooses Brachytherapy as their main treatment. The only really important drawback of receiving Brachytherapy treatment is that it can have increased side effects (compared to receiving normal radiation therapy treatment).

Heavy, dangerous amounts of radiation can remain in the body after the treatment period is over, which causes the body to emit the radiation to the patient’s surrounding environment and the people around the patient. Due to this, recovered patients, who received Brachytherapy, are advised by their radiation oncologist to stay away from pregnant women and children for a minimum of 2-3 weeks.

Another side effect of Brachytherapy treatment is that most patients have increased bladder problems, such as having an increased urge to go to the restroom. Brachytherapy can also cause many other side effects (that are not mentioned already) such as increased chances of infertility.

Success Story of Brachytherapy

Hank Ebbeling, a prostate and lung cancer patient at Milford Regional Medical Center, underwent brachytherapy after his wife spent time researching it on the internet. When brachytherapy was performed Hank, not only did it eliminate his prostate cancer, but it also helped reduce the intensity of his lung cancer. Hank and his wife even commented that brachytherapy killed most of his cancer cells and had the least amount of impact on his body (as opposed to other cancer treatments that Hank had previously undergone, such as normal chemotherapy).

Before choosing Brachytherapy as their main treatment, patients should genuinely consider the benefits and drawbacks that come with Brachytherapy. Despite the increased chances of having severe side effects, Brachytherapy can ultimately be made to form so many permutations and combinations that can easily be tailored to suit any cancer patient’s desired route for treatment. That being said, Brachytherapy can be an excellent option for a cancer patient to choose in their cancer treatment.

Sources:

• https://www.mayoclinic.org/tests-procedures/brachytherapy/about/pac-20385159

• https://www.cancer.gov/about-cancer/treatment/types/radiation-therapy/brachytherapyBrachytherapy (1)

• https://www.macmillan.org.uk/cancer-information-and-support/treatments-and-drugs/brachytherapy-for-prostate-cancer

• https://www.milfordregional.org/social-media/patient-stories/cancer-care/prostate-brachytherapy-2/