Name of the Procedure:

Brachytherapy Seed Implantation, Palladium-103 (C1804) Common Name: Brachytherapy, Seed Implantation Medical Term: Low-dose Rate (LDR) Brachytherapy with Palladium-103

Summary

Brachytherapy is a form of internal radiation therapy where small radioactive seeds are implanted directly into or near a tumor. The Palladium-103 seeds deliver targeted radiation to destroy cancer cells while minimizing damage to surrounding healthy tissue.

Purpose

Brachytherapy is primarily used to treat various types of cancer, including prostate cancer, breast cancer, and cervical cancer. The goal is to eradicate cancer cells, shrink tumors, and prevent cancer from spreading. Expected outcomes include the reduction or complete elimination of the tumor and preservation of healthy tissue function.

Indications

This procedure is indicated for:

• Localized prostate cancer
• Early-stage breast cancer
• Certain cases of cervical, head, and neck cancers
• Patients requiring targeted radiation therapy with minimal exposure to surrounding tissues

Appropriate candidates are those who have localized tumors and are otherwise in good health to tolerate the procedure.

Preparation

Patients may need to:

• Undergo imaging tests, such as CT scans or MRIs, to map the tumor
• Stop taking certain medications like blood thinners
• Follow specific dietary or fasting instructions on the day of the procedure
• Arrange for transportation post-procedure as sedation or anesthesia may impair their ability to drive

Procedure Description

1. Anesthesia: The patient may receive local anesthesia, sedation, or general anesthesia depending on the tumor location and individual needs.
2. Imaging and Planning: Real-time imaging (ultrasound, CT, or MRI) is used to guide the placement of the seeds.
3. Seed Placement: Small needles or applicators are used to insert the palladium-103 seeds into or near the tumor through the skin or body cavities.
4. Verification: The placement of seeds is verified using imaging to ensure precise delivery.

Tools used include imaging devices, needles, and applicators specially designed for brachytherapy.

Duration

The procedure typically takes about 1 to 2 hours, though this can vary based on complexity and location of the tumor.

Setting

Brachytherapy is usually performed in a hospital, outpatient clinic, or a specialized surgical center equipped with the necessary imaging and radiation therapy tools.

Personnel

The procedure involves:

• Radiation oncologists
• Medical physicists
• Radiologic technologists
• Nurses
• Anesthesiologists for sedation or anesthesia, if required

Risks and Complications

Common risks include:

• Pain or discomfort at the implantation site
• Mild bleeding or infection
• Temporary urinary or rectal symptoms (for prostate cancer)

Rare risks could involve:

• Seed migration
• Radiation exposure to surrounding organs
• Persistent pain or chronic symptoms

Management involves standard post-operative care and monitoring for complications.

Benefits

The benefits of brachytherapy include:

• High precision in targeting tumors
• Minimal damage to surrounding tissues
• Shorter treatment time compared to external radiation
• Faster recovery and fewer side effects

Benefits may be realized within weeks to months as the tumor shrinks or is eradicated.

Recovery

Post-procedure care involves:

• Monitoring for any immediate complications
• Pain management with prescribed medications
• Activity restrictions as advised by the healthcare provider
• Follow-up appointments to monitor progress through imaging and health assessments

Recovery time varies, but most patients can resume normal activities within a few days to weeks.

Alternatives

Alternative treatments might include:

• External beam radiation therapy (EBRT)
• Surgery (such as prostatectomy for prostate cancer)
• Hormone therapy
• Chemotherapy

Each alternative has its pros and cons, such as different side effect profiles, recovery times, and effectiveness depending on the type of cancer and stage.

Patient Experience

During the procedure, patients may feel pressure or mild discomfort, especially if under local anesthesia. Post-procedure, patients might experience soreness or minor localized pain, which can be managed with medication. Comfort measures include proper positioning, ice packs, and pain relief strategies. Follow-up support and monitoring ensure smooth recovery and effective treatment outcomes.