Narayana Health Care

We all know that there are several types of cancers and various treatment techniques have been developed to cater to them. Brachytherapy is one such treatment that is effective yet minimally invasive. In this, a sealed radioactive material in the form of a seed, pallet, wire or capsule, is implanted using a needle/catheter, in or near the tumor inside the patient’s body.

Brachytherapy is a form of local treatment and is targeted to a specific body part. The benefit of this method is that the implant used for treatment allows a higher dose of radiation to a limited area. At times brachytherapy alone is used to cure cancer while in some cases it is used as a boost following external beam radiotherapy to destroy the remaining cancer cells.

Techniques of Brachytherapy?

Interstitial Brachytherapy: It is used for early breast cancer, head and neck cancer, prostate cancer, soft tissue sarcoma, etc. In this, the radiation source is placed within the tumor.

Intracavitary Brachytherapy: In this, the radiation source is placed inside a body cavity close to the tumor. For example, while treating cervical cancer, the radiation source is placed in the uterine cavity/vagina.

Intraluminal Brachytherapy: It is used in esophageal cancer/anal cancer. In this technique, the radiation source is placed inside a lumen viz. Esophagus.

Catheter/applicator can be placed inside the patient’s body for a few minutes, for some days or for the rest of the life. The duration is entirely based on the type and stage of cancer, the patient’s health, type of radiation source, any past or ongoing cancer treatment of the patient.

Types of Brachytherapy –

1. LDR (LOW DOSE RATE) implants: In this type, the radiation duration is not so long. Due to this, the patient remains in the hospital under supervision. The radiation source may be kept for 1 day to 7 days. After completion of the procedure, the catheter/applicator and the radiation source is removed from the patient’s body.
2. HDR (HIGH DOSE RATE) implants: As per the type of cancer, the duration of the treatment is divided into multiple sessions as the patient can be given ration under medical supervision from 10-15 minutes in 2-5 sessions, for a month or maybe more. Catheter/applicator and the radiation source is removed from the patient’s body after completion of every session or on the completion of the entire treatment process. For this, the patient either has to stay in the hospital or have to visit as per the doctor’s suggestion.
3. Permanent implants: Once the radiation source implants are put at the correct place of the patient’s body then the catheter gets removed. The patient carries the implant for the rest of his life but implants deteriorate day by day. The patient carrying permanent implants must keep himself away from the people who can be prone to radiation such as kids and pregnant women.

Side effects of Brachytherapy –

Certain side effects have been observed by this radiation therapy (depends on which part of the body is getting treated).

1. Swelling
2. Bleeding
3. Pain and Discomfort at the implant site
4. Urinary troubles (incontinence or pain while urinating)
5. Rectal bleeding
6. Diarrhea
7. Erectile dysfunction

Where Brachytherapy is used –

Most commonly Brachytherapy is used in the management of cervical cancer following external beam radiotherapy. Other common uses include prostate cancer, early breast cancer, soft tissue sarcoma, etc.

Dr. Sayan Das, Associate Consultant – Radiation Oncology, Narayana Superspeciality Hospital, Howrah