Internal Radiation Therapy

What is Internal Radiation Therapy

Internal radiation therapy is a procedure that can be used to treat many different types of cancer. It uses a type of energy (ionizing radiation) to kill or shrink cancer cells.

During this procedure, radioactive material is placed inside the body, close to a tumor or directly into a tumor. The radioactive material is usually contained inside of an implant, such as a capsule or seed.

The amount of radiation you will receive and the length of your therapy will depend on your medical condition. There are different types of internal radiation therapy.

  • Brachytherapy. This type of therapy involves placing a source of radiation inside the body. There are different ways of receiving brachytherapy.
    • A low-dose implant gives off a low dose of radiation for one to several days. The applicator may be left in place or removed between treatments. The applicator and implant are removed after the last treatment has been done.
    • A high-dose implant gives off a high dose of radiation for only a few minutes. The applicator may be left in place or removed between treatments. The applicator and implant are removed after the last treatment has been done.
    • A permanent implant stays in the body after placement. It gives off radiation for weeks or months. After the radiation is gone, the implant can remain harmlessly inside the body.
  • Intraoperative radiation therapy. This type of radiation is delivered during surgery to remove a tumor, in case the surgeon cannot remove all cancer cells.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant, may be pregnant, or are breastfeeding.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Allergic reactions to medicines.
  • Bleeding.
  • Infection.
  • Tissue damage.
  • Treatment failure.

Radiation therapy can place you at higher risk for a second cancer later in life. Ask your health care provider if you have other risks that are specific to your cancer.

Most people have side effects from radiation therapy. Side effects depend on the amount and location of radiation. Common side effects include:

  • Soreness, bruising, or swelling.
  • Nausea and vomiting.
  • Diarrhea.
  • Fatigue.

What happens before the procedure?

Medicines

  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your doctor tells you to take them.
    • Taking over-the-counter medicines, vitamins, herbs, and supplements.
  • Take medicine to clean out your bowel (bowel prep) as directed.

General instructions

  • Follow instructions from your health care provider about eating or drinking restrictions.
  • You may have a complete physical exam, blood tests, or imaging tests.
  • Do not use any tobacco products, including cigarettes, chewing tobacco, and e-cigarettes, as told by your health care provider. If you need help quitting, ask your health care provider.
  • Do not drink alcohol.
  • Plan to have someone take you home from the hospital or clinic.
  • Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
  • Ask your health care provider what steps will be taken to help prevent infection. These may include:
    • Removing hair at the surgery site.
    • Washing skin with a germ-killing soap.
    • Antibiotic medicine.

What happens during the procedure?

  • An IV will be inserted into one of your veins.
  • You may be given one or more of the following:
    • A medicine to help you relax (sedative).
    • A medicine to numb the area (local anesthetic).
    • A medicine to make you fall asleep (general anesthetic).
  • If a long, thin tube (catheter) will be used, an incision may be made where the catheter will be inserted.
  • A delivery tool (applicator) will be inserted into your body and guided toward the cancer. The applicator may be a catheter, a needle, or a different type of applicator. An X-ray, ultrasound, MRI, or CT scan will be used to help guide the applicator.
  • The implant will be placed into your body through the applicator. The implant may be a capsule, seed, tube, ribbon, balloon, wire, or needle.
  • The applicator may be removed, or it may be left in place.
  • If you have an incision, it will be:
    • Closed with stitches (sutures), staples, or adhesive strips.
    • Covered with a bandage (dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
  • If you are having low-dose or high-dose therapy over several days, you may need to stay in the hospital during treatment.
  • If you are having high-dose therapy, you may need to avoid contact with people during your hospital stay. You may also need to limit or avoid contact with others for a certain amount of time after you leave the hospital. Ask your health care provider if this applies to you.
  • Do not drive until your health care provider approves. If you were given a sedative, you should not drive for 24 hours.

Summary

  • Internal radiation therapy uses a type of energy (ionizing radiation) to kill or shrink cancer cells.
  • During this procedure, radioactive material is put inside your body, close to a tumor or directly into a tumor. The material is usually contained within an implant.
  • To place the implant in your body, your surgeon may use a catheter, a needle, or a different type of applicator.
  • There are different types of internal radiation, including a low-dose implant, a high-dose implant, a permanent implant, or intraoperative radiation therapy.

Internal Radiation Therapy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

  • Soreness, bruising, or swelling.
  • Nausea or vomiting.
  • Diarrhea.
  • Fatigue.

Other side effects may occur, depending on which part of your body was exposed to radiation and how much radiation was used. Most side effects are usually temporary and get better over time. It can take up to 3–4 weeks for you to regain your energy or for side effects to get better.

Follow these instructions at home:

Activity

  • Most people can return to normal activities a few days or weeks after the procedure. Ask your health care provider what activities are safe for you.
  • Rest as told by your health care provider.

Driving

  • Do not drive until your health care provider approves.
    • If you were given a medicine to help you relax (sedative) during your procedure, do not drive for 24 hours.
    • Do not drive or use heavy machinery while taking prescription pain medicine.

Incision and delivery site care

  • If you have an incision, follow instructions from your health care provider about how to take care of your incision. Make sure you:
    • Change your bandage (dressing) as told by your health care provider.
    • Wash your hands with soap and water before you change your dressing. If soap and water are not available, use hand sanitizer.
    • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
  • If you have an incision, do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.
  • Check the area where your implant was placed (delivery site) every day for signs of infection. If you have an incision, you should also check that area every day. Check for:
    • Redness, swelling, or pain.
    • Fluid or blood.
    • Warmth.
    • Pus or a bad smell.

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If you were prescribed an antibiotic medicine, take it as told by your health care provider.

Lifestyle

  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay healing. If you need help quitting, ask your health care provider.
  • Try to eat regular, healthy meals. Some of your treatments might affect your appetite.

General instructions

  • If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
    • Drink enough fluid to keep your urine pale yellow.
    • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
    • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
    • Take an over-the-counter or prescription medicine for constipation.
  • Certain types of implants may set off metal or radiation detectors at airport security checkpoints. Carry a note from your health care provider to explain that you have an implant.
  • Ask your health care provider if you should avoid contact with others (especially children and pregnant women) for a period of time after treatment.
  • Keep all follow-up visits as told by your health care provider. This is important. You will need follow-up to determine how well the radiation therapy worked.

Contact a health care provider if you have:

  • A fever.
  • Any of the following around your delivery site or incision:
    • Redness, swelling, or pain.
    • Fluid or blood.
    • Warmth.
    • Pus or a bad smell.
  • Nausea or fatigue that does not go away after several days.

Get help right away if you:

  • Have difficulty breathing.
  • Feel like you are going to faint.
  • Have severe pain.
  • Have severe vomiting or diarrhea.

Summary

  • Most people can return to normal activities a few days or weeks after treatment. Ask your health care provider what activities are safe for you.
  • Ask your health care provider if you should avoid contact with children and pregnant women for a period of time after your treatment.
  • Check your delivery site every day for signs of infection. If you have an incision, check that area every day too.
  • Keep all follow-up visits as told by your health care provider. This is important.
  • Make sure you know what symptoms should cause you to contact a health care provider or get help right away.
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