Brachytherapy (brak-e-THER-uh-pee) is a procedure that involves placing radioactive material inside your body. Brachytherapy is one type of radiation therapy that's used to treat cancer. Brachytherapy is sometimes called internal radiation.

Brachytherapy allows doctors to deliver higher doses of radiation to more-specific areas of the body, compared with the conventional form of radiation therapy (external beam radiation) that projects radiation from a machine outside of your body. Brachytherapy may cause fewer side effects than does external beam radiation, and the overall treatment time is usually shorter with brachytherapy.

Brachytherapy is used to treat several types of cancer, including:

  • Bile duct cancer
  • Breast cancer
  • Cervical cancer
  • Endometrial cancer
  • Eye cancer
  • Head and neck cancers
  • Lung cancer
  • Prostate cancer
  • Rectal cancer
  • Skin cancer
  • Soft tissue cancers
  • Vaginal cancer

Brachytherapy can be used alone or in conjunction with other cancer treatments. For instance, brachytherapy is sometimes used after surgery to destroy any cancer cells that may remain. Brachytherapy can also be used along with external beam radiation.

Side effects of brachytherapy are specific to the area being treated. Because brachytherapy focuses radiation in a small treatment area, only that area is affected. You may experience tenderness and swelling in the treatment area. Ask your doctor what other side effects can be expected from your treatment.

Before you begin brachytherapy, you may meet with a doctor who specializes in treating cancer with radiation (radiation oncologist). You may also undergo scans to help your doctor determine your treatment plan. Procedures such as X-rays or computerized tomography (CT) may be performed before brachytherapy.

Brachytherapy treatment involves inserting radioactive material into your body near the cancer. How your doctor places that radioactive material into your body depends on many factors, including the location and extent of the cancer, your overall health, and your treatment goals. Placement may be inside a body cavity or into body tissue:

  • Radiation placed inside a body cavity. During intracavity brachytherapy, a device containing radioactive material is placed in a body opening, such as the windpipe or the vagina. The device may be a tube or cylinder made to fit the specific body opening.

    Your radiation therapy team may place the brachytherapy device by hand or may use a computerized machine to help place the device. Imaging equipment, such as a CT scanner or ultrasound machine, may be used to ensure the device is placed in the most effective location.

  • Radiation inserted into body tissue. During interstitial brachytherapy, devices containing radioactive material are placed within body tissue, such as within the breast or prostate. Devices that deliver interstitial radiation into the treatment area include wires, balloons and tiny seeds the size of grains of rice.

    A number of techniques are used for inserting the brachytherapy devices into body tissue. Your radiation therapy team may use needles or special applicators. These long, hollow tubes are loaded with the brachytherapy devices, such as seeds, and inserted into the tissue where the seeds are released. In some cases, narrow tubes (catheters) may be placed during surgery and later filled with radioactive material during brachytherapy sessions. CT scans, ultrasound or other imaging techniques may be used to guide the devices into place and to ensure they're positioned in the most effective locations.

High-dose rate vs. low-dose rate brachytherapy

What you'll experience during brachytherapy depends on your specific treatment. Radiation can be given in a brief treatment session, as with high-dose rate brachytherapy, or it can be left in place over a period of time, as with low-dose rate brachytherapy. Sometimes the radiation source is placed in your body permanently:

  • High-dose rate brachytherapy. High-dose rate brachytherapy is often an outpatient procedure, which means each treatment session is brief and doesn't require that you be admitted to the hospital. During high-dose rate brachytherapy, radioactive material is placed in your body for a short period — from a few minutes up to 20 minutes. You may undergo one or two sessions a day over a number of days or weeks.

    You'll lie in a comfortable position during high-dose rate brachytherapy. Your radiation therapy team will position the radiation device, in the case of intracavity brachytherapy, or the radiation-holding device may already be in place if you're having interstitial brachytherapy. The radioactive material is inserted into the brachytherapy device with the help of a computerized machine.

    Your radiation therapy team will leave the room during your brachytherapy session. They'll observe from a nearby room where they can see and hear you. You shouldn't feel any pain during brachytherapy, but if you feel uncomfortable or have any concerns, be sure to tell your caregivers.

    Once the radioactive material is removed from your body, you won't give off radiation or be radioactive. You aren't a danger to other people, and you can go on with your usual activities.

  • Low-dose rate brachytherapy. During low-dose rate brachytherapy, a continuous low dose of radiation is released over time — from several hours to several days. You'll stay in the hospital while the radiation is in place.

    Radioactive material is placed in your body by hand or by machine. Brachytherapy devices may be positioned during surgery, which may require anesthesia or sedation to help you remain still during the procedure and to reduce discomfort.

    You'll likely stay in a private room in the hospital during low-dose rate brachytherapy. Because the radioactive material stays inside your body, there is a small chance it could harm other people. For this reason, visitors will be restricted. Children and pregnant women shouldn't visit you in the hospital. Others may visit briefly once a day or so. Your health care team will still give you the care you need, but may restrict the amount of time they spend in your room.

    You shouldn't feel pain during low-dose rate brachytherapy. Keeping still and remaining in your hospital room for days may be uncomfortable. If you feel any discomfort, tell your health care team.

    After a designated amount of time, the radioactive material is removed from your body. Once brachytherapy treatment is complete, you're free to have visitors without restrictions.

  • Permanent brachytherapy. In some cases, such as with prostate cancer brachytherapy, radioactive material is placed in your body permanently. The radioactive material is typically placed by hand with the guidance of an imaging test, such as ultrasound or CT. You may feel pain during the placement of radioactive material, but you shouldn't feel any discomfort once it's in place.

