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Your doctor may decide that very intense radiation given
to a small area of your body is the best way to treat your
cancer. Internal radiation therapy places the source of the
high-energy rays as close as possible to the cancer cells
so that fewer normal cells are exposed to radiation. By using
internal radiation therapy, the doctor can give a higher
total dose of radiation in a shorter time than is possible
with external treatment. Instead of using a large radiation
machine, the radioactive material is placed directly into
(or as close as possible to) the affected area. Some of the
radioactive substances used for internal radiation treatment
include radium, cesium, iridium, iodine, phosphorus, and
palladium.
Internal radiation therapy often is used for cancers of
the head and neck, breast, uterus, thyroid, cervix, and prostate.
Your doctor may recommend a combination of internal and external
radiation therapy.
Implant radiation means internal radiation treatment.
You also may hear the terms interstitial radiation, intracavitary
radiation, or brachytherapy; each is a form of internal radiation
therapy. Some people use the term "brachytherapy" whenever
they are talking about any form of internal radiation therapy.When
interstitial radiation is given, the radiation source is
placed right in the affected tissue, usually in small tubes
or containers. These implants may be temporary or permanent.
When intracavitary radiation is used, a container of radioactive
material is placed in a cavity of the body such as the uterus.
In brachytherapy, the radioactive source, which is sealed
in a small container, is placed on the surface of the body
near the tumor or a short distance from the affected area.
The radioactive source also may be delivered to the tumor
through-tubes; this is called remote brachytherapy. Internal
radiation also may be given by injecting a solution of radioactive
substance into the bloodstream or a body cavity. When the
substance is injected, it is not sealed in a container and
may be called unsealed internal radiation therapy.
For most types of implants, you will need to be in the hospital
and have general or local anesthesia while the doctor places
the container for the radioactive material in your body. To
get the radiation as close as possible to the cancer, doctors
may use implants of radioactive material sealed in wires,
seeds, capsules, or needles. The type of implant and the
method of placing it depend on the size and location of the
cancer. Implants may be put right into the tumor, in special
applicators inside a body cavity, on the surface of a tumor,
or in the area from which the tumor has been taken.
The radioactive substance in your implant may transmit rays
outside your body. While you're receiving implant therapy,
the hospital may require you to stay in a private room. Although
the nurses and other people caring for you will not be able
to spend a long time in your room, they will give you all
of the care you need. You should call for a nurse when you
need one, but keep in mind that the nurse will work quickly
and speak to you from the doorway more often than from your
bedside. Inmost cases, your urine and stool will contain
no radioactivity. However, either one may contain some radioactive
material if you have unsealed internal radiation therapy.
There also will be limits on visitors while your implant
is in place. Most hospitals do not let children younger than
18 or pregnant women visit patients who have an implant.
Visitors should sit at least 6 feet from your bed and stay
for only a short time each day (10 to 30 minutes). Have visitors
ask your nurse for specific instructions before they enter
your room.
You are not likely to have severe pain or feel ill during
implant therapy. However, if an applicator is holding your
implant in place, it may be somewhat uncomfortable. If you
need it, the doctor will order medicine to help you relax
or to relieve pain. Some patients feel drowsy, weak, or nauseated
after having the anesthesia to place the implant, but these
effects do not last long.
The total amount of time that an implant is left in place
depends on the dose (amount) of radioactivity with which
the patient is treated. The implant may be low dose rate
and left in place for several days, or it may be high dose
rate and removed after a few minutes. Generally, low dose
rate implants are left in place from 1 to 7 days. Your treatment
schedule will depend on the type of cancer, where it is,
your general health, and other cancer treatments you have
had. Depending on where the implant is placed, you may have
to stay in bed and lie fairly still to keep the implant from
shifting.
For some cancer sites, the implant may be left in place
permanently. If your implant is permanent, you may need to
stay in your room away from other people in the hospital
for a few days while the radiation is most active. The implant
will lose energy each day, so by the time you are ready to
go home, the radiation in your body will be much weaker.
Your doctor will advise you if there are any special precautions
you need to use at home.
High dose rate remote brachytherapy allows a person to be
treated within a few minutes in the radiation oncology department. With
remote brachytherapy, a very powerful radioactive source
travels by remote control through tubes, or catheters, to
the tumor. The radioactivity remains at the tumor for only
a few minutes. This procedure is done by the brachytherapy
team, who will watch you on a closed-circuit television.
They will talk to you through an intercom. In some cases,
several remote treatments may be required. Sometimes, the
catheter stays in place between treatments and sometimes
it is removed, depending on your condition.
High dose rate treatments are short (usually a few minutes)
and result in less discomfort than other types of radiation
therapy. Because radioactive materials are not left in your
body, you can return home soon after you recover. Remote
brachytherapy has been used to treat cancers of the cervix,
breast, lung, pancreas, prostate, and esophagus.
Usually there is no need to have an anesthetic to take out
the implant. Most can be taken out right in the patient's
hospital room. If you had to stay in bed during implant therapy,
you might have to remain in the hospital an extra day or
so after the implant is removed. Once the implant is removed,
there is no radioactivity in your body. The nurses and your
visitors no longer will have to observe any special rules.
Your doctor will tell you if you should limit your activities
after leaving the hospital. Most patients are allowed to
do as much as they feel like doing. You may need some extra
sleep or rest breaks during your first days at home, but
you will feel stronger quickly.
The area that has been treated with an implant may be sore
or sensitive for some time after therapy. Your doctor may
advise you to limit sport and sexual activity for a while
if they cause irritation in the treatment area.
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