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What Is Brachytherapy and How Is It Used in Cancer Treatment?

Brachytherapy is a type of internal radiation treatment used to treat cancer. Instead of sending radiation from outside the body, brachytherapy places small radioactive sources directly inside or very near a tumour. This lets doctors deliver a high dose of radiation precisely where it’s needed while reducing exposure to the surrounding healthy tissues.

Brachytherapy is commonly used for cancers of the prostate, cervix, uterus, breast, and sometimes head or neck, either alone or along with external beam radiation or other treatments. Patients may receive the radioactive sources for a short time or permanently, depending on the type and goal of treatment.

Purpose & Benefits of Brachytherapy

● Delivers focused radiation right to the tumour with less impact on nearby healthy tissues.

● Shorter treatment time compared with many external radiation schedules.

● Often fewer side effects since less normal tissue receives radiation.

● Can be used as a primary treatment or to boost the radiation dose after external beam therapy.

● May help shrink tumours and improve symptom control.

● Treatment sessions are usually short and outpatient in many cases.

Who May Need Brachytherapy?

Brachytherapy may be recommended for people who:

• Have early-stage prostate cancer as a main treatment or after surgery.
• Have cervical or uterine cancer as part of definitive therapy.
• Are treated for breast cancer after lumpectomy (to reduce recurrence).
• Have cancers that are difficult to reach or treat safely with external radiation only.
• Need radiation with less effect on quality of life or nearby structures like bladder and bowel.

Your radiation oncologist will review your medical history, scan results, and goals to decide if brachytherapy is suitable for you.

Types of Brachytherapy

1. Low-Dose-Rate (LDR) Brachytherapy

Radioactive seeds or pellets are placed in or near the tumour and remain there for hours to permanently release radiation slowly over time. This method is common for prostate and some gynaecological cancers.

2. High-Dose-Rate (HDR) Brachytherapy

A stronger radiation source is temporarily inserted into the tumour area for a few minutes per session and then removed. Multiple sessions are often scheduled over several days.

3. Pulsed-Dose-Rate (PDR) Brachytherapy

Radiation is delivered in periodic pulses, mimicking aspects of HDR but with different timing and dosing patterns. It’s used in select centres and cancer types.

Brachytherapy Procedure: Step-by-Step

1. Planning and Imaging: Before treatment, your care team uses CT, MRI, or ultrasound scans to map the exact tumour location and nearby organs.

2. Placement of Applicators or Seeds: For LDR, tiny radioactive seeds are placed into the target area. For HDR or PDR, tubes or applicators are positioned temporarily into or near the tumour.

3. Delivery of Radiation:

• LDR: Seeds remain in place and deliver radiation over time.
• HDR/PDR: A radiation source travels through the applicators for the planned duration, then is removed.

4. Monitoring and Support: Nurses and radiation therapists carefully monitor your comfort and positioning to help ensure treatment accuracy.

5. Completion and Follow-Up: After the session or seed placement, you may go home the same day. Follow-up visits check how you’re responding and manage any side effects.

The exact steps depend on the cancer type and the chosen brachytherapy method.

Recovery & Aftercare

After brachytherapy:

● You may have some localised discomfort near the treatment area, often mild and short-lived.

● Most people return to normal activities quickly, especially with outpatient HDR or PDR treatments.

● Your care team may recommend specific activity limits or hydration guidance, especially after prostate brachytherapy.

● Follow-up appointments help monitor tumour response and side effects.

Routine imaging and lab tests may be scheduled over months to years as part of long-term cancer care.

Risks & Possible Complications

Brachytherapy is generally well-tolerated, but some side effects can occur:

● Local irritation or discomfort at the implant site.

● Urinary symptoms such as frequency, urgency, or irritation (common with prostate treatments).

● Bowel changes such as diarrhoea or rectal irritation with pelvic treatments.

● Skin redness or tenderness near entry points with temporary applicators.

● Rarely, infection or bleeding at placement points.

● Radiation effects on nearby normal tissues, though reduced compared with external beam.

Your oncologist discusses specific risks based on your cancer type, dose, and health status.

Brachytherapy vs Other Radiation Treatments

● Brachytherapy vs External Beam Radiation: Brachytherapy delivers higher doses near the tumour with less exposure to surrounding tissues, while external beam directs radiation from outside the body, often in multiple sessions over weeks.

● Brachytherapy vs Surgery: Surgery removes cancer physically, while brachytherapy uses targeted radiation to destroy cancer cells without cutting tissue. The choice depends on cancer type, stage, and overall health.

● Brachytherapy vs Systemic Treatments: Systemic treatments (like chemotherapy) travel throughout the body, while brachytherapy focuses radiation locally. Sometimes they are used together for better control.

Your cancer care team helps weigh these options based on expected benefits and side effects.