Brachytherapy: An Overview

Brachytherapy is a technique used to treat various cancers with internal radiation therapy. Unlike external radiation treatment, this method involves the placement of radioactive sources inside or near the tumor. This local treatment allows high doses of radiation to be delivered, which harmlessly affect the surrounding tissue but not the healthy ones. Cancers such as prostate, cervical, breast, and skin really need this kind of treatment that converges on the action while minimizing the undesired side effects of traditional radiation therapy.

Types of Brachytherapy

Brachytherapy is divided into conditions with different intensities of radiation exposure.

1. Low-Dose Rate (LDR) Brachytherapy—It delivers radiation for a few hours to days, mainly using radioactive seeds or sources that are planted inside the body.

2. High-Dose Rate (HDR) Brachytherapy—Radiation doses are delivered per session in a matter of minutes, and the patients usually have several treatment sessions for completion.

3. Permanent Seed Implantation—We deposit small radioactive seeds in or near a tumor, which gradually lose their radioactivity over time.

4. Intracavitary Brachytherapy—This uses radioisotopes put inside body cavities, for example, the uterus or vagina for treating cancer.

5. Interstitial Brachytherapy: Radioactive needles are inserted directly into the cancerous tissue in this treatment, which is mostly used for prostate, breast, and head and neck tumors.

Symptoms

A common example of symptoms for which brachytherapy can be applied is:

• Tumor growth and pain.

• Obstruction of organs by the increased size of tumors.

• Bleeding may occur if and when the tumor has metastasized, as in the case of cervical and prostate cancer.

Diagnosis

Before proceeding with brachytherapy, the clinician will conduct several thorough examinations:

• Imaging studies to ascertain the size of the tumor, using MRI or computed tomography.

• Needle core biopsy for tumor identification from the metastases.

• Blood tests to ascertain general health and organ function.

• Review the past medical history for underlying conditions that may complicate treatment.

Risks and Complications

The rate of complications and risks in brachytherapy is minimal and includes:

• Localized complaints like redness, swelling, or pain at the site.

• Infection in case of trouble in carrying out or maintaining implants.

• Radiation Exposure to Others—Temporary isolation precautions must be taken to protect others whenever permanent seed implants are used.

• Complications in the urinary and bowel areas are common in prostate brachytherapy.

• Fatigue due to radiation.

Causes

The following conditions are suitable for brachytherapy:

• Primary localized cancers where direct radiation can lead to tumor regression.

• Highly targeted delivery of radiation in patients with cancers.

• Prostate, cervical, breast, head, and neck tumor syndromes.

• Tumors with recurrence of diseases and inability to be controlled by external beam radiation.

Preparation

Before brachytherapy, patients must be prepared.

The patient was firmly fixed on the pre-treatment imaging.

• Discuss concerns relating to medications with the physician regarding potential interactions between them.

• Follow dietary instructions: fasting or eating Enclosed are the client instructions for fasting if needed, etc.

• Storage for help needed with driving and supervision, as some anesthetic procedures are resident in nature.

Procedure

1. Patient Setup: We will set up the patient so that the implant is located appropriately.

2. Anesthesia for the patient: Treatments could be given with local or general anesthesia, depending on their respective types of brachytherapy.

3. Implant delivery: Applicators or catheters place radioactive seeds or sources in or near the tumor.

4. Imaging and Assessment: Some form of imaging helps in ascertaining the adequacy of sources.

5. Removal: When using HDR brachytherapy, we remove the sources after applying the required radiation dose.

Recovery

Recovery from brachytherapy is dependent on the nature of brachytherapeutic procedures followed:

• LDR Brachytherapy: The patient stays in the hospital until the radiation decays sufficiently.

• HDR Brachytherapy: Usually done as an outpatient; it has a short time of downtime.

• Managing Pain: Over-the-counter medications can help manage mild pain.

• Activity Restriction: Refrain from heavy activities for a couple of days.

• Regular follow-ups: keeping imaging and blood tests to monitor the effectiveness of treatment.

Clinical Trials

The present clinical trials are doing research on:

• New Radioactive Materials: To improve precision and safety.

• Combining Treatments: Studying brachytherapy with chemotherapy or immunotherapy.

• Personalized Radiation Delivery: AI-based treatment planning for individualized approaches.

• Using Brachytherapy in More Diseases: Investigating other types of cancer.

Side Effects

Some common side effects experienced by individuals undergoing brachytherapy include

• Temporary swelling and bruising.

• Fatigue due to radiation exposure.

• Short-term urinary or bowel changes.

• Localized skin irritation or tenderness.

Success Rate of Brachytherapy

The success rate greatly varies depending on the type and stage of cancer.

• Prostate Cancer—Greater than 90% successful in early stages.

• When using external radiation, cervical cancer treatment is 85–95% effective.

• Breast Cancer—High survival rates with the addition of partial breast irradiation.

• Head and neck cancers—Tumor reduction with ulcer pain relief.

Diet to follow after treatment

A good diet helps in recovery and for general well-being, including:

• High-protein foods promote tissue repair with strength.

• Hydration assists in the removal of toxins as well as in reducing the adverse effects caused by the radiation.

• Antioxidant fruits and vegetables help in reducing inflammation.

• Fiber content eliminates the constipating effects of some treatment modalities.

• Avoid alcohol & processed foods that act as a stressor against the body's natural healing.

Cost of Brachytherapy in India

The cost of brachytherapy in India changes depending on the situational ambience of the hospital, the type of cancer, and the treatment plan:

• Basic Charges of the Procedure: 150,000 to 500,000 INR.

• Hospitalization Charges: From 20,000 to 100,000 INR depending on the period.

• Extras like medications/tests: 10,000 to 50,000 INR.

• Total Estimated Cost: 200,000 to 700,000 INR.

Conclusion

Brachytherapy is a very effective and precise method of treating various cancers, allowing for localized targeting with minimal side effects. As technology advances, its applications are expanding, hence improving outcomes for cancer patients across the globe. With an optimal approach for preparation, follow-up care, and lifestyle modifications, the applicant can improve their quality of life and ensure better survival.