Name of the Procedure:

Common Name: Brachytherapy with Palladium-103

Technical Terms: Non-Stranded Palladium-103 Source (HCPCS Code: C2641)

Summary

Brachytherapy with Palladium-103 is a cancer treatment that involves placing radioactive material inside the body, directly within or near a tumor. This procedure allows for targeted radiation therapy, which minimizes damage to surrounding healthy tissue.

Purpose

Medical Conditions:

• Prostate cancer
• Head and neck cancers
• Breast cancer
• Eye cancer

Goals:

• Destroy cancerous cells
• Shrink tumors
• Improve survival rates and quality of life

Indications

Symptoms/Conditions:

• Diagnosis of localized cancer suitable for brachytherapy
• Tumors accessible by implantation of radiation sources

Patient Criteria:

• Good overall health to undergo minor procedures
• Tumor size and location appropriate for this treatment
• No contraindications to anesthesia or radiotherapy

Preparation

Pre-procedure Instructions:

• Fasting for a specified period if sedation or anesthesia is used
• Discontinue certain medications if advised by the doctor (e.g., blood thinners)
• Complete blood counts and imaging tests (e.g., MRI, CT scans)

Procedure Description

1. Assessment: Imaging tests to determine the precise location for implantation.
2. Anesthesia: Local or general anesthesia may be administered.
3. Implantation: Small incisions are made to insert Palladium-103 seeds directly into or near the tumor using needles or catheters.
4. Verification: Post-implant imaging (e.g., X-rays) to confirm proper placement.

Tools/Equipment:

• Needles or catheters
• Palladium-103 radioactive seeds
• Imaging devices (e.g., ultrasound, CT)

Anesthesia:

• Local anesthesia for minor procedures, general anesthesia for more invasive placement

Duration

The procedure typically takes between 1 to 3 hours, depending on the number and location of seeds implanted.

Setting

This procedure is performed in a hospital, outpatient clinic, or specialized surgical center.

Personnel

• Radiation oncologist
• Radiologist or imaging specialist
• Surgical nurse
• Anesthesiologist

Risks and Complications

Common Risks:

• Pain or discomfort at the implantation site
• Temporary swelling or bruising

Rare Risks:

• Infection
• Misplacement of seeds
• Damage to surrounding healthy tissue

Management:

• Antibiotics for infections
• Imaging and repositioning for seed misplacement

Benefits

Expected Benefits:

• Effective tumor control
• Limited exposure of radiation to healthy tissues
• Potential reductions in cancer recurrence
• Benefits typically realized within weeks to months

Recovery

Post-procedure Care:

• Rest for 24-48 hours
• Avoid strenuous activities for a few days
• Follow-up imaging to monitor seed placement and tumor response

Recovery Time:

• Most patients can resume normal activities within a week
• Regular follow-up appointments to assess progress

Alternatives

Other Treatment Options:

• External beam radiation therapy
• Surgery
• Chemotherapy

Pros and Cons of Alternatives:

• External Beam Radiation: Non-invasive but may affect more healthy tissue.
• Surgery: Effective but more invasive with longer recovery time.
• Chemotherapy: Systemic treatment affecting the entire body, not just the tumor site.

Patient Experience

During the Procedure:

• Minimal discomfort due to anesthesia
• Awareness of the procedure (if under local anesthesia)

After the Procedure:

• Mild pain or discomfort manageable with pain relievers
• Some fatigue or weakness

Pain Management:

• Prescribed pain medications
• Over-the-counter pain relievers as recommended