What Are the Side Effects of Brachytherapy?

Brachytherapy is the name for internal radiation therapy for cancer. Side effects can include bleeding and bruising at the radiation site. Other side effect symptoms depend on the location of the therapy and type of cancer.

Brachytherapy is a type of internal radiation therapy cancer treatment that allows a higher dose of radiation in a more limited area than can be accomplished with external radiation treatment.

In brachytherapy, radiation is delivered to a specific part of the body using a radioactive implant, which may be temporary or permanent, depending on the type of cancer being treated. Implants called pellets, seeds, wires, needles, capsules, ribbons, balloons, or tubes, are placed close to or inside the tumor so the radiation has a minimal effect on normal, healthy cells.

Brachytherapy is used to treat cancers of the:

• Head and neck
• Breast
• Prostate
• Gynecological cancers
  • Cervix
  • Vagina
  • Uterus
• Eye
• Lung
• Rectum
• Skin 
• Brain
• Pancreas

Brachytherapy implants are inserted through a small catheter or a larger device called an applicator. The procedure is generally performed in a hospital setting where the radiation is kept inside the room. 

The patient receives anesthesia of some sort (general or local) and the catheter or applicator is moved into position. Once the catheter or applicator is in place, the radiation source is positioned and may be kept in place for minutes, days, or permanently. The length of the placement depends on the type of radiation source, the type of cancer being treated, the location of the cancer in the body, the patient’s health, and other cancer treatments that may have been used.

Techniques for placing brachytherapy include:

• Interstitial brachytherapy
  • The radiation source is placed in or near the tumor, but not in a body cavity
  • This technique is often used for prostate cancer
• Intracavity brachytherapy
  • The radiation source is placed within a body cavity or a cavity created by surgery
  • Radiation may be placed in the vagina to treat cervical or endometrial cancer, or in a body cavity such as the rectum or anus
• Episcleral brachytherapy
  • The radiation source is attached to the eye
  • This is used to treat melanoma of the eye

There are three types of brachytherapy:

• Low-dose rate (LDR) implants
  • The radiation source remains in place for one to seven days and patients are usually hospitalized for this time
  • When treatment is complete, the radiation source and the catheter or applicator is removed
• High-dose rate (HDR) implants
  • The radiation source is left in place for 10 to 20 minutes at a time and then removed
  • Treatments may be given twice a day for 2 to 5 days or once a week for 2 to 5 weeks, depending on the type of cancer being treated
  • A catheter or applicator may remain in place, or it may be put in place before each treatment
  • Patients may be in the hospital during this time or they may go to the hospital each day receive treatments
  • When treatment is complete, the catheter or applicator is removed
• Permanent implants
  • When the radiation source is inserted, the catheter is removed
  • Implants remain in the patient’s body for life, but the radiation gets weaker as time goes on
  • Initially, patients may need to limit time around other people and take other safety measures to avoid exposing others to radiation, especially children and pregnant women

Risks and complications of brachytherapy may affect different parts of the body, depending on where the radiation was placed and may include:

• Vagina: 
  • Narrowing of the vagina which may require use of dilators
  • Painful sexual intercourse 
  • Vaginal dryness
  • Increased risk of vaginal infections, such as yeast infections
• Bladder: 
  • Urinary frequency
  • Blood in urine
  • Difficulty urinating
  • Burning sensation when urinating 
  • Urinary incontinence
• Bowels: 
  • More frequent bowel movements
  • Loose stools
• Prostate:
  • Impotence