Name of the Procedure:

Unlisted procedure, clinical brachytherapy

• Common Name: Clinical Brachytherapy
• Technical Terms: Radiotherapy, Internal Radiation Therapy

Summary

Clinical brachytherapy is a type of internal radiotherapy where a radiation source is placed inside or next to the area requiring treatment. It targets cancer cells more precisely and reduces exposure to surrounding healthy tissues.

Purpose

• To treat various types of cancer, including prostate, cervical, and breast cancers.
• The goal is to destroy cancer cells while minimizing damage to healthy tissues.
• Expected outcomes include the reduction or eradication of tumors.

Indications

• Symptomatic cancers such as prostate cancer, cervical cancer, and localized breast cancer.
• Candidates include patients with localized tumors that have not spread significantly.

Preparation

• Patients may be instructed to fast for a set number of hours before the procedure.
• Medication adjustments may be required, particularly discontinuing blood thinners.
• Pre-procedure diagnostic tests might include imaging studies like CT scans or MRIs to plan the placement of the radiation source.

Procedure Description

1. The patient is positioned appropriately depending on the treatment area.
2. Anesthesia or sedation is administered if necessary.
3. A catheter or applicator is inserted to deliver the radiation source to the targeted area.
4. Imaging technology (e.g., ultrasound, X-ray, or CT scan) guides precise placement.
5. The radiation source is placed inside the applicator for a specified duration, varying from minutes to several days, depending on the cancer and treatment plan.
6. After the radiation dose is delivered, the source and applicator are removed.

Duration

• The procedure can take from a few minutes to a few hours for placement and delivery, depending on the treatment regimen.
• Some treatments might involve multiple sessions.

Setting

• Typically performed in a hospital or specialized radiotherapy center.

Personnel

• Involves a team of healthcare professionals including a radiation oncologist, radiologist, medical physicist, oncology nurse, and possibly an anesthesiologist.

Risks and Complications

• Common risks: localized pain or discomfort, temporary swelling, and bleeding at the insertion site.
• Rare risks: infection, unintended radiation exposure to adjacent tissues, or more significant organ damage.
• Management: Risks are minimized through precise placement guided by imaging and strict infection control practices.

Benefits

• High precision in targeting cancer cells, minimizing exposure to healthy tissues.
• Potentially faster recovery times compared to external beam radiotherapy.
• Benefits can be seen over weeks to months with successful tumor shrinkage or eradication.

Recovery

• Post-procedure care includes monitoring for immediate complications like bleeding or infection.
• Patients may need to avoid strenuous activities for a short period.
• Follow-up appointments are necessary to monitor progress and manage any side effects.

Alternatives

• External Beam Radiotherapy: Less invasive but typically involves longer treatment periods and broader radiation exposure.
• Surgery: May be an option but involves more significant risks and recovery.
• Chemotherapy: Systemic treatment, which might be used in combination or when other local therapies are unsuitable.

Patient Experience

• During the procedure: Patients may feel pressure or mild discomfort when the applicator is inserted.
• Post-procedure: Patients might experience mild pain or tenderness at the insertion site, managed with over-the-counter pain relievers.
• Comfort measures: Sedation or anesthesia is used to minimize discomfort during the procedure, and careful follow-up ensures effective pain management.