Brachytherapy Source: Non-Stranded, High Activity, Palladium-103, Greater Than 2.2 mCi (NIST), Per Source (C2635)

Name of the Procedure:

• Common Name(s): Brachytherapy
• Technical Term: High Activity Palladium-103 Brachytherapy

Summary

Brachytherapy is a cancer treatment where a high-activity radioactive source, such as Palladium-103, is placed close to or inside the tumor. It delivers targeted radiation to kill cancer cells while sparing surrounding healthy tissue.

Purpose

Brachytherapy is primarily used to treat localized cancers, such as prostate cancer. The goal is to destroy cancer cells by delivering a high dose of radiation directly to the tumor, reducing the risk of damage to nearby tissues.

Indications

• Localized cancers (e.g., prostate cancer, certain gynecological cancers)
• Tumors that are accessible and well-defined

Preparation

• Pre-procedure fasting may be required.
• Discontinue certain medications as advised by the healthcare provider.
• Diagnostic tests like imaging scans may be done to locate the tumor precisely.

Procedure Description

1. The patient is positioned appropriately, and local or general anesthesia may be administered.
2. Imaging techniques like ultrasound, CT, or MRI are used for guidance.
3. Hollow needles or catheters are inserted into or near the tumor site.
4. High-activity Palladium-103 sources are placed through these needles or catheters directly into the tumor.
5. The radioactive sources deliver a targeted dose of radiation before being removed or left in place, depending on the treatment plan.

Duration

The procedure typically takes 1-2 hours, depending on the complexity and location of the tumor.

Setting

Brachytherapy is generally performed in a hospital or specialized outpatient clinic.

Personnel

• Radiation oncologists
• Medical physicists
• Radiologic technologists
• Nurses
• Anesthesiologists (if sedation or anesthesia is required)

Risks and Complications

• Common Risks: Localized pain, swelling, bruising.
• Rare Risks: Infection, bleeding, unintended radiation exposure to nearby healthy tissues, urinary or rectal side effects.

Benefits

• High precision in targeting cancer cells.
• Minimal damage to surrounding healthy tissue.
• Shorter treatment times compared to external beam radiation therapy.
• Quicker recovery and fewer side effects.

Recovery

• Follow-up appointments to monitor for side effects and the effectiveness of the treatment.
• Patients may experience mild discomfort or bruising at the insertion site.
• Most patients can return to normal activities within a few days.

Alternatives

• External beam radiation therapy (EBRT): Longer treatment duration but non-invasive.
• Surgery: Involves removing the tumor, which may be more invasive.
• Chemotherapy: Systemic treatment which affects the entire body.
• Pros and Cons: Brachytherapy is highly localized and precise but requires a procedure; external therapies are less invasive but may impact a broader area.

Patient Experience

• Patients may feel mild discomfort during needle insertion, mitigated by anesthesia.
• Post-procedure pain is typically manageable with over-the-counter pain relievers.
• Anxiety related to the procedure can usually be addressed with pre-procedure counseling and sedation options if needed.