09/04/2024
Nuvance Health offers a compassionate approach to internal beam radiation therapy for cervical cancer and endometrial cancer to improve your comfort and experience.
If you or someone you love has been diagnosed with cervical cancer or endometrial cancer, you are probably wondering what treatments are available. During what can be an overwhelming time, understanding your options can help. Radiation therapy is usually part of a comprehensive treatment plan for gynecological cancers. Brachytherapy, or internal radiation therapy, can be an effective treatment. But what is it, exactly?
Here is what you need to know about brachytherapy for gynecological cancer.
When is brachytherapy for gynecological cancers used?
Brachytherapy, or internal radiation therapy, is a treatment technique where a radioactive source, smaller than a grain of rice, is placed directly in or near the tumor to precisely deliver high doses of radiation to the tumor while also limiting the exposure to surrounding normal tissues.
Brachytherapy is an effective treatment option for people with gynecological cancers, including those with:
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Cervical cancer: Brachytherapy is often used in combination with external beam radiation therapy (EBRT) in the primary management of cervical cancer.
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Endometrial cancer: Brachytherapy can be used following surgery for early-stage endometrial cancer to eliminate any remaining cancer cells.
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Recurrent gynecological cancer: Brachytherapy can be an option for treating recurrent tumors in previously irradiated areas.
Eligibility for brachytherapy will depend on your specific cancer type, stage and overall health and treatment goals. A thorough evaluation by your gynecological and radiation oncologists is essential to determine the most appropriate treatment plan for you.
How does brachytherapy differ from external beam radiation therapy?
External beam radiation therapy (EBRT) uses a linear accelerator machine to aim radiation beams at cancer from outside the body.
Brachytherapy delivers radiation from within the body (internally), directly targeting the cancerous tumor that is deep within the pelvis. There are various types of brachytherapy, but high-dose-rate (HDR) brachytherapy is recommended for its convenience and safety.
Radiation is delivered by placing a treatment applicator near or in the target tumor. The radiation source then travels within the applicator to the target and delivers treatment over a few minutes. Following treatment, the source is removed so no radiation is left behind in the body.
Brachytherapy allows for a higher radiation dose to be delivered while sparing surrounding healthy normal tissue, thereby reducing normal tissue damage and treatment-related toxicity.
What is tandem and ovoid brachytherapy for cervical cancers?
Tandem and ovoid brachytherapy is a specialized form of internal radiation therapy used to treat cervical cancer. “Tandem” refers to the slender tube that is inserted into the uterus. The “ovoids” are small, hollow capsules placed near the cervix. Together, these devices deliver high-dose radiation precisely to the cervix, minimizing exposure to surrounding healthy tissues.
What should you expect before, during and after brachytherapy for gynecological cancer?
Brachytherapy usually involves the following steps:
Before the treatment:
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Consultation and planning: You will meet with your radiation oncologist to discuss the treatment. You will undergo imaging studies to precisely locate the tumor and plan the placement of the tandem and ovoids.
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Fasting: You may be asked to fast for several hours before the procedure, typically from midnight the night before.
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Preparation: Anesthesia and sedation plans will be discussed with you before the treatment. At the Norwalk Hospital Whittingham Cancer Center, patients are given conscious sedation to ensure they are asleep and comfortable during the procedure.
During the treatment:
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Sedation: An anesthesiologist will administer conscious sedation, allowing you to relax and sleep through the entire procedure. This is like the sedation you would receive during a routine colonoscopy.
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Insertion: A radiation oncologist will insert the tandem and ovoids into the uterus and cervix through the vagina.
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Radiation delivery: While you remain asleep, the radioactive source will travel through the tandem and ovoids directly to the cervix to deliver high doses of radiation over a few minutes.
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Completion: After the prescribed radiation dose is delivered, your doctor will remove the entire tandem and ovoid applicator, and the radioactive source will leave your body before you wake up from sedation.
After the treatment:
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Recovery: Your care team will monitor you as you wake up from sedation. You may experience very mild period-like cramping, which can be managed with medication.
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Follow-up care: You will receive instructions for at-home care and follow-up appointments to monitor your progress and manage any side effects.
What are the possible side effects of brachytherapy for gynecological cancer?
Side effects from brachytherapy can vary depending on the individual and the specific treatment plan.
Possible short-term side effects:
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Discomfort in the lower back or cramping, like menstrual cramps
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Fatigue
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Vaginal discharge or spotting
Possible long-term side effects:
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Vaginal dryness or stenosis (narrowing of the vaginal canal)
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Changes in bladder or bowel function
Most side effects are temporary and can be managed with appropriate medical care and lifestyle adjustments. It is important to discuss potential side effects with your radiation oncologist to understand how they may impact your health and well-being.
Why choose Norwalk Hospital for your gynecologic care?
Outcomes
Brachytherapy is an effective treatment technique for gynecologic cancers. There are currently no treatment alternatives that result in the same outcomes as brachytherapy, making it an integral component of gynecologic oncology care.
Experience and mental health
Brachytherapy can cause anxiety and distress for patients. A study published in the International Journal of Radiation Oncology shared the experiences of women who received brachytherapy for cervical cancer through qualitative interviews. The study noted the potential distress women may experience during treatment, and 41% of these women may continue to experience symptoms of post-traumatic stress disorder (PTSD) following brachytherapy.
Patient-centered care
Your health and experience matter, and we provide patient-centered care that is compassionate and thoughtful. At the Norwalk Hospital Whittingham Cancer Center, we have a care team that works together to prioritize your comfort during brachytherapy. You will remain asleep during the entire procedure to reduce your stress and anxiety.
The bottom line: At Norwalk Hospital, our compassionate and expert care ensures you receive the best possible treatments with the least amount of stress and discomfort. If you or a loved one are considering brachytherapy, we are here to help you every step of the way. We are proud of the multi-disciplinary patient-centered care we deliver at our center.