High Dose Rate Brachytherapy
High Dose Rate Brachytherapy for Prostate Cancer
Prostate cancer is very common in the United States. The prostate is a small gland sandwiched between the bladder and rectum. Due to the prostate’s close proximity to the bladder, urethra, neurovascular bundles and rectum, the most common side effects of any surgical or radiological prostate cancer treatment include urinary, bowel and sexual (erectile dysfunction) side effects. There are several treatment options for men with prostate cancer. Preserving quality of life should be an important goal in prostate cancer treatment strategies. In addition to meeting with a urologist, it is equally important to consult with a radiation oncologist to fully understand all of the radiation therapy options available for prostate cancer treatment.
Several advances in the delivery of radiation therapy have led to increases in our ability to deliver higher doses more safely, thereby increasing cure rates and quality of life for our patients. Just as intensity-modulated radiation therapy (IMRT) is a leap forward in our ability to more effectively and safely deliver external beam radiation, high dose rate (HDR) brachytherapy is a leap forward in the delivery of precise brachytherapy for prostate cancer.
HDR brachytherapy is the safest, most technologically advanced method to deliver a high dose of radiation therapy while minimizing urinary, bowel, and sexual side effects. HDR brachytherapy is most commonly used to boost treatment when combined with an abbreviated (5-week) course of external beam radiation therapy in patients who have intermediate- or high-risk prostate cancer.
A radiation oncologist and a urologist perform the treatment. Then they perform a CT scan of the pelvic region. They use images from the CT scan to precisely contour the outlines of the prostate, urethra, bladder and rectum. Using sophisticated software, they design a radiation therapy treatment plan to maximize dose to the prostate gland while minimizing dose to nearby critical structures such as the bladder and rectum. This ability for precise treatment planning with CT scan information obtained after the catheters have been placed is what makes HDR brachytherapy one of the most exact, safest methods for treating prostate cancer.
High Dose Rate Brachytherapy for Gynecological Cancer
Endometrial cancer and cervical cancer remain prevalent in our society. In fact, uterine cancer is the most common cancer of the female genital tract in the United States, and cervical cancer remains the most common cause of female cancer mortality worldwide. Yet the incidence of cervical cancer has decreased greatly in countries where routine PAP smears are commonly performed. Despite these advances, we are still treating many patients with these cancers. HDR or high dose rate brachytherapy is critical for treating cervical and endometrial cancers.
HDR brachytherapy is a type of radiation therapy where the oncologist places a radioactive source close to the tumor or area of interest. Female anatomy provides a unique opportunity to use this type of treatment. We deliver a high dose of radiation to the tumor or area of interest while minimizing radiation to normal tissues. This treatment opportunity translates into great success for cervical and endometrial cancer treatments. HDR brachytherapy has been the preferred form for treating endometrial cancer for some time. For cervical cancer, HDR brachytherapy has become the preferred form since it does not require hospitalization, limits radiation exposure to hospital personnel, and has similar outcomes when compared to low dose rate brachytherapy (LDR).
Treatment for cervical cancer may include surgery, radiation therapy, chemotherapy or some combination. Cervical cancer is often treated with combined chemotherapy and radiation therapy. Radiation therapy will likely include external beam and brachytherapy. Once the treatment is done, the patient can continue her day. Patients will require four to eight treatments for cervical cancer. These treatments are generally well tolerated and do not require hospitalization.
Endometrial cancers are treated mainly with surgery. However, some patients require radiation therapy or chemotherapy. If a patient needs radiation therapy, it may consist of external beam, brachytherapy or a combination. HDR brachytherapy is most commonly recommended. The treatment process takes about an hour and most patients will require three treatments. After the treatment is complete, the patient can continue with her day.
Brachytherapy for gynecologic malignancies is a very important part of successful treatment. Our physicians have special training in these treatments and can provide you with the best care possible. We encourage you to contact us for an appointment so that we can answer any additional questions you have about HDR brachytherapy or the treatment of gynecologic malignancies.
For Breast Brachytherapy, please reference Accelerated Partial Breast Irradiation
