How does the patient prepare for brachytherapy?

The patient will be advised by his or her doctor on specific preparations, which may include:

  • Blood tests
  • Imaging tests such as ultrasound, MRI, or CT scans
  • Electrocardiogram (EKG)
  • Chest X-rays
  • Bowel cleansing

These tests help determine what type of anesthesia will be used during brachytherapy, to plan the course of treatment, and to help ensure that computer images of cancerous tissue are precise and clear.

How is brachytherapy performed?

  • The patient usually receives either general or local anesthesia in an operating room, after which the radioactive substances are placed into body cavities or body tissues using plastic or metal catheters or needles. The doctor will likely use results of an imaging test to find the exact spot to place the catheter.
  • If the radioactive elements are to remain inside the body permanently, the catheters or needles are removed once the implants are set in place. The patient may be able to go home after the procedure is completed.
  • In temporary low-dose rate therapy, implants remain in place for hours, or as long as 1 to 7 days before being taken out. During this time, the patient is likely to be kept in a special hospital room in order to limit others’ exposure to radiation. While the implant is in place, time with visitors may be kept short.
  • In high-dose rate therapy, implants stay in place for a few minutes at a time while delivering a powerful dose of radiation, and are then taken out. The catheter used to deliver the implants may stay in place throughout the course of treatment or may be put in place before each session. Treatments may have to be repeated a number of times over the course of days or weeks, during which time the patient will need to either stay in the hospital or to make daily trips to the hospital.

Receiving brachytherapy is usually not painful, other than some discomfort or tenderness in the area where the applicator is inserted. Pain medications can be used to reduce this discomfort. Extra sleep or rest periods for several days after treatment may be necessary as the body recovers.

The type of implant received and the treatment schedule will depend on the form of cancer, where it is located, the patient’s overall health, and other treatments that have already been completed or will be needed in the future. For example, brachytherapy may be used alone or in combination with external radiation treatments, which will affect decisions on how each therapy is delivered.

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