Name of the Procedure:

Brachytherapy Needle (HCPCS Code: C1715)

Summary

Brachytherapy is a type of radiation therapy where radioactive seeds or sources are placed directly into or near a tumor. A brachytherapy needle is a specialized instrument used to accurately position these radioactive seeds within the body.

Purpose

Brachytherapy is used to treat various types of cancer, including prostate, cervical, breast, and skin cancer. The procedure aims to deliver high doses of radiation to cancer cells while minimizing exposure to surrounding healthy tissue. The goal is to shrink or eliminate the tumor, thereby improving patient outcomes and potentially providing a cure.

Indications

• Localized cancer that can be targeted with precision
• Tumors located in areas where it's crucial to spare surrounding healthy tissue
• Patients who require a high dose of radiation delivered directly to the tumor site

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Medication adjustments, such as stopping blood thinners, may be required.
• Pre-procedure imaging tests (e.g., MRI, CT scan) to map the tumor location and plan needle placement.

Procedure Description

1. The patient is positioned based on the tumor's location.
2. Local anesthesia or sedation is administered to ensure comfort.
3. Using imaging guidance (e.g., ultrasound, CT), the brachytherapy needle is inserted into the body and directed to the tumor site.
4. Radioactive seeds are then precisely placed through the needle into the tumor.
5. The needle is removed, and seed placement is confirmed with additional imaging.
6. The patient is monitored briefly post-procedure for immediate reactions or complications.

Duration

The procedure typically takes 1 to 2 hours, depending on the tumor's size and location.

Setting

Brachytherapy procedures are usually performed in a hospital's radiology or oncology department, sometimes in a specialized outpatient clinic.

Personnel

• Radiation oncologist
• Radiologic technologist
• Oncology nurse
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Infection at the needle insertion site
• Bleeding
• Displacement of radioactive seeds
• Potential damage to surrounding tissues
• Rarely, radiation-induced secondary cancers

Benefits

• Targeted delivery of high-dose radiation directly to the tumor
• Reduced exposure and risk to surrounding healthy tissues
• Shorter treatment times compared to external beam radiation therapy
• High success rates for certain localized cancers

Recovery

• Post-procedure care includes monitoring the insertion site for signs of infection or bleeding.
• Patients may experience mild discomfort or swelling, managed with pain medications.
• Most patients can resume normal activities within a day or two.
• Follow-up appointments are essential to monitor progress and confirm the effectiveness of the treatment.

Alternatives

• External Beam Radiation Therapy: Less invasive but may expose more healthy tissue to radiation.
• Surgery: Provides immediate removal of the tumor but involves a longer recovery period.
• Chemotherapy: Systemic treatment that can be combined with brachytherapy but varies in effectiveness depending on cancer type.

Patient Experience

During the procedure, the patient may feel pressure or slight discomfort. Post-procedure, mild soreness at the insertion site is common. Pain management involves over-the-counter or prescribed medications. Comfort measures, such as ice packs and rest, are often recommended to enhance recovery.