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What is Brachytherapy?

Friday, November 6, 2009 1:00:00 AM Posted by Cancer Centers

There are several ways of giving radiation dosage to a cancerous tumor. The most common method is to deliver the required dosage from an external beam of radiation produced outside the body. In this case the source of radiation beam is located 80-100 cm from the body of the person receiving radiation. Sometimes placing the source of radiation within the tumor might have advantages over delivering radiation from an external source. This method of delivering required radiation from an internal source embedded within the tumor is called brachytherapy.

If you are aware of the inverse square law in physics you would know the dosage of radiation therapy delivery changes by a great proportion depending upon the distance of the radiation source to the intended target. In brachytherapy the source of radiation is within the tumor volume and the proper placement of these sources of radiation within the tumor is of crucial importance.

There are several radioactive isotopes used in the brachytherapy. These include radium-226, cesium-137, cobalt-60, iridium192, iodine-125, gold-198 and palladium-103. Radium has a longer half-life compared to some of the other radioactive isotopes. In the past radium was the primary isotope used in brachytherapy, but recently radium has been largely replaced by cesium, gold and iridium, which have relatively shorter half-life and lower energies and because of this the radiation from these isotopes can be easily shielded.

Brachytherapy can be delivered with devices known as implants. Brachytherapy can be delivered with permanent or temporary implants. These implants might be temporary or permanent. Temporary implants usually have a longer half-life and higher energies compared to the permanent implants. All temporary implants are inserted into the tumor during surgery. The duration of treatment for the temporary implant is usually 1-3 days.

Interstitial low-dose rate (LDR) brachytherapy is usually used for cancers involving the mouth and oral cavity, pharynx. This mode of treatment is often used in the treatment of sarcomas. Prostate cancer treatment is the most common form of LDR brachytherapy using seeds. Uterine cancer is the most common application of intracavitary LDR treatment. These patients are often isolated to prevent radiation exposure to nursing and other supportive staff during the care of the person.

The most common uses of high-dose rate (HDR) brachytherapy includes treatment of esophageal cancer, lung cancer and recently breast cancer and prostate cancer. Most HDR treatments are done as outpatient procedures allowing the patients to return to home the same day as treatment.

The Key Facts Behind Prostate Cancer
Prostate cancer is the most commonly diagnosed cancer of UK men. Modern surgical techniques, combined with drugs such as Viagra, mean that an operation to treat prostate cancer does not signal the end of a patient's sex-life.

The prostate itself is a small, walnut-sized gland situated near the bladder in men that produces one component of semen. There are a broad range of prostate cancers, some of which are extremely gentle and indolent and may not cause any significant ill health. However, others have the ability to spread to other parts of the body and cause more significant damage if not treated. This means it is important to catch prostate cancer early and then it is possible to treat it using a radiotherapy and surgery.

The Symptoms of Prostate Cancer
The first sign of prostate cancer can be noticed when you go to the toilet. The symptoms of prostate cancer are caused by the growth of cells, whether malignant or benign, pushing against the urethra, the thin tube which links the bladder to the penis. If you are suffering from the above symptoms then you should also look out for painful urination or ejaculation, blood in urine or semen, and pain in lower back, hips or thighs.

There are several ways that a doctor can check for prostate cancer. The simplest way is the digital rectal examination, in which the doctor insert a gloved finger into the rectum to feel for an an enlarged prostate. Following this a blood test can be conducted to look for any rises in any chemicals in the blood, and after this comes more sophisticated tests, such as ultrasound scans, and x-rays.

The Causes of Prostate Cancer
The exact causes of prostate cancer are still unclear but there are a number of factors which may increase your chances of developing it. These include, but are not limited to, a family history of prostate cancer, and a fat-rich diet.

There have been a number of studies into the link between prostate cancer and vasectomy but these have so far proved to be inconclusive.

Treatment for Prostate Cancer
Sometimes the best treatment for prostate cancer can be to not treat it at all. This is sometimes the case of older men when it is judged that surgery or other treatments may cause more harm than good.

If the cancer has spread from the prostate, or it is believed that it will spread, then surgery is normally the first course of action to remove it whilst is still possible and prevent further spreading. A prostatectomy is when the prostate gland is removed, usually along with small parts of the lymphatic system near the gland. However, this type of surgery can cause nerve damage which can prevent men from getting an erection ever again, or maintain complete control over urination. This does not mean that a man's sex life is over though as modern "nerve-sparing" surgical techniques, when combined with drugs such as Viagra, can ensure that the effects on both function and quality of life are minimised.

Other treatment option is radiotherapy which will be precisely targeted on the pelvic area, whilst other doctors are fighting prostate cancer by using the body's own hormones. In the latter's case, prostate cells, including cancerous ones, which are sensitive to levels of certain male hormones, can be rendered far less active if levels are reduced. However, this can reduce the sex-drive of the patient.

Advances in Prostate Cancer Surgery
Advances in prostate cancer surgery mean that surgeons can now successfully remove the prostate without causing the problematic nerve damage which has been inevitable in the past. In addition, radiotherapy technology advances mean that far higher doses can be targeted more precisely on the prostate, killing more cancer cells with fewer treatments.

A technique called prostate brachytherapy has also made some great advances in recent times and its use is becoming more and more common. There are two methods of brachytherapy - permanent seed implantation and high dose rate (HDR) temporary brachytherapy.

Permanent seed implantation involves injecting approximately 100 radioactive seeds into the prostate gland, which give off cancer-killing radiation at a low dose rate over several weeks or months, and the seeds remain in the prostate gland permanently.

HDR temporary brachytherapy involves placing very tiny plastic catheters into the prostate gland, and then giving a series of radiation treatments through these catheters. Another option is High Intensity Focussed Ultrasound, which uses sound waves to "melt" away the cancer.


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