Name of the Procedure:

• Common Name: Brachytherapy with Iodine-125
• Technical Term: Brachytherapy source, non-stranded, iodine-125, per source (HCPCS Code: C2639)

Summary

Brachytherapy with Iodine-125 involves placing tiny radioactive seeds directly into or near a tumor. It provides targeted radiation treatment, minimizing damage to surrounding healthy tissues.

Purpose

• Conditions Treated: Typically used for cancers such as prostate cancer.
• Goals: To shrink or eliminate tumors by delivering high doses of radiation precisely, while preserving healthy tissue.

Indications

• Symptoms/Conditions: Cancer that is localized and well-defined, such as early-stage prostate cancer.
• Patient Criteria: Patients who are eligible for localized radiation treatment and can tolerate minor surgical procedures.

Preparation

• Pre-Procedure Instructions: Patients may be instructed to fast for several hours before the procedure. Medications may need to be adjusted or paused.
• Diagnostic Tests: Imaging studies like MRI, CT scans, or ultrasounds to map the tumor.

Procedure Description

1. Anesthesia: Typically performed under local or general anesthesia.
2. Placement: Using imaging guidance, needles are inserted into the tumor area.
3. Inserting Seeds: Iodine-125 seeds are placed through the needles directly into the tumor.
4. Verification: Imaging is used to confirm precise placement.
5. Completion: Needles are removed, and the treatment area is dressed.

Duration

The procedure typically takes 1-2 hours.

Setting

Performed in a hospital's radiology or surgical department or an outpatient clinic equipped for minor surgical procedures.

Personnel

• Radiation Oncologists
• Medical Physicists
• Radiation Therapists
• Nurses
• Anesthesiologists (if general anesthesia is used)

Risks and Complications

• Common Risks: Infection at insertion sites, temporary discomfort or pain.
• Rare Complications: Radiation-related side effects, seed displacement, or damage to nearby organs. Management usually involves symptomatic treatment or minor corrective procedures.

Benefits

• Expected Benefits: Precise targeting of tumors, preserving surrounding healthy tissue.
• Realization of Benefits: Tumor reduction or elimination can be observed over weeks to months, with ongoing monitoring.

Recovery

• Post-Procedure Care: Mild pain management with over-the-counter pain relievers, avoid strenuous activities for a short period.
• Recovery Time: Typically a few days to a week.
• Follow-Up: Regular follow-up appointments to monitor the treatment effectiveness and manage any side effects.

Alternatives

• External Beam Radiation Therapy: Less invasive but may affect more surrounding tissue.
• Surgical Removal: Direct removal of the tumor, but more invasive with longer recovery.
• Observation/Active Surveillance: For slow-growing tumors, monitoring without immediate treatment.

Patient Experience

• During the Procedure: Minimal discomfort, especially if under anesthesia.
• After the Procedure: Mild soreness at the insertion site, managed with pain relievers.
• Comfort Measures: Cold packs and over-the-counter pain medication can be used post-procedure. Most patients can return to normal activities relatively quickly.