Name of the Procedure:

Common Name: Catheter for Brachytherapy Seed Administration
Technical/Medical Term: Catheter, Brachytherapy Seed Administration (HCPCS Code C1728)

Summary

Catheter-based brachytherapy seed administration is a minimally invasive procedure where tiny radioactive seeds are placed into or near a tumor using a catheter. This form of internal radiation therapy targets cancer cells and minimizes exposure to surrounding healthy tissue.

Purpose

The procedure is primarily used to treat localized cancers, such as prostate and certain gynecological cancers. The goal is to deliver a high dose of radiation directly to the tumor to destroy cancer cells while sparing nearby healthy tissues as much as possible.

Indications

• Prostate cancer
• Cervical cancer
• Other localized tumors where precision radiation is beneficial
• Patients who are not good candidates for surgical removal of the tumor

Preparation

• Fasting may be required 6-8 hours prior to the procedure
• Blood tests and imaging studies (e.g., MRI, CT scans) may be necessary to plan the procedure
• Adjustments to current medications, such as blood thinners
• Consultations with oncology specialists and anesthesiologists

Procedure Description

1. Preparation: The patient is prepped and typically given sedatives or anesthesia to minimize discomfort.
2. Insertion of Catheter: A catheter is carefully inserted into the body and guided to the tumor site.
3. Seed Placement: Using imaging guidance, tiny radioactive seeds are delivered through the catheter to the precise location within or near the tumor.
4. Completion: Once all seeds are placed, the catheter is removed, and the patient is monitored as they recover from anesthesia.

Tools Used: Catheter, radioactive seeds, imaging technology (CT, MRI, ultrasound), and possibly anesthesia equipment.

Anesthesia: Local or general anesthesia, depending on the patient's needs and the tumor's location.

Duration

The procedure typically takes 1-2 hours, but this can vary based on the complexity and tumor location.

Setting

The procedure is usually performed in a hospital, outpatient clinic, or specialized surgical center equipped with imaging and radiation therapy facilities.

Personnel

• Radiation Oncologist
• Medical Physicist
• Radiologist
• Oncology Nurse
• Anesthesiologist (if sedation or general anesthesia is required)
• Surgical Technicians

Risks and Complications

Common Risks:

• Discomfort or pain at the catheter insertion site
• Minor bleeding or infection
• Temporary urinary or bowel changes

Rare Risks:

• Misplacement of seeds requiring additional intervention
• Reaction to anesthesia
• Radiation exposure to nearby healthy tissues

Management: Risks are managed with careful planning, imaging guidance, and post-procedure care.

Benefits

• Targeted radiation reduces damage to healthy tissues
• Minimally invasive with quicker recovery times compared to traditional surgery
• Effective in controlling and/or eliminating localized tumors

Recovery

• Patients may need to rest for several hours post-procedure
• Pain and discomfort are usually manageable with medications
• Patients are typically advised to avoid strenuous activities for a few days
• Follow-up appointments to monitor the placement and effectiveness of the seeds

Alternatives

• External beam radiation therapy: Less invasive but may affect more healthy tissue.
• Surgical removal of the tumor: More invasive with a longer recovery time.
• Chemotherapy: Systemic treatment but with broader side effects.
• Active surveillance: Regular monitoring without immediate treatment, sometimes appropriate for slow-growing tumors.

Patient Experience

Patients may feel discomfort during catheter insertion but sedation or anesthesia helps manage pain. After the procedure, there may be some mild pain or pressure at the insertion site. Most patients can return to normal activities within a few days, though they may experience temporary changes in urinary or bowel function. Pain management will be addressed through prescribed medications, and patients will receive clear instructions on how to care for themselves post-procedure.