HDR Brachytherapy

In brachytherapy, the radiation oncologist applies a radioactive source directly to the tumor while sparing nearby healthy tissue and surrounding organs.

High Dose Rate (HDR) brachytherapy has been used for over twenty years to successfully treat many gynecologic cancers including cervix and uterine cancer, often in combination with external beam radiation and/or surgery.

The Maddock Center was the first radiation oncology practice to bring HDR brachytherapy to Rhode Island using the microSelectron Variable HDR Afterloading System designed and built by Nucletron.

The word "Brachy" (pronounced Brake-ee, or Brack-ee) is Greek for "short distance". Like other radiation treatments, brachytherapy uses radioactive sources to eliminate cancerous cells that cause malignant tumors.

Interestingly, brachytherapy is not new. Shortly after radium was discovered in 1898, brachytherapy was used successfully to treat facial basal cell skin cancers. In the 1940s, the technique was expanded to treat internal tumors. However, the procedure usually required a hospital stay of several days. In 1996, HDR brachytherapy received a great deal of publicity following Fortune Magazine's cover story about Intel Corporation CEO Andy Grove's use of HDR brachytherapy to battle his prostate cancer.

Because HDR brachytherapy allows doctors to safely apply an increased dose of radiation specifically to the tumor, there are several significant benefits for patients:

  1. Eliminates hospitalization. Until recently, brachytherapy was performed in-hospital and required a stay of three to five days. Using the HDR method, patients are treated on an out-patient basis.
  2. Reduced treatment time. Usually, the entire procedure is performed in only a few hours with the radiation treatment itself lasting only ten to fifteen minutes.
  3. Decreased side effects. Because the radiation is applied directly to the tumor, normal, surrounding tissues are spared and side effects are significantly reduced; i.e. nausea, hair loss or diarrhea.
  4. Decreased recovery time. After a brief rest of one or two hours, you can usually go home or back to work.

As with external beam therapy, each treatment is customized for the individual patient. Following an initial consultation and physical examination, Dr. Maddock or Dr. Lane develops a detailed treatment plan with the Medical Physicist. Computerized calculations are used to determine the precise dose of radiation necessary to treat your tumor.

Treatment is administered by placing small, flexible plastic applicators, which look like long tubes, next to the tumor to be treated. For surface tumors, these tubes are positioned using a custom designed mask or mould. For internal tumors, applicator placement takes place in the operating room with the aid of an Oncologic Surgeon. The applicators stay in place for the duration of your treatment after which they are painlessly removed.

Each applicator is connected to a computer-controlled machine, which guides a single radioactive source into the tubes sequentially. The therapists and physicist control how long the source remains in each tube, thereby delivering a precise dose of radiation to each area targeted by the tube. This precise delivery is one of the main advantages of HDR brachytherapy.

Although each prescription is unique, the following are typical procedures you can expect during treatment:

  • You are escorted to the treatment room for the procedure.
  • Applicators (long tubes) are positioned.
  • X-rays are taken to ensure proper positioning of the applicators.
  • The Maddock Center staff, including the Medical Physicist, Radiation Therapists, and Radiation Oncologist, monitor your treatment and keep in constant communication with you.
  • Treatment starts when the system sends the radiation source to the tumor site through the long, flexible tubes.
  • The radiation sources retract into the system's protective storage unit immediately after treatment ends.
  • After a brief rest, you are allowed to go home and resume normal activities.
  • The number of HDR brachytherapy treatments depends on the your custom prescription. Dr. Maddock or Dr. Lane discusses this with you prior to your first treatment.

Therapies & Technologies at the Maddock Center: