About Brachytherapy
Brachytherapy is a type of precision radiation therapy that treats cancer from within the body, directly at the source of the cancer. WashU Medicine physicians at Siteman Cancer Center insert radioactive material into a patient’s body to destroy cancer cells, delivering a concentrated dose right where it’s needed to limit exposure and harm to tissues.
Brachytherapy is a well-established treatment for several types of cancer that is effective in reducing cancer with low risk to patients.
Together at Siteman Cancer Center, a multidisciplinary team of specialists assigned will be assigned to you as a care team, which will determine if brachytherapy is an appropriate treatment for you before issuing a recommendation. They will conduct a thorough diagnosis and meet as a group to weigh every option available. Multidisciplinary specialists who compose these care teams at Siteman Cancer Center specialize in all types of treatments available for patients with different types of cancer.
WashU Medicine physicians have propelled this treatment forward by advancing its application for many types of cancers. Those advances demonstrate how Siteman is moving the standard of care forward into new, innovative applications.
Why Choose Siteman
Siteman Cancer Center cares for thousands of cancer patients each year, with an average of 1,200 who receive brachytherapy. That volume means we treat more patients with this type of therapy than almost any other cancer center in the United States.
Being cared for at a high-volume cancer center benefits patients in significant ways. Research shows that higher caseloads can boost survival rates for patients treated with brachytherapy. For example, one study focused on cervical cancer patients who benefited from this treatment. When choosing a cancer center, patient volume matters.
The Department of Radiation Oncology at WashU Medicine has a proven history with brachytherapy. Physicians first used brachytherapy here over 100 years ago and were the first in St. Louis and the Midwest to use high-dose rate brachytherapy for many parts of the body. Early incorporation of advanced imaging, including MRI, to guide the delivery of brachytherapy was also pioneered at WashU Medicine. Our early adoption and continued precision in this highly specialized field of medicine has made a significant impact in the lives of our patients.
WashU Medicine physicians also lead rigorous training programs to teach this method to future doctors around the country and the world. They set the standard for the best use scenarios for this type of treatment centered on patients’ well-being and quality of life.
Our Siteman care coordinators – oncology-trained nurses who help with scheduling, finding the right specialist, and guidance – can help you through the process.
Call us directly or submit a form, and we will call you back.
High Quality Brachytherapy in St. Louis
For certain types of cancer, such as cervical and prostate cancer, brachytherapy can be more effective than EBRT alone in preventing the cancer from coming back. This is because brachytherapy targets the tumor directly. Because of the advancements of this type of therapy by WashU Medicine physicians, patients at Siteman have more control over their disease from early to advanced stages of cancer.
Clinical trials are research studies that help us find new ways to prevent, diagnose, and treat cancer. If you have a rare or complex diagnosis or your treatment path seems uncertain, you might qualify for a clinical trial.
Our team will help you find a study that is right for you. Call us to speak with a Siteman care coordinator.
How Brachytherapy Works
Brachytherapy is a type of internal radiation therapy used to treat tumors. Instead of receiving radiation from external sources, physicians insert radioactive materials directly into the body at or near the cancer site.
Your specific treatment regimen will vary depending on your type of cancer, stage, and medical history. Many of these procedures are done on an outpatient basis, so you can go home after treatment and resume your normal activities.
In some cases, brachytherapy may offer better treatment outcomes than conventional surgery or other forms of radiation therapy. Brachytherapy targets the tumor directly or nearby, avoiding exposure to other surrounding organs and tissues.
Depending on the type of cancer you have, physicians might use catheters, tubes, or other devices to hold the radioactive material in place for a few hours, a few days, or in some cases, permanently. These tools allow the oncologists to administer highly concentrated doses at precise intervals, targeting the disease location and protecting surrounding organs and tissues.
There are two main types of brachytherapy: high-dose rate brachytherapy (HDR) and low-dose rate brachytherapy (LDR).
- In high-dose rate brachytherapy (HDR), physicians will place a patient under anesthesia or provide medication before placing plastic catheters into or near the tumor. A machine delivers precise doses of radiation from the inside over a short amount of time.
- In low-dose rate brachytherapy (LDR), doctors insert radioactive material into or near the tumor permanently, allowing the therapy to act for a few weeks to several months. The radioactive material decays at predictable rates that your physician will review with you.
For patients with liver cancer, your physician may also refer to your brachytherapy treatment as Y-90, short for Yttrium-90. This type of brachytherapy is also known as selective internal radiation therapy (SIRT).
Your Second Opinion at Siteman
Siteman wants to be your first choice for cancer care, but that might not always be possible. If you have received a cancer diagnosis, started care somewhere else, or are a physician seeking specialized care for your patient, ask us about a second opinion. You can start the process. To make it easy, our care coordinators guide scheduling for yourself or your patient.
How Siteman Advanced Brachytherapy for Gynecological Cancers
Image-Guided Adaptive Brachytherapy (IGABT) is an advanced form of brachytherapy for patients with cervical cancer, and Siteman was one of the first in the United States to offer it. Literature reviews showed that IGABT improved tumor control and reduced severe long-term side effects, showing marked improvements in patients’ quality of life.
Medical teams use a PET scan with brachytherapy to control where they place the radioactive material in IGABT. Physicians also might combine brachytherapy with Intensity-Modulated Radiation Therapy, or IMRT, for patients with cervical or uterine cancer – a completely unique treatment in the region offered at Siteman.
