Name of the Procedure:

Common name(s): Brachytherapy Technical/medical name(s): Brachytherapy source, non-stranded, cesium-131, per source (HCPCS C2643)

Summary

Brachytherapy using a Cesium-131 source involves placing radioactive seeds directly into the tumor or treatment area. This technique allows concentrated radiation to target cancer cells while minimizing damage to surrounding healthy tissue.

Purpose

Brachytherapy with Cesium-131 is used to treat various types of cancers, including prostate, head and neck, and gynecologic cancers. The procedure aims to shrink or eliminate tumors by delivering high doses of radiation directly to the cancerous cells.

Indications

This procedure is indicated for patients with localized tumors who require a precise delivery of radiation. Specific conditions include early-stage prostate cancer, certain head and neck cancers, and other malignant growths that can be internally reached by the radiation sources.

Preparation

• Patients may need to fast for a certain period before the procedure.
• Medications that affect blood clotting may need to be adjusted.
• Pre-procedure assessments could include imaging studies, blood tests, and consultations with a radiation oncologist and urologist (for prostate cancer).

Procedure Description

1. Anesthesia or sedation is administered.
2. Using imaging guidance, radioactive Cesium-131 seeds are placed directly into or adjacent to the tumor using specialized applicators or catheters.
3. The seeds remain in place to deliver continuous radiation over time.

Tools: Imaging equipment (CT, MRI, ultrasound), specialized applicators or catheters, Cesium-131 seeds. Anesthesia: General or local anesthesia along with sedation.

Duration

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

Setting

Brachytherapy with Cesium-131 is performed in a hospital, outpatient clinic, or specialized surgical center with facilities for radiation therapy.

Personnel

• Radiation oncologist
• Radiologist
• Nurses specialized in radiation therapy
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Common: localized pain, bruising, and swelling at the implantation site.
• Rare: infection, radiation exposure to surrounding tissues leading to secondary effects, dislodgement of seeds.

Benefits

Brachytherapy with Cesium-131 offers precise targeting of tumors, minimizing damage to surrounding tissues. Benefits can typically be seen within weeks to months post-procedure as the tumor shrinks or disappears.

Recovery

• Patients may experience mild discomfort for a few days post-procedure.
• Physical activities may be limited for a short period.
• Follow-up appointments are necessary to monitor progress through imaging and clinical assessments.

Alternatives

• External beam radiation therapy: Non-invasive but may affect surrounding healthy tissue.
• Surgery: Effective for certain cancers but involves longer recovery times and higher risks.
• Chemotherapy: Useful for systemic cancer but has broader side effects.

Patient Experience

During the procedure, patients will receive anesthesia to minimize discomfort. Post-procedure, mild pain or discomfort is common but usually manageable with over-the-counter pain relievers. Most patients can return to regular activities within a few days, with specific instructions provided for care and follow-up.