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HDR Brachytherapy
In brachytherapy, the radiation oncologist applies a radioactive
source directly to the tumor while sparing nearby healthy tissue
and surrounding organs.
High Dose Rate (HDR) brachytherapy has been used for over twenty
years to successfully treat many gynecologic cancers including cervix
and uterine cancer, often in combination with external beam radiation
and/or surgery.
The Maddock Center was the first radiation oncology practice
to bring HDR brachytherapy to Rhode Island using the microSelectron
Variable HDR Afterloading System designed and built by Nucletron.
The word "Brachy" (pronounced Brake-ee, or Brack-ee) is
Greek for "short distance". Like other radiation treatments,
brachytherapy uses radioactive sources to eliminate cancerous cells
that cause malignant tumors.
Interestingly, brachytherapy is not new. Shortly after radium
was discovered in 1898, brachytherapy was used successfully
to treat facial basal cell skin cancers. In the 1940s, the technique
was expanded to treat internal tumors. However, the procedure
usually required a hospital stay of several days. In 1996, HDR
brachytherapy received a great deal of publicity following Fortune
Magazine's cover story about Intel Corporation CEO Andy Grove's
use of HDR brachytherapy to battle his prostate cancer.
Because HDR brachytherapy allows doctors to safely apply an increased
dose of radiation specifically to the tumor, there are several significant
benefits for patients:
- Eliminates hospitalization. Until recently, brachytherapy
was performed in-hospital and required a stay of three to five
days. Using the HDR method, patients are treated on an out-patient
basis.
- Reduced treatment time. Usually, the entire procedure is performed
in only a few hours with the radiation treatment itself lasting
only ten to fifteen minutes.
- Decreased side effects. Because the radiation is applied directly
to the tumor, normal, surrounding tissues are spared and side
effects are significantly reduced; i.e. nausea, hair loss or
diarrhea.
- Decreased recovery time. After a brief rest of one or two hours,
you can usually go home or back to work.
As with external beam therapy, each treatment is customized
for the individual patient. Following an initial consultation
and physical examination, one of our radiation oncologists develops a
detailed treatment plan with the Medical Physicist. Computerized
calculations are used to determine the precise dose of radiation
necessary to treat your tumor.
Treatment is administered by placing small, flexible plastic applicators,
which look like long tubes, next to the tumor to be treated. For
surface tumors, these tubes are positioned using a custom designed
mask or mould. For internal tumors, applicator placement takes place
in the operating room with the aid of an Oncologic Surgeon. The
applicators stay in place for the duration of your treatment after
which they are painlessly removed.
Each applicator is connected to a computer-controlled machine, which
guides a single radioactive source into the tubes sequentially.
The therapists and physicist control how long the source remains
in each tube, thereby delivering a precise dose of radiation to
each area targeted by the tube. This precise delivery is one of
the main advantages of HDR brachytherapy.
Although each prescription is unique, the following are typical
procedures you can expect during treatment:
- You are escorted to the treatment room for the procedure.
- Applicators (long tubes) are positioned.
- X-rays are taken to ensure proper positioning of the applicators.
- The Maddock Center staff, including the Medical Physicist,
Radiation Therapists, and Radiation Oncologist, monitor your
treatment and keep in constant communication with you.
- Treatment starts when the system sends the radiation source
to the tumor site through the long, flexible tubes.
- The radiation sources retract into the system's protective
storage unit immediately after treatment ends.
- After a brief rest, you are allowed to go home and resume
normal activities.
- The number of HDR brachytherapy treatments depends on the
your custom prescription. One of our radiation oncologists discusses
this with you prior to your first treatment.
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