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HDR Brachytherapy With Afterloading Catheters

This information will help you prepare for high-dose radiation (HDR) brachytherapy with afterloading catheters, including what to expect before, during, and after your treatment.

HDR brachytherapy is a type of radiation therapy. During this treatment, radioactive material will be placed inside your body, in or near the tumor. Only this area will get the radiation. The material is put inside your body with afterloading catheters.

Afterloading Catheters

Afterloading catheters are hollow tubes that feel and look like long, thin, soft straws. They are placed during surgery. The catheters can be placed in any part of your body, depending on where the tumor is located. Figure 1 shows what the catheters look like if they are in the forearm. A special drain may also be placed in the area to prevent swelling and infection. There may be a bandage over your catheters, or you may see them coming out through your skin.

While You Are in the Hospital

  • After your catheters are placed, you may be in the hospital for a number of days. Your surgeon and radiation oncologist will oversee your care.
  • While you are on the inpatient unit, there will be nothing radioactive in your catheters. You do not have to be alone and can have visitors.
  • You will be shown how to move around without damaging or moving your catheters.
  • You cannot shower while your catheters are in place, but you can take sponge baths.

Planning Your Treatment

On the day of your surgery, you will have a procedure called a simulation. During this procedure, images will be taken of the area to be treated. These will be done on a computed tomography (CT) scan and may also be done with an x-ray machine called a simulator. These scans are used to plan your treatment. They are not used for diagnosis or to find tumors.

During Your Treatment

Once you have recovered from your surgery, your treatment will begin. Your radiation oncologist will tell you your treatment schedule. For example, some patients may be treated 2 times a day for several days in a row. Your treatment will be given in a shielded room in radiation oncology. You will be taken there each time you are scheduled for a treatment.

Each day of your treatment, we will bring you into the room and position you on the table. Cables that look like long, plastic tubes will be attached to your afterloading catheters. The cables will be connected to a machine that stores the radioactive material. You will hear your therapist calling out numbers. This is to make sure that each catheter is connected correctly to the machine.

Once everything is set up, you will be left alone in the room to get your treatment. Your therapists can see and hear you at all times. They will be sending the radioactive material through the cables and into your catheters. The cables will remain in place for 10 to 20 minutes. You may hear the machine humming when it is turned on.

While the material is in your body, it sends out radiation to the area of the tumor. You will not feel any pain or discomfort during your treatment.

After your treatment is done, the radioactive material will be moved back into the storage machine. Your therapists will come back into the room to disconnect the cables. You will then be taken back to your room.

Removing Your Afterloading Catheters

After your last treatment, your doctor will remove your afterloading catheters. This is often done in radiation oncology or in an operating room. It depends on where the catheters were placed in your body.

Before your catheters are removed, you will be given pain medication. You may feel a pulling sensation as the doctor removes your catheters. A bandage will be applied to the area after your catheters are removed.

Caring for Yourself at Home

You may be discharged right after your last treatment is given or some time later. It depends on the care you need. Before you leave the hospital, you will be told when to make follow-up appointments to see your radiation oncologist and surgeon. 

Look at your incision with your nurse before you leave the hospital. He or she will teach you how to care for it. Then, check it every day at home.

Your catheter sites will be small and will heal quickly after your catheters are removed. Cover the sites with a bandage for the first 24 hours. After that, they can be left open to the air. Shower daily, but do not use soap in the area until all your sites are healed. Call your doctor if you develop any of the following symptoms at your catheter sites or incision:

  • Redness
  • Swelling
  • Drainage

Side Effects

If you have any side effects, they may begin 7 to 10 days after your treatment and last for 2 to 3 months. Your radiation oncologist or nurse will tell you what side effects to expect. They will also tell you how to manage them if they develop.

Your skin may become red, dry, and itchy if the radioactive materials were close to your skin. You will notice this about 2 weeks after your treatment. Apply a moisturizer such as Aquaphor® or Eucerin®. Do not put the moisturizer on any open areas. Call your surgeon if you have:

  • Swelling
  • Pain
  • Blisters on your skin

If the radioactive materials were in your head and neck area, your mouth may become dry and sore. You may have trouble swallowing. 

Other side effects of brachytherapy are rare and depend on the location of the treatment. Other side effects you may have include: