Internal Beam Radiation
What is internal radiation therapy?
Internal radiation therapy is a form of treatment where a source of radiation is put inside your body. One form of internal radiation therapy is called brachytherapy. In brachytherapy, the radiation source is a solid in the form of seeds, ribbons, or capsules, which are placed in your body in or near the cancer cells. This allows treatment with a high dose of radiation to a smaller part of your body. Internal radiation can also be in a liquid form. You receive liquid radiation by drinking it, by swallowing a pill, or through an IV. Liquid radiation travels throughout your body, seeking out and killing cancer cells. Brachytherapy may be used with people who have cancers of the head, neck, breast, uterus, cervix, prostate, gall bladder, esophagus, eye, and lung. Liquid forms of internal radiation are most often used with people who have thyroid cancer or non-Hodgkin's lymphoma. You may also get internal radiation along with other types of treatment, including external beam radiation, chemotherapy, or surgery.
What happens before my first internal radiation treatment?
You will have a 1- to 2-hour meeting with your doctor or nurse before you begin internal radiation therapy. At this time, you will have a physical exam, talk about your medical history, and maybe have imaging tests. Your doctor will discuss the type of internal radiation therapy that is best for you, its benefits and side effects, and ways you can care for yourself during and after treatment. You can then choose whether to have internal radiation therapy.
How is brachytherapy put in place?
Most brachytherapy is put in place through a catheter, which is a small, stretchy tube. Sometimes, it is put in place through a larger device called an applicator. When you decide to have brachytherapy, your doctor will place the catheter or applicator into the part of your body that will be treated.
What happens when the catheter or applicator is put in place?
You will most likely be in the hospital when your catheter or applicator is put in place. Here is what to expect:
- You will either be put to sleep or the area where the catheter or applicator goes will be numbed. This will help prevent pain when it is put in.
- Your doctor will place the catheter or applicator in your body.
- If you are awake, you may be asked to lie very still while the catheter or applicator is put in place. If you feel any discomfort, tell your doctor or nurse so he or she can give you medicine to help manage the pain.
What happens after the catheter or applicator is placed in my body?
Once your treatment plan is complete, radiation will be placed inside the catheter or applicator. The radiation source may be kept in place for a few minutes, many days, or the rest of your life. How long the radiation is in place depends on which type of brachytherapy you get, your type of cancer, where the cancer is in your body, your health, and other cancer treatments you have had.
What are the types of brachytherapy?
There are three types of brachytherapy:
- Low-dose rate (LDR) implants. In this type of brachytherapy, radiation stays in place for 1 to 7 days. You are likely to be in the hospital during this time. Once your treatment is finished, your doctor will remove the radiation sources and your catheter or applicator.
- High-dose rate (HDR) implants. In this type of brachytherapy, the radiation source is in place for 10 to 20 minutes at a time and then taken out. You may have treatment twice a day for 2 to 5 days or once a week for 2 to 5 weeks. The schedule depends on your type of cancer. During the course of treatment, your catheter or applicator may stay in place, or it may be put in place before each treatment. You may be in the hospital during this time, or you may make daily trips to the hospital to have the radiation source put in place. Like LDR implants, your doctor will remove your catheter or applicator once you have finished treatment.
- Permanent implants. After the radiation source is put in place, the catheter is removed. The implants always stay in your body, while the radiation gets weaker each day. You may need to limit your time around other people when the radiation is first put in place. Be extra careful not to spend time with children or pregnant women. As time goes by, almost all the radiation will go away, even though the implant stays in your body.
What happens while the radiation is in place?
- Your body will give off radiation once the radiation source is in place. With brachytherapy, your body fluids (urine, sweat, and saliva) will not give off radiation. With liquid radiation, your body fluids will give off radiation for a while.
- Your doctor or nurse will talk with you about safety measures that you need to take.
- If the radiation you receive is a very high dose, safety measures may include:
- Staying in a private hospital room to protect others from radiation coming from your body
- Being treated quickly by nurses and other hospital staff. They will provide all the care you need, but they may stand at a distance and talk with you from the doorway to your room.
- Your visitors will also need to follow safety measures, which may include:
- Not being allowed to visit when the radiation is first put in
- Needing to check with the hospital staff before they go to your room
- Keeping visits short (30 minutes or less each day). The length of visits depends on the type of radiation being used and the part of your body being treated.
- Standing by the doorway rather than going into your hospital room
- Not having visits from children younger than 18 and pregnant women
You may also need to follow safety measures once you leave the hospital, such as not spending much time with other people. Your doctor or nurse will talk with you about the safety measures you should follow when you go home.
What happens when the catheter is taken out after treatment with LDR or HDR implants?
- You will get medicine for pain before the catheter or applicator is removed.
- The area where the catheter or applicator was might be tender for a few months.
- There is no radiation in your body after the catheter or applicator is removed. It is safe for people to be near you - even young children and pregnant women.
- For 1 to 2 weeks, you may need to limit activities that take a lot of effort. Ask your doctor what kinds of activities are safe for you.
For ways to learn more about internal radiation therapy, see "Resources for Learning More".
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