Internal Radiation Therapy
What is internal
radiation therapy?
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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.
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What happens
before my first
internal radiation
treatment?
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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.
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How is
brachytherapy
put in place?
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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.
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What happens
when the catheter
or applicator is
put in place?
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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.
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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.
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Tell your doctor or nurse if you are in pain.
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What happens
after the catheter or
applicator is placed
in my body?
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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.
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What are the types
of brachytherapy?
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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.
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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.
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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.
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What happens
while the radiation
is in place?
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- 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.
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What happens
when the catheter
is taken out after
treatment with
LDR or HDR
implants?
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- You will get medicine for pain before the catheter or
applicator is removed.
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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.
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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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