Brachytherapy is a type of radiation therapy. It involves placing radioactive material inside or near a tumor to destroy cancer cells. The procedure has some benefits over other radiation techniques but comes with some risks, too.

Brachytherapy is an internal radiation therapy for treating some types of cancer. It involves placing radioactive material, usually in the form of seeds, pellets, ribbons, or wires, inside or next to a tumor. The radioactive source emits high frequency waves that damage the DNA of the cancer cells.

Doctors sometimes use brachytherapy as the primary treatment for cancer. They may also use it after surgery or external radiation therapy to destroy any cancer cells that may have been left behind.

Though it’s a safe and usually painless procedure, you may need to stay in a hospital and away from other people during your treatment period.

Doctors typically use brachytherapy for small, early stage cancers that haven’t spread to other parts of the body.

Whether brachytherapy may be a suitable option for you depends on the type of cancer and how well you may be able to tolerate certain side effects.

Cancers that may benefit from brachytherapy

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Brachytherapy can be temporary or permanent.

Temporary brachytherapy involves placing radioactive material inside a catheter, which is removed after a short period.

Permanent brachytherapy involves placing radioactive seeds inside or near the tumor. The seeds lose their radioactivity over several weeks or months. After they become inactive, they remain in the body permanently.

Brachytherapy takes place inside an operating room using special precautions to contain the radiation. In general, the procedure is as follows:

  1. You may receive general anesthesia to put you to sleep or local anesthesia to numb the implant site.
  2. A doctor places a catheter or applicator into your body.
  3. The doctor places the radiation source inside the catheter or applicator.
  4. The radiation source remains there for a few minutes, a few days, or permanently.
  5. You may have to stay in the hospital for a few hours or overnight.

Brachytherapy is generally a safe procedure, but side effects may occur.

In brachytherapy, the radiation source is enclosed within a nonradioactive metallic capsule to prevent the material from moving to other parts of your body. There’s a very small risk that some seeds could migrate to other parts of the body, like the lungs.

Possible side effects depend on where the radiation is implanted. Some side effects may include:

  • bowel problems, such as:
  • urinary problems, such as:
  • erectile dysfunction
  • fertility issues
  • fatigue
  • skin irritation
  • increased risk of bone fractures

Smoking can increase radiation side effects.

Your doctor will give you instructions to follow before your procedure.

Medications to stop

If you take blood thinners, ask your doctor about stopping or modifying your medications before the procedure.

Your doctor may ask you to stop taking medications that thin the blood before your treatment. This may include fish oil supplements or nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin.

Medications to take

Your doctor may prescribe antibiotics to prevent infection.

For brachytherapy to the prostate, your doctor may also prescribe a medication to increase and improve the flow of urine. Follow your doctor’s instructions for taking these medications before and after your procedure.

Bowel preparation

You may need to empty your bowels starting 2 days before the procedure. Follow the instructions from your doctor.

Drinking plenty of water can help flush out the bowels, but it’s usually best to avoid drinking fluids after midnight on the day of your procedure.

You won’t usually need anesthesia to remove a temporary implant. The treated area may be sore, but most people can return to regular activities within a few days.

You may have some pain or swelling in the area for about 1 week after treatment.

For a permanent implant, the implant stays in place even after the radiation runs out. For a few months, you may need to avoid being near some people, such as pregnant people and small children, because the radiation may affect them.

You’ll have follow-up visits with your doctor to check the status of the cancer and monitor your healing.

Contact your doctor if you develop a fever or severe pain after the procedure. Also let your doctor know if you notice any increases in the following near the implant site:

  • redness
  • swelling
  • warmth
  • hardness

Brachytherapy allows your doctor to administer higher doses of radiation to your tumor while minimizing damage to your surrounding organs.

The effectiveness of brachytherapy varies by cancer site. According to a 2022 review, studies show brachytherapy to be as effective as external beam radiation therapy (EBRT) and surgery for many cancers.

It’s more effective if your cancer has not spread, or metastasized, in the body.

Pros of brachytherapy

  • allows your doctor to administer higher doses of radiation than external beam radiation therapy (EBRT)
  • minimizes damage to surrounding organs
  • usually causes fewer side effects than EBRT
  • shorter treatment time than EBRT

Cons of brachytherapy

  • may increase the risk of urinary side effects
  • may need to remain in the hospital during the treatment period
  • may need to avoid pregnant people and small children for up to 2 months
  • can only be used in cancers with easy access to the tumors
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Here are answers to some frequently asked questions about brachytherapy.

How long does it take to recover from brachytherapy?

You most likely won’t have any pain during the implant procedure. However, the anesthesia may make you feel drowsy, weak, or sick to your stomach.

You can resume regular activities when you feel you’re able to, but you may feel tired for a few weeks.

You may also experience temporary side effects, like swelling, pain, or discomfort, at the spot where the radiation was delivered.

Is brachytherapy a one-time treatment?

Healthcare professionals usually deliver brachytherapy over multiple treatment sessions over a few days or once a day over a few weeks.

Do you have to stay away from people after brachytherapy?

If you’ve had permanent brachytherapy, you should stay away from pregnant people and small children for as long as the seeds are giving off radiation. This may be from several weeks to months.

You don’t have to avoid people if you’ve had temporary brachytherapy.

Can you have both brachytherapy and external beam radiation?

Yes, you can have both brachytherapy and EBRT as part of your cancer treatment.

Your doctor may decide to use EBRT after brachytherapy to destroy any cancer cells that may have been left behind if there’s a higher risk your cancer may spread.

Brachytherapy is usually a painless procedure with several advantages over external beam radiation therapy (EBRT), another cancer treatment.

Depending on your type of cancer and treatment plan, you might get a temporary or permanent implant. Talk with your doctor about the risks and benefits of using brachytherapy to treat your cancer.