Brachytherapy vs. Radiation for Cancer Treatment

A new cancer diagnosis can be devastating, not only for the patient but also for their loved ones. At the same time, you will be given a lot of new information about your condition and different treatment approaches so you and your healthcare providers can make decisions regarding a treatment plan that is best for you. All of this can be overwhelming. Knowing what to expect can help ease some of the anxiety. Please continue reading to learn about two common ways to treat cancer — radiation therapy and brachytherapy treatment.

What are the different types of cancer treatments?

Your health care team will develop a specific treatment plan for you depending on the type and stage of your cancer. According to the National Cancer Institute and American Cancer Society. Below are descriptions of different therapies available for treating cancer according to the National Cancer Institute and American Cancer Society:

Chemotherapy, which uses powerful chemicals to kill cancerous cells.
Radiation treatments (using high-dose radiation to shrink tumors while sparing healthy tissue).
Hormone therapy, which uses synthetic hormones to disrupt the body’s normal hormones. This is essential for cancerous cells to grow. Therefore, hormone therapy works to stop the growth of cancer cells and treat cancers such as prostate cancer and breast cancer.
Immunotherapy, which helps your immune system fight cancer.
Hyperthermia, which uses heat to kill cancerous cells.
Photodynamic therapy, which uses drugs activated by light to destroy cancer cells.
Stem cell transplants, which are used to restore stem cells in the bone marrow after radiation treatment.
Targeted therapy, which uses drugs to target specific proteins and genes in cancer cells that help them grow and survive.
Surgery, which is done to remove tumors from the body.

What is external and internal radiation therapy?

Radiation therapy is a type of cancer treatment that uses high doses of radiation to destroy cancer cells. It can be used alone or in combination with other cancer treatments. There are two main types of radiotherapy - external beam radiation therapy and internal radiation therapy.

External radiation therapy

External beam radiation therapy is performed with a fine beam of radiation that targets the tumor from many directions. It is performed using a large machine that does not touch your body. This is a local treatment that selectively targets the tumor. For example, if you have lung cancer, you will receive radiation therapy to your chest cavity and not your whole body. This type of radiation is more common than internal radiation. When you hear of someone receiving radiation therapy, more than likely, this is the treatment being referred to.

Internal radiation therapy

Internal radiation therapy is performed by placing a solid or liquid source of radiation inside your body in or near the tumor. When the dose of radiation comes from a solid source such as seeds, capsules, or ribbons, it is called brachytherapy or interstitial brachytherapy. If the radiation source is placed in a body cavity, such as the cervix, for the treatment of cervical cancer, it is called intracavity brachytherapy.

Brachytherapy is also a local treatment, like external radiation therapy, meaning it’s designed to target the cancerous organ or tissues. The radioactive materials are left in place for a specified time period. Brachytherapy is commonly used to treat cancers of the brain, eye, head and neck, esophagus, lung, breast, cervix, rectum, and prostate gland.

Internal radiation therapy can also be performed with a liquid source that is swallowed or injected. This is a systemic (body-wide) treatment where the radiation source travels throughout the body in the blood, identifying and killing cancer cells. An example of systemic radiation therapy is radioactive iodine I-131 therapy (Iodine 131), which is used to treat certain thyroid cancers.

Your doctor will choose the appropriate type of radiation therapy based on the type of cancer, size, and location of the tumor, whether you will have other cancer treatments, and your age, medical history, general health status, and personal preference if able.

How does brachytherapy work?

The radiation dose damages the DNA of the cancerous cells and stops them from growing and multiplying.

What are the different types of brachytherapy?

Permanent brachytherapy, also called low-dose rate brachytherapy, involves placing permanent implants (radioactive seeds or pellets) directly into the tumor and leaving them in place to slowly deliver the dose of radiation focusing on the cancer cells with less damage to the nearby health cells. After the treatment is over and the radiation source is no longer active, the seeds or pellets are left inside the body. For example, permanent prostate brachytherapy is the procedure used to treat prostate cancer. With this type of brachytherapy, many radioactive seeds are placed within the prostate. Permanent brachytherapy reduces the number of radiation therapy appointments you need.

Temporary brachytherapy involves placing temporary implants, such as balloons or, catheters (hollow tubes), close to the tumor and removing it after the treatment ends. Your doctor can use either low-dose or high-dose-rate brachytherapy with this type of treatment. High-dose-rate brachytherapy uses HDR implants (high-dose rate implants) to introduce a higher dose of radiation, while low-dose-rate brachytherapy uses LDR implants (low-dose rate implants) for treatment requiring low doses of radiation. Your doctor will make the decisions based on the type of cancer and how advanced it is.

What is the difference between brachytherapy and traditional radiation therapy?

The main difference between brachytherapy and traditional external radiation therapy is that in brachytherapy, the radiation source is placed inside your body, whereas in external radiation therapy, the radiation is delivered from a machine outside your body.

Why is brachytherapy the treatment of choice?

Brachytherapy allows a radiation oncologist to directly target a tumor with high doses of radiation by placing radioactive material inside your body over a shorter time period than what’s allowed with external beam therapy. This allows your doctors to treat only a specific part of your body and target a more precise area, sparing the surrounding tissue. In other words, brachytherapy more efficiently destroys cancer cells, causes milder side effects, and requires fewer hospital appointments compared to traditional external radiation therapy.

What are the disadvantages of brachytherapy?

Stay in hospital

High-dose therapy patients will need to be in the hospital for a few days. During this admission, you will stay in a private hospital room and adhere to certain rules to ensure safety for others while the radiation is active inside your body.

Most temporary brachytherapy treatment requires a stay in the hospital or radiotherapy unit for as long as the radioactive source is inside your body. Once the source is removed and you have undergone a radiation survey to confirm that all radioactive materials were removed, you can go home. If you are receiving a series of treatments, you may be able to go home between treatments.

If you are receiving permanent brachytherapy, you may be able to go home the same day after the radioactive material is implanted. In some cases, you may need to stay in the hospital for one or more days to recover. In contrast, an external radiation therapy treatment session can be performed on an outpatient basis.

Risk to others

When you are receiving brachytherapy, hospital staff may need to limit the amount of time they spend in your hospital room. There may also be restrictions on visitors while the radiation sources are present in your body. If you are receiving permanent implants, almost all of the radiation will be absorbed by your body, and there will be very low radiation levels surrounding you. Before discharge, radiotherapy staff will perform a radiation survey to confirm that the radiation levels surrounding you are at safe levels. However, you may be advised to take safety measures such as maintaining a safe distance from pregnant women and young children for a specified period of time.

Side effects

The radioactive implants may cause side effects depending on the location. For example, brachytherapy for prostate cancer can cause side effects such as difficulty starting a urine stream, frequency and urgency of urination, frequent urination at night, pain with urination, blood in the urine, incomplete bladder emptying, erectile dysfunction, blood in stool, and frequency or urgency of bowel movements.

What is the life expectancy after brachytherapy?

The life expectancy after brachytherapy can vary widely depending on the type and stage of the cancer. Your radiation oncologist will give you more information based on your cancer type and health status before you begin brachytherapy.

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