Cervical Brachytherapy: Treatment from Within

In this article, we’ll explore what cervical brachytherapy is, how the method works, and what to expect from it.

What is cervical brachytherapy?

Brachytherapy isB a type of radiation therapy. With this method, the doctor inserts a tiny radioactive implant or probe directly into the uterine cavity or the cervix. The radiation source is placed as close as possible to the tumor or directly inside it.

Thanks to this approach, the tumor receives a higher dose of radiation than with external therapy. Meanwhile, the surrounding healthy tissues (bladder, rectum, intestines) remain unharmed.

Important to know: Brachytherapy is a form of internal radiation therapy. It is not a surgical procedure and does not involve the removal of tissue. It is a targeted application of radiation to the tumor from within.

When is brachytherapy prescribed for cervical cancer?

Radiation therapy for cervical cancer using brachytherapy is prescribed in the following cases:

• Locally advanced cervical cancer, the treatment of which requires a combination of external radiation and internal brachytherapy.
• After surgery as an additional, preventive method. If there is a risk of recurrence after hysterectomy, internal radiation minimizes this risk.
• When surgical treatment is not possible due to the patient’s condition or the characteristics of the tumor.
• For recurrences: either as a standalone treatment or in combination with chemotherapy or repeat external radiation.

The decision regarding radiation therapy for cervical cancer is made by a gynecologic oncologist, a radiologist, and a medical oncologist. They assess the stage of the disease, the size of the tumor, the condition of adjacent organs, and the patient’s overall health.

Preparation for internal radiation therapy

Radiation therapy in gynecology is one of the leading treatment methods. The safety of the treatment depends on preparation for the procedure.

First, the woman undergoes an MRI or CT scan of the pelvis. These scans help determine the size and location of the tumor, plan the placement of the applicator, and calculate the radiation dose.

Before the procedure, the patient is asked to empty her bowels. This is necessary to ensure the rectum does not interfere with the proper insertion of the applicator and to reduce the radiation dose to it.

The doctor also explains the procedure in detail, answers questions, and prescribes sedatives if necessary.

How is the cervical brachytherapy procedure performed?

The procedure is performed in a radiation-shielded room. To minimize discomfort, local anesthesia and intravenous sedation are used.

The doctor inserts an applicator a device with hollow channels—into the uterine and vaginal cavities. Its shape is selected based on the patient’s anatomy and the characteristics of the tumor. To ensure precise placement, a follow-up CT or MRI scan is performed after the applicator is in place.

The patient is then connected to the HDR brachytherapy machine. A thin wire containing a radioactive isotope automatically moves through the applicator’s channels, pausing at calculated points for as long as necessary to ensure precise dose delivery. The entire process takes 10 to 30 minutes.

Medical staff monitor the patient via monitors. Once the session is complete, the applicator is immediately removed.

Important to know: With HDR brachytherapy (a high-dose-rate method), the radioactive source does not remain in the body. It automatically returns to a protective container after each session. Therefore, the patient poses no radiation hazard to those around her.

Possible Side Effects and Complications

After a course of brachytherapy, the following side effects may occur:

• Vaginal irritation a feeling of discomfort, swelling, and slight discharge. This resolves on its own within a few weeks.
• Frequent urination, a burning sensation, or discomfort. This is due to the proximity of the bladder to the irradiation area.
• Diarrhea, flatulence, and occasionally mild rectal irritation.
• General fatigue. This resolves after the completion of therapy.

Later complications include vaginal stenosis (narrowing of the vagina due to tissue fibrosis) and rare damage to the bladder or rectum. Therefore, cervical radiation therapy is planned with consideration for protecting adjacent organs, and doses are carefully calculated.

Important to know: Vaginal stenosis after brachytherapy is a predictable complication. Doctors recommend regularly using vaginal dilators, starting a few weeks after the course is completed.

Rehabilitation after completing the brachytherapy course

After completing cervical cancer treatment with radiation therapy, rehabilitation includes physical recovery and psychological support.

During the first month after treatment, the body is actively recovering. Avoid strenuous physical activity. Moderate activity (walking, light exercise) accelerates recovery. A balanced diet with sufficient fiber helps normalize bowel function.

Resuming sexual activity after radiation therapy for cervical cancer requires a gradual approach and consultation with a doctor at the Oncare medical center. Using lubricants and dilators helps prevent or minimize vaginal stenosis.

Many women experience anxiety after completing treatment, stemming from fear of recurrence, changes in their bodies, and relationship issues. Support from a psychologist or oncology psychologist is an integral part of rehabilitation.

Follow-up examinations are scheduled every 3 months for the first two years, then less frequently. They include a gynaecological examination, smear tests and, if necessary, MRI or PET-CT scans.

Radiotherapy in the treatment of cervical cancer is one of the most effective and precise methods of combating the disease.