Health & Wellness Resources: Provided by Allina Hospitals & Clinics

Internal Radiation Therapy

GENERAL INFORMATION:

What is internal radiation therapy?

Internal radiation therapy, also called brachytherapy, is a treatment which uses radiation to kill cancer cells. This treatment can make cancer tumors (lumps) stop growing, shrink, or go away. It may also help prevent cancer from spreading to other places in your body. Cancer is a condition where abnormal cells increase in number and get out of control. Cancer cells can grow quickly and form a tumor anywhere in your body. The tumor can pinch blood vessels which cuts off blood flow, and pinch nerves which causes numbness and pain. Pinched nerves and blood vessels can hurt your body organs and tissues. Cancer cells can break off from the tumor and travel through blood or lymph vessels. They can reach other parts of your body and grow into new tumors.
Brachytherapy can be used to treat tumors in your head, neck, chest, abdomen (stomach), and pelvic area. Brachytherapy may be used with other treatments such as external radiation therapy, medicines, and surgery. Having brachytherapy may decrease your signs and symptoms, and increase the years of your life.

How does brachytherapy work? During brachytherapy, radioactive seeds are placed inside and around your tumors. Seeds are small beads or bars which give off radiation (x-ray energy) in all directions around them. This radiation only reaches tumors and tissues that are close by. Cancer cells that get enough radiation may stop growing, and the cancer cells may die. Some seeds need to be taken out after a time, while others can be left inside your body. Brachytherapy may be given in several treatments. If so, you will be told when and how often to get the treatments. Seeds may be placed and then taken out at a later time. If so, caregivers will tell you how long you will need to have them in.

How is brachytherapy given?

Your caregiver may do a computed tomography (CT) scan, an magnetic resonance imaging (MRI), or x-rays. These tests are used to see the shape, size, and location of your tumor. There are different ways to get brachytherapy. The way that brachytherapy is given depends on many things, such as where the tumor or tumors are in your body. If your tumor is inside or near a body cavity, catheters (soft, hollow tubes) and brachytherapy seeds may be placed inside the body cavity. Body cavities are spaces in your body such as your esophagus (the tube that goes from your mouth to your stomach). If you are being treated for cancer in your airways, you may have a tube put into your nose that goes down into your airways. The brachytherapy seeds may be put in through the tube. Catheters may be placed in a female's vagina to treat tumors that are in her cervix or uterus.
Some tumors, such as those in a man's prostate gland, do not lie deep in the body. A special device may be used to push seeds through the skin into those tumors. For tumors in the breast, catheters can be placed around the tumor. One end of the catheter is put inside your body near the tumor. The other end sticks out your body, and has an opening at the tip. By using catheters, your caregiver can control how long the seeds stay inside your body. The catheters are left inside your body if you need to have several treatment sessions, and are taken out when your treatment is done.
You may need to have surgery to place the seeds or catheters in deep areas of your body that have tumors. Caregivers may do surgery to remove your tumor, and then place brachytherapy seeds or catheters in that area. You may need to have another surgery at a later date to remove the seeds.

What body areas with cancer tumors may be treated with brachytherapy? Cancer tumors in body areas can cause many problems. Brachytherapy may help relieve the problems caused by the tumors. Treatment may be done to the following body areas:

Cervix or uterus: Females who have tumors in the cervix or uterus may have problems getting pregnant. Tumors in this area can be painful.
Chest: You can have shortness of breath, or get pneumonia (lung infection) if a tumor is inside your lungs. You may cough a lot and cough up blood. Tumors in the breast can cause pain, and hurt nearby tissue.
Head and neck: You can have headaches, vomiting, and seizures (convulsions). You can have a hard time swallowing if the tumor is in your tongue. Tumors in your throat can make your voice very scratchy, or you may lose your voice.
Prostate gland: Tumors inside a man's prostate gland can cause pain and block the flow of urine. The tumor can also damage nerves near a man's penis and make it hard for him to get an erection. You may have trouble emptying your bladder completely, and feel that some urine is still left inside. Urine may leak out when you do not expect it, such as when you cough or while you sleep. You may also get more infections, which can hurt your kidneys.
Skin: Tumors on your skin can cause pain, and damage skin and other tissues nearby.
Stomach or bowels: Your organs can get swollen and painful, and may not work as they should. You can have problems getting nutrients from food, and you may get very weak. Tumors in your bowels can make it hard to pass stools.

What are the risks of having brachytherapy? Brachytherapy works best when tumors are smaller, and are not spreading quickly. Brachytherapy may not cure your cancer, but it may decrease your symptoms and help you live a longer life. The radiation given through brachytherapy kills cancer cells, but can also hurt normal cells. Most of the radiation is centered on the tumor. Some radiation also goes to tissues that are around the treatment area. These normal tissues can be hurt by the radiation. The following are some problems you may have when you get brachytherapy. The problems that you may have can depend on where in your body you are being treated with brachytherapy. Talk to your caregiver about the following:

Coughing up blood or blood in your sputum (spit).
Feeling very tired.
Higher than usual chance of getting urinary tract infections (UTI's).
Swelling and pain in organs or tissues that the radiation reaches. Organs such as your stomach or bowels may not work as well as before, or they may stop working.
Women may have trouble getting pregnant.

When should I call my caregiver? Call your caregiver if:

You have a fever.
You get sick (a cold or flu).
You cannot make it to your treatment on time.

When should I seek immediate help? Seek care immediately or call 911 if:

You get new or severe (very bad) pain in your stomach or pelvis, or feel faint or weak.
You have a seizure (convulsion).
You have chest pain, or sudden trouble breathing.
You suddenly have trouble remembering things.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

References and sources