How to Reverse Brachytherapy Implants

Brachytherapy is a form of radiation therapy that treats certain cancers using radioactive implants the size of a grain of rice to deliver small, concentrated doses directly to a tumor. In many cases, the used-up radiation implants are allowed to remain in place, but in some types of brachytherapy treatment, your doctor may remove the implants. The removal is a same-day surgical procedure done a few days after the implant is placed.

Instructions

• 1

  Before the treatment, you may receive a povidone-iodine douche to cleanse the area and/or an enema to prevent you from dislodging the applicator during a bowel movement. Under regional anesthesia, you will be fitted with a foley catheter to help you pass urine while the implant is in place. After the implant is in place, you may be isolated and kept on bed rest, so bring plenty of things to do while lying on your back, like books and magazines or a small hobby like crocheting or drawing.

• 2

  There are two types of brachytherapy: intracavity treatment and interstitial treatment. In intracavity treatment, under regional anesthesia, doctors sew a stent in place to keep the cervix open a few days before the procedure. To place the implant, they insert the radioactive source through an applicator into the body cavity (such as the uterus, vagina or rectum) to the tumor site. In interstitial treatment, under regional or general anesthesia, the radioactive source is stitched in place directly into the tumor or surrounding tissue, and then clipped away when it is time to remove it.

• 3

  When it is time to remove an intracavity implant, again under regional anesthesia, your doctor will carefully remove the implant through the applicators, followed by the applicators and the catheter. With an interstitial implant, again under regional anesthesia, your doctor will clip the stitches holding the implant in place and remove it. You will go to the recovery room until you can feel your lower body again.

• 4

  You will be sent home with strict instructions about care of the implant site (for example, using a peri bottle to irrigate the perineum after the surgery), pain management, diet, physical and sexual activity and symptoms to watch for that may indicate a problem you should discuss with your doctor.