Brachytherapy is a type of radiation therapy used to treat many types of cancer, such as cervical, prostate, breast and skin cancer. It involves placing radioactive material directly inside or next to the tumor being treated. Brachytherapy delivers a higher dose of radiation to the tumor while minimizing the radiation exposure to surrounding healthy tissues. This makes it an effective treatment option for many cancers with fewer side effects compared to other radiotherapy techniques.
What is Brachytherapy?
Brachytherapy, also known as internal radiation therapy, refers to a cancer treatment technique in which sealed radioactive sources are placed inside or next to the tumor. The radioactive sources are encapsulated in small seeds, capsules, wires or catheters which are surgically implanted near the tumor site. This allows precise delivery of radiation directly to the tumor at close range through interstitial, intracavitary or surface application.
Some Common Types of Brachytherapy
There are different types of brachytherapy based on the method of application:
- Interstitial brachytherapy: In this type, thin flexible plastic tubes called applicators are surgically placed into the tumor or surrounding tissue through tiny incisions. Then, small radioactive seeds are placed inside the applicators directly into the tumor site. This technique is commonly used to treat prostate, breast and brain cancers.
- Intracavitary brachytherapy: In this method, a special applicator placed in a body cavity such as the vagina, uterus or esophagus. Radioactive sources are loaded into the applicator to deliver radiation to tumors in these cavities for treating cancers of cervix, uterus, esophagus etc.
- Surface brachytherapy: In this technique, radioactive sources are placed as seeds, wires or applicators on the skin or body surface near superficial tumors for their treatment. Cancers treated this way include skin cancer, breast cancer and eye cancer.
- Temporary and permanent brachytherapy: Brachytherapy can be temporary where radioactive sources are placed for a specified time period and then removed. Or it can be permanent by leaving radioactive seeds, permanently implanted, in the tumor site to continue delivering radiation.
Advantages of Brachytherapy
Some of the key advantages of brachytherapy include:
- High radiation dose to tumor: With radioactive sources in close proximity of the tumor, brachytherapy can deliver a very high dose of radiation precisely to the tumor tissues while sparing surrounding healthy tissues.
- Fewer side effects: Compared to external beam radiotherapy, brachytherapy lowers damage to surrounding healthy tissues and critical organs. This results in fewer short-term and long-term side effects.
- Shorter treatment time: Brachytherapy treatment sessions are usually performed over a few minutes, hours or days versus several weeks in case of external beam radiation. This reduces interruption to daily lives of patients.
- Retains treatment options: Brachytherapy provides another treatment option to boost tumor response either alone or alongside chemotherapy or external beam radiation. This retains treatment flexibility in multidisciplinary cancer care.
Brachytherapy Procedures and Applications
Here is a overview of procedures and clinical applications of some common brachytherapy techniques:
Cervical Cancer Brachytherapy
Applicators are placed in the vagina and uterus to deliver internal radiation directly to the cervix and surrounding tissues over several fractions. It can be used alone or with external beam radiation for localized cervical cancers.
Prostate Cancer Brachytherapy
Radioactive seeds are permanently implanted in the prostate gland through needle insertion via transrectal or transperineal route. This is an effective option for low-risk prostate cancer in combination with external radiation or surgery.
Skin Cancer Brachytherapy
Radioactive sources are placed on the skin as seeds, wires, or surface molds near superficial tumors for a short treatment time and quick recovery. It is well-suited for basal cell and squamous cell skin cancers.
Breast Brachytherapy
Catheters or single entry applicators are surgically placed into the tumor cavity following lumpectomy. Radioactive sources delivered through these applicators provide radiation boost to minimize chances of recurrence. Used together with whole breast external beam radiation.
Applications for other cancer sites include intra-operative radiation for brain cancer, esophageal brachytherapy for esophageal cancer and nasopharyngeal brachytherapy for nasal cancers. Ongoing research also explores various advanced brachytherapy techniques and applications in modern radiation oncology practices.
In summary, brachytherapy is an important component of radiation oncology that allows delivery of high-dose radiation precisely to cancer tumors with good control of treatment volumes. Developing over past decades, it is now well-established as an effective treatment option either alone or in combination with other therapies for numerous cancer types. Its ability to reduce side effects while retaining treatment efficacy makes brachytherapy a valuable treatment modality for many cancer patients.
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