IGABT is only offered at a limited number of institutions in the world. For patients with cervical or uterine cancers, access to a high-volume, pioneering center can make a measurable difference in survival. At Siteman, WashU Medicine physicians continue to advance IGABT and set national standards that improve patient outcomes.
Siteman Breakthroughs with Brachytherapy for Prostate Cancers
Brachytherapy is a highly effective option for patients with prostate cancer and can outperform external beam radiation on long-term measures. Other institutions recognize brachytherapy as an effective treatment for prostate cancer, including the American Urological Association (AUA) and American Society for Radiation Oncology (ASTRO), two leading institutions that promote high-quality standards of care for people with cancer.
Their guidelines on prostate cancer, found in the AUA Journal of Urology, confirm that both LDR and HDR brachytherapy are solid, evidence-based choices for patients with localized disease. It also demonstrates research to support that brachytherapy in combination with external beam radiation therapy (EBRT) has improved results compared to randomized trials—a combination treatment endorsed by the American Brachytherapy Society.
Although effective with other types of treatment, brachytherapy as a standalone treatment is also highly effective against prostate cancer. Choosing a care center that treats many patients with this therapy can improve results, and Siteman cares for hundreds of prostate cancer patients each year.
Frequently Asked Questions About Brachytherapy
Some of the main benefits of brachytherapy include:
- Physicians can deliver high radiation doses to a small area so that they limit exposure to surrounding organs or tissues.
- The treatment times may be shorter, and side effects may be less severe compared to other cancer therapies due to the higher radiation dose delivered at this level of precision
- Patients can go home and are not radioactive after most brachytherapy sessions
- For patients who do have radioactive materials in their body when they leave the hospital, they will be given specific instructions to avoid any risk to those around them
- Because of its targeted delivery, there is less risk of developing a second cancer from radiation exposure during treatment.
Physicians will set you up in a treatment room to safely receive radiation that they target directly at the site of the tumor. Your specific cancer type and stage will indicate the course of treatment, whether physicians determine you would benefit from LDR or HDR brachytherapy.
Most patients undergo this therapy on an outpatient basis, meaning that you will go home not long after treatment. In most cases, you can resume normal activities once you leave the hospital.
Most patients will be able to return home after the treatment team completes their treatment and resume normal activities in a few days. However, it’s important to rest and follow your doctor’s specific recommendations. Some patients will need to avoid strenuous exercise for a few weeks after your treatment session.
There are side effects associated with treatment, but they are usually temporary and resolve in weeks to a few months. Talk to your care team about anything causing you discomfort, and they can help address them and support you.
Common side effects from patients who undergo brachytherapy depend on the specifics of your treatment and might include some of the following:
- Swelling, bruising, or other forms of discomfort at the area of application
- Urinary pain or incontinence (for treatments near the bladder)
- Diarrhea, constipation, or rectal bleeding (for treatments near the bowel)
- Fatigue
These typically resolve over time but be sure to communicate with your care team if you experience any symptoms. They will work with you to manage the symptoms specific to your case.
Since brachytherapy is a highly targeted treatment, most patients have no radioactivity in their body when they leave the treatment room and are not at risk of exposing anyone around them. In nearly all cases, radiation exposure is not a concern when you are considering this type of treatment.
In some cases, however, patients will have radioactivity in their bodies when they leave the hospital, and your care team will provide safety precautions if necessary that include avoiding close contact with pregnant women or children. If relevant to your treatment, your care team will provide you with a card to carry when you travel, as the levels may trigger some airport security systems. Be sure to ask your care team about any concerns you might have when considering this treatment.
Your care team carefully deliberates every type of treatment before they offer recommendations. They look at several factors: your cancer type and stage, your health history, your personal preferences, and how brachytherapy compares to other treatment options.
The multidisciplinary team will collaborate in a tumor board meeting to review your case as a group to determine what type of brachytherapy is the best treatment for you. This ensures that Siteman personalizes your care to your specific needs.
While brachytherapy can be sufficient on its own, some physicians might recommend you pair it with another type of cancer treatment. In some of those cases, doctors might combine brachytherapy with EBRT or other types of imaging-guided radiation therapy to deliver the dose more accurately.
Using a dual or multi-therapy approach helps WashU Medicine physicians see where the cancer is and how far it has spread. This way, they can deliver therapy more effectively. They will only recommend this if they determine it to have a significant clinical benefit that brachytherapy alone may not provide.
Cost can play into the decision to pursue treatment, but most insured patients, including those with Medicare or Medicaid, will have coverage for these treatments. There are also programs that can reduce or cut out-of-pocket costs for others.
If you need to explore financial assistance options, reach out to the billing department at WashU Medicine or BJC HealthCare, depending on the billing entity listed on your invoice. They will let you know all your options for coverage or payment plans. You don’t have to face the cost of treatment alone.
WashU Medicine Financial Assistance BJC HealthCare Financial Assistance
In a few instances, yes. Since this type of therapy is highly targeted, it can reduce long-term side effects and deliver treatment with greater efficacy.
In select cases of pediatric malignancies, such as soft tissue sarcoma and clear cell adenocarcinoma, the therapy has shown positive treatment responses. A care team with Siteman Kids at St. Louis Children’s hospital would determine the right approach to pediatric treatment.
Nurses at Siteman answer every call and every form. Speak with them directly 8:00 am to 4:30 pm CT Monday- Friday for guidance on appointments, second opinions, and referrals.
