Cancer Treatment

Cancer Treatment

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    Partial breast brachytherapy is a breast conserving therapy that has become a major treatment modality for Stage I and II breast cancer for people who have undergone a lumpectomy. One type of partial breast treatment technique is referred to as MammoSite Breast Brachytherapy. Treatment of breast cancer with MammoSite usually involves a five-day treatment course (2 times a day) with each treatment taking about 15 minutes each. After the breast cancer is removed, a small, soft balloon attached to a thin catheter is placed inside the lumpectomy cavity. The balloon is filled with saline solution and remains in place during the five-day treatment. During the twice-per-day treatments, the catheter is attached to a computer-controlled HDR brachytherapy unit, which inserts the radioactive sources according to the treatment plan. Partial breast brachytherapy is delivered directly to the cavity from which the breast cancer was removed rather than to the entire breast, which allows for a much higher daily dose compared to that used during the standard whole breast radiation therapy and often yields excellent cosmetic results. At the end of the five days, the treatment is complete and the catheter is removed.

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    Unfortunately, damage to the body’s heart and blood vessels can be a side effect of brachytherapy, or internal radiation therapy that is sometimes used for cancer treatment. Brachytherapy involves having radioactive material placed directly in the body, targeting a specific area. Radiation therapy can cause heart damage by directly damaging the heart muscle, injuring blood vessels, causing inflammation of the sac surrounding the heart (the pericardium) and causing heart valve damage.

    Heart problems related to radiation treatment for cancer may not emerge for many years. If you come under a cardiologist’s care for heart problems and were treated with brachytherapy in the chest area, be sure your cardiologist is aware of your cancer treatment history.

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    High-dose rate brachytherapy (HDR) treatment refers to the use of a temporary, but very intense, radiation source, placed inside a tumor or body cavity where cancer may be present. HDR brachytherapy is delivered quickly (a fast "rate" of delivery) and is typically done in an outpatient setting, and may or may not require any use of sedation or anesthesia. Many types of cancer may be treated with HDR brachytherapy, including gynecologic cancers (cervix, endometrial, vagina), lung cancer with airway tumor obstruction, and breast cancer when only partial breast radiation is needed. HDR brachytherapy may be combined with external beam radiation, depending upon clinical circumstances.
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    A , Hematology & Oncology, answered
    As with permanent brachytherapy for prostate cancer, the radioactive material in high-dose-rate brachytherapy is inserted into the prostate. But given the high intensity of the material, it cannot be left in the body for long. After a set period of time, a remote-controlled machine pulls the material out. The process is then repeated several times in one day or over multiple days. Catheters remain in place until after the final treatment.

    One reason most radiation oncologists don't use high-dose-rate brachytherapy is that it's difficult for patients to have the catheter in the perineum for a few days. And because it lacks the speed and convenience of permanent brachytherapy, many patients avoid it. Most radiation facilities do not offer high-dose-rate brachytherapy because other treatments are less complicated and usually just as effective.
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    A , Oncology, answered
    Brachytherapy, also known as internal radiation, is another way to deliver radiation therapy. Instead of aiming radiation beams from outside the body, radioactive seeds or pellets are placed directly into the breast tissue next to the cancer. It is often used as a way to add an extra boost of radiation to the tumor site (along with external radiation to the whole breast), although it may also be used by itself (see below). Tumor size, location, and other factors may limit who can get brachytherapy.

    There are different types of brachytherapy.
    Intracavitary brachytherapy: This method of brachytherapy consists of a small balloon attached to a thin tube. The deflated balloon is inserted into the space left by the lumpectomy and is filled with a salt water solution. (This can be done at the time of lumpectomy or within several weeks afterward.) The balloon and tube are left in place throughout treatment (with the end of the tube sticking out of the breast). Twice a day a source of radioactivity is placed into the middle of the balloon through the tube and then removed. This is done for 5 days as an outpatient treatment. The balloon is then deflated and removed. This system goes by the brand name, Mammosite®. This type of brachytherapy can also be considered a form of accelerated breast irradiation. Like other forms of accelerated breast irradiation, there are no studies comparing outcomes with this type of radiation directly with standard external beam radiation. It is not known if the long-term outcomes will be as good.