    Your body will emit low doses of radiation from the area being treated at first. Usually the risk to others is minimal and may not require any restrictions about who can be near you. In some cases, for a short period of time you may be asked to limit the length and frequency of visits with pregnant women or with children. The amount of radiation in your body will diminish with time, and restrictions will be discontinued.

Your doctor may recommend scans after brachytherapy to determine whether treatment was successful. What types of scans you undergo will depend on the type and location of your cancer.

Experienced and highly trained Mayo Clinic radiation oncologists have performed brachytherapy, an advanced treatment for people who have cancer, for nearly 20 years. More than 2,000 patients have received brachytherapy treatment for cancer at Mayo Clinic.

"Brachy" is a Greek word meaning short. Brachytherapy involves treating disease by exposure to a radioactive substance (radiotherapy). Doctors place a small radioactive source (pellet or seed) in or a short distance from a cancerous tumor. Brachytherapy allows use of a high dose of radiation while reducing the risk of damage to nearby healthy tissue and increasing the likelihood the cancer is destroyed.

Doctors may place brachytherapy seeds inside a body cavity, such as the vagina, or insert seeds into body tissue using hollow needles. Brachytherapy may be used alone or with radiation given externally. Radioactive seeds may be left permanently in place or removed after some time.

Most radiation given off affects the area immediately next to the seeds and the radiation dose to nearby healthy tissues is low. Many people have no major side effects from brachytherapy.

In Mayo Clinic's system, radiation oncologists work closely with other specialists, including oncologists, urologists and anesthesiologists, to find the most appropriate treatment.

At Mayo Clinic, we assemble a team of specialists who take the time to listen and thoroughly understand your health issues and concerns. We tailor the care you receive to your personal health care needs. You can trust our specialists to collaborate and offer you the best possible outcomes, safety and service.

Mayo Clinic is a not-for-profit medical institution that reinvests all earnings into improving medical practice, research and education. We're constantly involved in innovation and medical research, finding solutions to improve your care and quality of life. Your doctor or someone on your medical team is likely involved in research related to your condition.

Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care — and trusted answers — like they've never experienced.

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Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Men who are candidates for a permanent prostate seed implant may have the seeds inserted during outpatient surgery at Mayo Clinic Hospital. They often return to normal activity the next day.

Most people who receive temporary brachytherapy implants will remain in the hospital for two to three days for delivery of their low dose rate brachytherapy.

High dose rate brachytherapy is available at Mayo Clinic Specialty Building on the Phoenix campus.

Treatment team

People who receive brachytherapy treatment at Mayo Clinic in Arizona work with doctors in radiation oncology and other specialties such as urology and anesthesiology. The team develops the most appropriate treatment plan for each person. Radiation oncologists also coordinate therapy with other doctors involved in each person's care.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Doctors at Mayo Clinic in Florida treat gynecologic tumors, melanoma of the eye, sarcomas of the extremities and tumors of the breast, prostate and bile duct.

Mayo Clinic in Florida also offers intravascular brachytherapy (IVBT). IVBT is used to treat several types of heart artery disease.

Treatment Team

People who receive brachytherapy at Mayo Clinic in Florida work with a radiation oncology team of doctors, radiation therapists, specialists in measuring the dosage of radiation (dosimetrists), physicists and oncology nurses. Each radiation oncologist specializes in treating certain types of cancers. Radiation oncologists also coordinate care with other doctors caring for a person.

Appointments

To request an appointment with a physician in Radiation Oncology, call 904-953-1000 between 8 a.m. and 5 p.m. Eastern time, Monday through Friday. The fax number is
904-953-1010.

Online Request
Request an appointment at Mayo Clinic in Florida using our online form:

Doctors at Mayo Clinic in Minnesota have treated more than 2,000 people with brachytherapy for cancer.

Treatment team

Doctors from radiation oncology work with doctors from other cancer-related specialties to provide the most appropriate treatment for people who have cancer.

Appointments

For appointments or more information, call the Department of Radiation Oncology at 507-284-9409 between 8 a.m. and 5 p.m. Central time Monday through Friday.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Mayo Clinic doctors use brachytherapy in the treatment of many cancers, including:

Brachytherapy is an effective option for some people who have prostate cancer or cervical cancer, and may be preferred for some women who have uterine (endometrial) cancer. Doctors recommend brachytherapy for people who are at risk for tumor regrowth in the upper vagina after removal of the uterus.

Mayo Clinic doctors monitor people who receive brachytherapy to constantly improve care.

Endometrial cancer

In a Mayo Clinic study, researchers reported that women at risk of recurrence of endometrial cancer could be treated safely and effectively with three high dose-rate (HDR) brachytherapy treatments during a one- to two-week period. They found the treatment to be more convenient than a six-week course of daily external radiation and associated with fewer side effects in women whose main risk for cancer relapse is the upper vagina.

Bile duct cancer

Mayo Clinic doctors found that chemotherapy, external beam radiotherapy and brachytherapy given before transplant resulted in a higher cure rate following liver transplantation for bile duct cancer than is expected for liver transplantation alone.

Ocular melanoma

A Mayo Clinic study showed that a temporary low dose rate (LDR) implant is an effective alternative to removal of the eye for patients with melanoma

Mayo Clinic researchers study therapies in development as possible new treatments for cancer through the Mayo Clinic Cancer Center. People may enroll in research studies and learn about their illness to actively participate in decisions about their treatment.

Publications

See a list of publications from Mayo Clinic doctors on brachytherapy on PubMed, a service of the National Library of Medicine.

Jul. 29, 2011