Brachytherapy is a gentle form of radiotherapy with few side effects. It is used to treat cancer at appropriately specialized clinics.
In brachytherapy, tiny radiation sources are introduced directly into the tumor. There are two possible procedures that can be used here:
- afterloading with a radiation source at the tip of small wires, or
- seed implantation, in which radioactive material is enriched in tiny metal pins (seeds).
The high-energy radiation damages and kills the cancer cells due to the close proximity to the tumor. At the same time, the healthy tissue is largely spared.
"Brachy" comes from the Greek and stands for "short". The term refers to the fact that the radiation source is located in the immediate vicinity (short distance) of the tumor. Brachytherapy is therefore also known as
- internal radiation therapy,
- short-distance radiotherapy,
- contact radiation or
- proximity irradiation
radiation.
Watch the treatment procedure in the video:
The two basic procedures are afterloading and seed implantation.
In afterloading, tubes, hollow tubes or hollow needles are first inserted into the area to be treated. Computer-controlled punctiform radiation sources are then introduced from an afterloading device. After irradiation, the radiation sources are returned to the afterloading device and the inserted tubes are removed.
During seed implantation , the radioactive metal pins are inserted into the affected organ using hollow needles under ultrasound guidance. The pins usually remain there permanently.
In intracavitary brachytherapy, the radiation source is inserted into a natural body cavity using an applicator. It is removed again after the radiation treatment.
In surface brachytherapy (contact therapy), the radiation source is also only temporarily placed directly on the tumor to be irradiated, e.g. in the case of skin cancer or uveal melanoma.
Small or locally advanced tumors in particular can be treated with internal radiation therapy. Metastases, on the other hand, are not suitable for internal radiotherapy.
Brachytherapy specialists use this therapy concept successfully in the treatment of various tumors.
- Brachytherapy for breast cancer: The afterloading procedure has now become an important breast-conserving form of treatment for breast cancer.
- Brachytherapy for prostate cancer: In the case of prostate cancer, around 30 to 50 brachytherapy seeds are inserted into the prostate, where they remain for the rest of the patient's life. However, the radioactive radiation wears off after some time.
- Brachytherapy for cervical cancer: The radiation source is inserted into the uterine cavity using an applicator.
- Brachytherapy for skin cancer: In the case of skin cancer, the radiation source is placed externally, but directly on the tumor.
- Brachytherapy in the eye: Contact therapy is also used for tumors in the eye (e.g. choroidal melanoma).
- Brachytherapy for colorectal cancer: The radiation source is placed in the intestinal lumen next to the tumor using the afterloading method.
Brachytherapy is a gentle cancer treatment with few side effects due to the close proximity of the radiation source to the tumor. The direct irradiation of the tumor means that the surrounding organs are spared as far as possible. This means that the risk of radiation-related damage is lower compared to external radiation.
The side effects are minimized compared to surgical treatment or chemotherapy or hormone therapy.
Depending on the tumor, brachytherapy is also possible both as an inpatient and outpatient treatment at brachytherapy clinics. No or only a short general anesthetic is required.
Further advantages are
- Significantly shorter hospital stays,
- fewer scars and
- a reduced risk of infection due to the operation.
In normal radiotherapy, the body is treated from the outside with radioactive rays - this increases the risk of complications © Mark Kostich | AdobeStock
Seed implantation can be carried out on an outpatient basis. However, pain therapy is required for the procedure and to check the correct position of the seeds. This is usually easier to organize during a hospital stay. For this reason, seed implantation is often performed during a short inpatient stay.
The placement and removal of the guide channels for afterloading are also performed under short anesthesia.
Patients should avoid very close physical contact with pregnant women or children in the first few days after seed implantation.
Depending on the location of the tumor and the type of internal radiotherapy, immediately after treatment you may experience, for example
may occur.
In rare cases, late effects may include
may occur.
Specialists in brachytherapy are usually specialists in radiotherapy/radiation oncology or radiology. They often work in an interdisciplinary team with, for example, oncology specialists at specialized brachytherapy clinics.