Brachytherapy to treat cancer

Brachytherapy is a type of treatment for certain types of tumors. It is also known as internal radiotherapy.

It is based on Place radioactive material directly inside or very close to the tumor with the objective of administering a high dose of radiation to the affected area, at the same time minimizing the damage to the surrounding healthy tissues.

This allows you to eliminate tumor cells, getting a very localized and precise radiationbeing less invasive than other types of radiotherapy, such as external radiotherapy (radiation beams are administered from an exterior source of the body).

For what types of tumors are used?

Brachytherapy is used to treat different types of cancer, especially when they are located and accessible.

Among the most common are:

• Prostate cancer: It is one of the most frequent uses.

• Cervical cancer (cervix): especially in early or intermediate stages.

• Breast cancer: In some cases as a complementary treatment after conservative surgery.

• Endometrium cancer (uterus).

• Esophagus cancerbiliary route or bronchial tumors: palliatively or in combination with other therapies.

• Skin cancer, especially when surgery is not viable.

How is it done?

In brachytherapy sealed implants are introduced (Also called seeds, wires, capsules or tubes) that contain radioactive materials such as Iridio-192, Iodo-125 or Paladio-103. These implants are placed through applicators or catheters, with maximum precision through the use of image tests such as ultrasound, CT or magnetic resonance in order to ensure precise placement.

The treatment can be:

• Interstitial: The implant is placed directly in the tumor (for example, in prostate).
• Intracavitary: It is placed in a body cavity (uterus, vagina, straight).
• Superficial: To treat skin lesions.
• EPISCERAL: In contact with the eye to treat certain eye melanomas.

Brachytherapy can be applied in different ways, depending on the type of cancer and the location of the tumor:

High dose rate (HDR) brachytherapy

• It lasts a few minutes per session.
• It is applied in outpatient sessions or short hospitalization.
• A powerful source is used that is temporarily introduced by remote control.
• Very common In gynecological, breast and prostate cancers.

Low dose rate brachytherapy (LDR)

• It is left in the body 1 to 7 days.

• It requires hospitalization to avoid patient movement.

• It emits continuous radiation at low intensity.

• Indicated In tumors such as prostate, cervix and head/neck.

Brached brachytherapy (PDR)

• It emits radiation at regular intervals (pulses every hour).
• It requires prolonged hospitalization and protected rooms.
• Combines advantages of HDR and LDR, being Useful in complex tumors.

Permanent brachytherapy

Steps of the procedure

• Initial evaluation: Includes physical exam, analysis, image studies and dosimetric planning.
• Implant placement: It is performed under local anesthesia, sedation or general anesthesia, in the operating room or in a specialized room.
• Treatment administration:
  • In HDR, the source enters by remote control for minutes.
  • In LDR or PDR, it remains in the body for hours or days.
• Surveillance: The patient may be in isolation to protect other people (since he is a radioactivity issuer).
• Implant withdrawal: In the storms it is extracted at the end of the treatment. In the permanent, the seeds remain in the body, but cease to be active over time.

What are the risks and side effects?

Like any cancer treatment, with the administration of this treatment they may appear:

• Local effects: inflammationdiscomfort or bleeding in the treated area.

• Urinary or rectal problems (In prostate cancer).

• Vaginal or intestinal irritation (in gynecological cancers).

• Tiredness or general discomfortalthough they are usually lower than with external radiotherapy.

• Radiological risks: They are minimal, and security protocols are very controlled.

Treated area	Common effects
Head and neck	Changes of taste, dryness, oral pain, dysphonia
Mother	Edema, sensitivity, skin changes
Prostate and pelvis	Urinary or sexual difficulties, diarrhea, fatigue
Rescue	Mild, diarrhea bleeding, discomfort
Fur	Redness, peeling

Generally, the side effects are mostly temporary.

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What advantages does this treatment have?

• High precision and efficacy.

• Less sessions than conventional radiotherapy.

• Less affectation of healthy organs.

• Faster recovery in many cases.

• It can be used as the only treatment, surgery complement, or reinforcement after external radiotherapy.

What you should know …

• Brachytherapy is a form of internal radiotherapy that Enter radioactive material near or inside the tumorallowing a radiation located with the minimum damage to healthy tissues.

• It is used In various types of cancer (Prostate, cervix, breast, among others) and can be applied in different modalities according to dose, duration and location of the tumor.

• It is an effective and precise treatmentwith less side effects than external radiotherapy, and usually has a faster recovery.