Available Treatments
Brachytherapy
Brachytherapy is the placement of radiation directly inside the body, as close as possible to the cancer cells. With brachytherapy, you can receive a higher total dose of radiation in a shorter time than is possible with external radiation therapy.
Instead of using an external radiation machine, the radioactive material is sealed in a thin wire or a catheter (hollow tube) and implanted directly into the cancerous area. Brachytherapy concentrates the radiation on the cancer cells and lessens radiation damage to the normal tissue near the cancer. The implants can be temporary or permanent.
There are two ways to perform brachytherapy: sealed in seeds and catheters and implanted directly into or near a tumor (also called interstitial radiation therapy or radioactive seed placement) or in a cavity of the body such as the uterus (also called interstitial radiation therapy).
During brachytherapy, radioactive chemical seeds are placed inside the area of the body where cancer is present so that radiation can be focused to a very limited area. The dose of radiation (number of seeds) and length of time prescribed depends upon the tumor size and location, and its sensitivity to radiation. Cooper offers four types of brachytherapy:
- High Dose Rate (HDR) Brachytherapy, the most advanced form of brachytherapy, HDR brachytherapy is done on an outpatient basis and is available only at Cooper and a few other centers in South Jersey
- Low Dose Rate Brachytherapy is done in the hospital over several days
- MammoSite® High Dose Rate (HDR) Radiation Therapy is used for breast cancer
- Cardiac Intravascular Brachytherapy is used for heart disease.
Brachytherapy can also be given by injecting a radioactive solution into the bloodstream or a body cavity. Radioactive substances used for brachytherapy include cesium, iridium, iodine, phosphorus, and palladium. Internal radiation may be used alone or in combination with external radiation therapy and/or surgery to cure, control, or relieve symptoms of many different types of cancer. How long brachytherapy treatments last and whether they are done on an outpatient or inpatient basis depends upon the specific type of brachytherapy used and the nature of the cancer. Brachytherapy can be completed as quickly as three to five outpatient treatments over several days. Some types of brachytherapy require up to a week in the hospital.
Types of Cancer Treated with Brachytherapy:
High Dose Rate (HDR) Brachytherapy
High dose rate (HDR) brachytherapy involves the temporary placement of a tiny radioactive source into the center of a tumor through a catheter (a hollow tube) to deliver a concentrated dose of radiation to the tumor while sparing much of the surrounding healthy tissue. After using digital images to pinpoint the exact location of the catheter within the tumor, the catheter is positioned and connected to the HDR machine, which delivers the radiation therapy. After the treatment, the radioactive source retracts into the machine and the catheter is removed.
In some cancers, HDR brachytherapy is as effective as low dose rate brachytherapy. HDR brachytherapy is more convenient and less expensive than low dose rate brachytherapy, and has fewer side effects and a very low risk of radiation injury.
HDR brachytherapy takes 10 to 20 minutes at a time, compared to several days for low dose rate brachytherapy. It is usually done in three to five outpatient treatments over several days.
Types of Cancer Treated with HDR Brachytherapy:
MammoSite® HDR Radiation Therapy
The MammoSite® Radiation Therapy System delivers high dose rate (HDR) brachytherapy in patients with early stage breast cancer after lumpectomy. The MammoSite system delivers HDR radiation directly to the lumpectomy site where the tumor was removed, targeting the area where the cancer would most likely recur and sparing nearby healthy tissue. Doctors place a catheter (a hollow tube) with a balloon on the end into the cavity created by the lumpectomy and then thread a radioactive seed through the catheter into the balloon. After the final treatment, the catheter is removed.
Treatments are delivered on an outpatient basis in five days, compared to seven weeks of external radiation therapy. MammoSite can be used on its own or in combination with external radiation therapy, where it shortens the length of daily radiation treatment following surgery.
Type of Cancer Treated with MammoSite® High Dose Rate Brachytherapy:
Low Dose Rate Brachytherapy
Low dose rate brachytherapy delivers radiation slowly, over a few days, and is often performed as an inpatient procedure. Radiation can be delivered through temporary or permanent implants. When temporary implants are used, surgeons place catheters (hollow tubes) near the site of the tumor. The radioactive sources are usually placed (or loaded) in the catheters several hours or days after surgery. When permanent implants are used, the radioactive sources are placed directly into the tumor tissue and remain inside the body because the radioactive source works fast. Your activities and visitors may be restricted during low dose rate brachytherapy.
Types of Cancer Treated with Low Dose Rate Brachytherapy:
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Breast cancer
- Head and neck cancer
- Gynecologic cancers (e.g., cervical and ovarian)
- Prostate cancer
Cardiac Intravascular Brachytherapy
Cardiac intravascular brachytherapy is used to prevent a previously blocked coronary artery that had been opened with a stent from narrowing again. Working with cardiologists, radiation oncologists place a tiny seed around the stent to slow the scar tissue that usually causes the artery to re-narrow.
For more information about Radiation Oncology at Cooper University Hospital or to make an appointment with a Cooper University Hospital physician at an office near you, please call 1-800-8-COOPER to speak with a member of our physician referral and information service.
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Brachytherapy with Afterloading
Remote afterloading has replaced the use of radium and manual afterloading. To minimize the radiation exposure of personnel, an electro-mechanical loading device for radioactive sources is developed. The Remote Afterloader automatically places the radioactive source at predetermined positions within the applicator and stores the source between treatments.
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