Brachytherapy is the temporary or permanent placement of a sealed or unsealed radioactive isotope into a body tissue or cavity. The rationale for using brachytherapy includes preservation of vital organ function, reduction of damage to surrounding tissues, improvement in control of local disease, and treatment of areas that may be at high risk for recurrence.8
Brachytherapy may be used for cancers of the endometrium, breast, cervix, lung, head and neck, colon, prostate, thyroid, and ocular melanoma.45 Individuals receiving brachytherapy may be treated as an outpatient or inpatient, depending on the type of therapy to be delivered.46 Due to the nature of the delivery of the radioactive source, specific safety precautions and procedures must be adhered to.
Brachytherapy types and techniques
Afterloading interstitial and intracavity brachytherapy systems:47
- Guide wires are introduced into a cavity and iridium-192 wires are passed into the guide wires.
- Treatment generally takes five days.
Remote-controlled afterloading brachytherapy systems:47
- An applicator is positioned adjacent to the cancer.
- Low dose machine uses a cesium source.
- High dose machine uses an iridium source.
Permanent seed implant (PSI):42, 47, 48
- Refers to the placement of radioactive seeds directly into a tumour, commonly within the prostate, using needles guided by imaging techniques.
- Iodine-125 or Palladium-103 are the radioisotopes commonly used, and they gradually release their radioactivity over a period of 6 to 12 months.
- The seeds become inert over time and remain in the prostate indefinitely.
- Unsealed radioactive source given by ingestion, inhalation or absorption.
- Used to concentrate a radioactive substance in a particular part of the body, to allow investigations or to elicit a treatment effect on the body area.
- Administered orally or by intravenous injection.
- Following administration, all body fluids are radioactive.
- Iodine-131 is used in the treatment of thyroid cancer and is given as a capsule which is soluble in water and excreted in the urine.
Outline the education you would provide for a person admitted for treatment with iodine-131 for thyroid cancer to promote safety for the person and health workers.
Describe interventions the SCN may use to ensure the psychosocial well-being of a woman having brachytherapy for cervical cancer.