Radiation treatment for cervical cancer via internal means
Brachytherapy is a type of radiation therapy used to treat cervical cancer. This internal radiation therapy involves implanting a contained source of radiation into the cervix, uterus, or vagina, either temporarily or permanently.
Preparing for Brachytherapy
Before undergoing brachytherapy, a person discusses their treatment plan with a doctor or nurse, undergoes a physical examination, medical history review, and possibly imaging tests. The number of brachytherapy sessions depends on the individual's cancer and type of brachytherapy, ranging from one treatment per week for 2-5 weeks.
The Brachytherapy Procedure
Brachytherapy can be performed under general or local anesthetic. The goal of brachytherapy is to deliver higher doses of radiation in a smaller area than external beam radiation can. This is achieved by implanting a radiation source near to or inside the tumor.
There are two main types of brachytherapy: high-dose and low-dose. High-dose brachytherapy involves the implant giving off powerful radiation doses for a shorter period, often repeated multiple times. On the other hand, low-dose brachytherapy involves keeping the implant in place for several days, giving off low doses of radiation. Permanent implants remain in the body and stop giving off radiation over time.
Side Effects of Brachytherapy
Both short-term and long-term side effects can occur with brachytherapy. Common short-term side effects include vaginal irritation (such as soreness, discharge, spotting), bladder and bowel discomfort (frequent urination, diarrhea, abdominal discomfort), fatigue, and pelvic cramping. These symptoms usually occur during or shortly after treatment and tend to improve over time.
Long-term side effects may develop months or years later and can be more challenging to manage. These include vaginal stenosis (narrowing or decreased flexibility of the vaginal tissue), bladder complications such as radiation cystitis, leading to frequent urination or blood in urine, bowel complications like radiation proctitis, which causes persistent bowel issues, lymphedema, swelling in the legs or lower body due to lymph node damage, and rarely, fistulas—abnormal openings between the vagina and bladder or rectum that may require further treatment.
Pelvic radiation including brachytherapy can also lead to early menopause or premature ovarian insufficiency because radiation can damage ovarian follicles, causing infertility and long-term effects such as heart disease, osteoporosis, and menopausal symptoms like hot flushes, mood changes, and vaginal dryness.
Post-Treatment Care
After the treatment, the applicator and temporary implant are removed without the need for anesthetic. A person may need to take special precautions after treatment, such as remaining in the hospital room for some time, limiting visitors, avoiding interaction with pregnant people or children, and staying a certain distance away from visitors for some time.
In combination with external beam radiation therapy, brachytherapy can improve a person's outlook for cervical cancer, with studies showing that a majority of people who received both types of radiation therapy achieved tumor remission, and recurrence rates also improved slightly. However, it's important to note that each individual's experience with brachytherapy can vary.
[1] National Cancer Institute. (2019). Radiation Therapy for Cervical Cancer. Retrieved from https://www.cancer.gov/types/cervical/patient/cervical-treatment-pdq
[2] American Cancer Society. (2020). Cervical Cancer Treatment. Retrieved from https://www.cancer.org/cancer/cervical-cancer/treatment/index.html
[3] Mayo Clinic. (2020). Radiation Therapy for Cervical Cancer. Retrieved from https://www.mayoclinic.org/diseases-conditions/cervical-cancer/diagnosis-treatment/drc-20371819
[4] American Society for Radiation Oncology. (2020). Brachytherapy for Cervical Cancer. Retrieved from https://www.rtanswers.org/patients/patient-resources/brachytherapy-for-cervical-cancer
[5] National Comprehensive Cancer Network. (2020). Cervical Cancer. Retrieved from https://www.nccn.org/patients/guidelines/cervical/index.html
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