Brachytherapy is a minimally invasive form of radiation therapy for cancer. Unlike conventional radiation therapy, the radiation sources are placed directly inside the body, allowing them to destroy tumor cells at close range.
Here you will find further information as well as a selection of brachytherapy specialists and centers.
Brachytherapy is a gentle form of radiation therapy with few side effects. It is used to treat cancer at specialized clinics.
In brachytherapy, tiny radiation sources are placed directly into the tumor. There are two possible procedures that can be used for this:
- afterloading, which uses a radiation source attached to the tip of small wires, or
- seed implantation, in which radioactive material is embedded in tiny metal pins (seeds).
Due to its proximity to the tumor, the high-energy radiation damages and kills the cancer cells. At the same time, healthy tissue is largely spared.
“Brachy” comes from Greek and means “short.” The term refers to the fact that the radiation source is located in the immediate vicinity (at a short distance) of the tumor. Brachytherapy is therefore also known as
- internal radiation therapy,
- short-distance radiation therapy,
- contact irradiation, or
- close-range radiation therapy
.
Watch the video to see the treatment process:
What procedures are used in brachytherapy?
The two basic procedures are afterloading and seed implantation.
In afterloading, catheters, hollow tubes, or hollow needles are first placed in the area to be treated. Point-shaped radiation sources are then inserted from an afterloading device under computer control. After irradiation, the radiation sources are retrieved back into the afterloading device, and the tubes are removed.
In seed implantation, radioactive metal seeds are inserted into the affected organ using hollow needles under ultrasound guidance. The seeds generally remain in place permanently.
In intracavitary brachytherapy, the radiation source is inserted into a natural body cavity using an applicator. After irradiation, it is removed again.
In surface brachytherapy (contact therapy), the radiation source is also placed directly on the tumor to be treated—such as in cases of skin cancer or choroidal melanoma—but only temporarily.
For which diseases is brachytherapy used?
Small or locally advanced tumors, in particular, can be treated with internal radiation therapy. Metastases, on the other hand, are not suitable for this type of internal radiation therapy.
Specialists in brachytherapy successfully use this treatment approach for various tumors.
- Brachytherapy for breast cancer: The afterloading procedure has now become an important breast-conserving treatment for breast cancer.
- Brachytherapy for prostate cancer: In prostate cancer, approximately 30 to 50 brachytherapy seeds are implanted into the prostate, where they remain for life. However, the radioactive radiation decays over time.
- Brachytherapy for cervical cancer: The radiation source is inserted into the uterine cavity using an applicator.
- Brachytherapy for skin cancer: In skin cancer, the radiation source is placed externally but directly on the tumor.
- Brachytherapy in the eye: Contact therapy is also used for tumors of 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 technique.
Advantages of brachytherapy
Because the radiation source is so close to the tumor, brachytherapy is a gentle cancer treatment with few side effects. Direct irradiation of the tumor spares the surrounding organs as much as possible. This reduces the risk of radiation-related damage compared to external beam radiation therapy.
Side effects are minimized compared to surgical treatment or chemotherapy or hormone therapy.
Depending on the tumor, brachytherapy can also be performed on an inpatient or outpatient basis at clinics specializing in brachytherapy. No general anesthesia is required, or only a brief period of it is needed.
Additional advantages include
- significantly shorter hospital stays,
- fewer scars, and
- a reduced risk of surgery-related infection.
In conventional radiation therapy, the body is treated from the outside with radioactive rays—which increases the risk of complications © Mark Kostich | AdobeStock
How does treatment with brachytherapy work?
Seed implantation can be performed on an outpatient basis. However, pain management is required for the procedure and to verify the correct placement of the seeds. This is usually easier to organize during a hospital stay. Therefore, seed implantation is often performed as part of a short inpatient stay.
The placement and removal of the delivery channels during afterloading are also performed under short-term anesthesia.
Patients should avoid very close physical contact with pregnant women or children during the first few days after seed implantation.
What side effects can be expected with brachytherapy?
Depending on the tumor’s location and the type of internal radiation therapy, the following side effects may occur immediately after treatment, for example:
- swelling,
- bleeding,
- discharge,
- urinary retention,
- urinary incontinence, or
- pain when urinating
may occur.
In rare cases, long-term complications may include
- urinary and digestive problems,
- erectile dysfunction, or
- scarring
may occur.
Which specialists and specialized clinics perform brachytherapy?
Specialists in brachytherapy are typically medical specialists in radiation therapy/radio-oncology or radiology. They often work as part of an interdisciplinary team with, for example, medical specialists in oncology at specialized clinics for brachytherapy.