    Interstitial brachytherapy: In this approach, several small, hollow tubes called catheters are inserted into the breast around the area of the lumpectomy and are left in place for several days. Radioactive pellets are inserted into the catheters for short periods of time each day and then removed. This method of brachytherapy has been around longer (and has more evidence to support it), but it is not used as much anymore.

    While these methods are sometimes used as ways to add a boost of radiation to the tumor site (along with external radiation to the whole breast), they are also being studied in clinical trials as the only source of radiation for women who have had a lumpectomy. In this sense they can also be considered forms of accelerated partial breast irradiation.
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    Nearly half of all people with cancer receive radiation therapy to treat their cancer or relieve symptoms. Radiation therapy kills cancer cells by destroying their DNA, but it may also affect normal cells and adjacent organs in the process. The goal of brachytherapy, or internal radiation therapy, is to precisely target the radiation exposure to the tumor where it is needed and avoid surrounding healthy tissues by placing radioactive sources directly on or inside cancer tissues.

    “By treating the tumor from the inside out, we can rapidly deliver higher doses of radiation to the tumor, with relatively few side effects,” explains UCLA radiation oncologist and chief of the Division of Brachytherapy D. Jeffrey Demanes, MD, a pioneer of high-dose-rate (HDR) brachytherapy. HDR brachytherapy has been used successfully to treat prostate, breast, head and neck, gynecologic, gastrointestinal, skin, soft tissue sarcomas and many other types of cancer. “In some cases, it is used as the only treatment, and in other cases, this precision radiation therapy is combined with surgery, external-beam radiation therapy or chemotherapy, depending upon the type and extent of the cancer and needs of the individual patient,” Dr. Demanes says.

    HDR brachytherapy uses a computerized robotic-delivery device to temporarily insert a tiny radiation source into a tumor. It is performed by inserting thin, straw-like applicators about the size of an intravenous line in or near the treatment site.
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    MammoSite, or brachytherapy, is an internal therapy in which the radiation source is placed inside the body.

    MammoSite is a targeted radiation therapy treatment for breast cancer performed following a lumpectomy. A small, soft balloon is placed inside the lumpectomy cavity through a small incision in the breast. A portion of the catheter remains outside the breast and is connected to a computer-controlled machine that inserts a radiation "seed" to the area where cancer is most likely to recur.

    The implant is placed in a hospital operating room by a doctor using an imaging test (such as an X-ray or MRI) to look at the exact area where the radiation needs to be to most effectively treat the cancer.

     

     

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    Internal radiation therapy (brachytherapy) is used to treat cancer. With internal radiation therapy, a radiologist places radioactive material inside the body. These “seeds” give off radiation to destroy nearby cancer cells. The seeds may be placed inside the body with needles, catheters or minor surgeries. Some of the seeds are permanent, and some are temporary. The permanent seeds stop giving off radiation over time. They do no damage by remaining in the body.
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    A , Hematology & Oncology, answered
    After permanent brachytherapy for prostate cancer, there is a small risk that the seeds will be discharged during urination, so some doctors suggest straining the urine for a few days, though iodine seeds can be flushed down the toilet. In rare cases, when seeds are not connected together, a seed can enter the bloodstream and travel to the lungs or another part of the body. (Most seeds are linked.) The radiation emitted by a single seed is low, so it shouldn't pose any significant health problems, but it may in rare circumstances.
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    Brachytherapy for endometrial cancer involves inserting small amounts of radioactive material into or around the cancer, typically through the vagina. It is more targeted, affecting less healthy tissue than external beam radiation, and may use a higher radiation dosage so fewer treatments are required. Side effects may include fatigue, vaginal irritation, abdominal cramping, and diarrhea.