Brachytherapy
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Brachytherapy is a type of radiation therapy that uses an implanted device to expose tumors to radiation. This makes the radiation more targeted, sparing more healthy tissue from damage. Brachytherapy can be used to treat mesothelioma and asbestos-related lung cancer.[1]
What Is Brachytherapy?
Brachytherapy is a radiation therapy in which a device that gives off radiation is implanted inside the body. The surgeon places it next to a tumor to kill cancer cells.
About Radiation Therapy
Radiation therapy, which utilizes concentrated energy to kill cancer cells, is one of the three main treatments for cancer. It is often used with chemotherapy and surgery.
Traditional radiation therapy, called external beam radiation therapy, kills cancer cells by aiming a high-energy beam at the part of the body with the tumor. The radiation must penetrate healthy skin and other tissues to reach the tumor cells.[2]
Radiation poses a significant risk of harming healthy tissue, especially if the tumor is deep and hard to reach.
Radiation can also damage the genetic material in healthy cells, increasing the risk of those healthy cells becoming cancerous. Patients have developed secondary cancers after undergoing radiation therapy.[3]
How Does Brachytherapy Work?
One way to make radiation more targeted is to implant a small device inside a tumor. The implanted device then gives off radiation from within, killing those tumor cells.
The type of radiation emitted by the device does not travel far, making the risk to healthy cells minimal and highly localized. This is called brachytherapy.[4]
Temporary vs. Permanent Brachytherapy
The implanted device is usually removed after a specified period of time. This is known as temporary brachytherapy.
Permanent brachytherapy is the insertion of a small radioactive implant that stays in place indefinitely. Over time, it stops giving off radiation. It could take ten months to become inert.
With a permanent implant, you will give off radiation for a period of time. This means you need to be careful to stay away from vulnerable people, such as pregnant women and young children.
High-Dose vs. Low-Dose Brachytherapy
High-dose brachytherapy is a larger dose of radiation that is given over a short period of time. If you are undergoing this type of therapy, you will likely be admitted on an outpatient basis. The implant will be inserted and remain in place for a few minutes or up to 20 minutes.
With low-dose brachytherapy, you get an implant that gives off less radiation, but it stays in place longer. This could be a few hours or a few days and does typically require that you stay in the hospital.
What Does Brachytherapy Treat?
Like other types of radiation therapy, brachytherapy treats cancer. Radiation is high-energy and readily kills living cells, including cancer cells.
Brachytherapy Radiation Treatment for Mesothelioma
Brachytherapy is not a standard mesothelioma treatment. However, it shows promise for several types of cancer. Ongoing research and clinical studies with mesothelioma patients may open the door for more patients to benefit from this treatment.
What Are the Benefits of Brachytherapy?
There are important benefits of brachytherapy, especially when compared to traditional radiation therapy.
- Because brachytherapy places radioactive material directly inside or near the tumor, higher radiation doses can be administered more directly to cancer cells. Traditional radiation therapy is directed from outside the body, often damaging healthy cells. This requires a lower dosage. With higher doses used in brachytherapy, treatment may shrink tumors more effectively.[1]
- Brachytherapy typically causes fewer side effects because healthy cells are less affected, and the therapy is more focused.[1] Treatment and recovery time may also be shorter with brachytherapy.
- In studies of brachytherapy on lung cancer patients, survival times were extended compared to patients who did not receive this type of therapy.[5]
- Brachytherapy may also help patients with mesothelioma or lung cancer find relief from symptoms by shrinking tumor size. This is known as palliative care, and it is important for improving quality of life.
Potential Risks and Complications of Brachytherapy
One benefit of brachytherapy is fewer side effects. Because radiation is more localized, it harms fewer healthy cells. Damage to healthy cells is a major source of side effects in traditional radiation therapy.
With brachytherapy, surgery is required to insert the device. Surgery of any type can lead to infections, pain, bleeding, and other complications. The most common side effect of brachytherapy is pain and tenderness at the insertion site.
Temporary brachytherapy implants may cause a patient to give off radiation, meaning a hospital stay with limited visitors may be necessary to protect others. In most cases, however, the amount of radiation is limited and mostly restricted to the area of the tumor.[4]
How Effective Is Brachytherapy for Lung Cancer and Mesothelioma?
As experts continue to develop and refine brachytherapy, more studies are conducted and are finding that it can benefit mesothelioma patients.
In one study, brachytherapy combined with surgery was not found to slow or stop the growth of mesothelioma.[6] More research is anticipated, especially since brachytherapy shows promise for treating lung cancer.
Lung cancer responds well to brachytherapy treatments. In a study of over 100 patients, approximately 25% survived more than five years after the treatment. With more traditional lung cancer treatments, only about 15% survive that long.[5]
Who Qualifies for Brachytherapy?
Your medical team can determine if you qualify for brachytherapy. It is not standard in the treatment of mesothelioma, but you might benefit from it.
Generally, brachytherapy is currently used for head and neck cancers, breast cancer, eye cancer, prostate cancer, and cervical cancer.[7]
What to Expect When Undergoing Brachytherapy Mesothelioma Radiation
If you are going to undergo brachytherapy, your medical team will explain what will happen. Most implants are placed using a catheter, a thin tube. In some cases, doctors will use an applicator, which is larger.[7]
Once the catheter or applicator is in place, they will insert the radioactive implant. Your doctors might place it directly within a tumor or within a body cavity.
When the prescribed period of time for applying radiation is over, your medical team will remove the catheter. You will get pain medication for this, as it can be painful.
Once the implant has been removed, you are no longer radioactive or dangerous to other people. You might experience mild pain for a period of time after the removal.
Brachytherapy is a treatment that delivers radiation to tumor cells without using an external beam; instead, radiation is targeted and localized, minimizing side effects and damage to healthy tissue. Brachytherapy may also kill more cancer cells; however, it does need to be combined with surgery.
While results are mixed and inconclusive for treating mesothelioma, brachytherapy does show great promise as a treatment, especially for those patients living with lung cancer caused by asbestos.
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Anne Courtney has a Doctor of Nursing Practice degree and is an Advanced Oncology Certified Nurse Practitioner. She has years of oncology experience working with patients with malignant mesothelioma, as well as other types of cancer. Dr. Courtney currently works at University of Texas LIVESTRONG Cancer Institutes.