Brachytherapy Department

The Brachytherapy Department’s experienced team of Board Certified Radiation Oncologists, physicists, radiation therapists and nurses deliver a technically advanced form of radiation treatment, called High Dose Rate (HDR) Brachytherapy. HDR Brachytherapy as provided by Alta Bates Summit can be an effective treatment for specific cancers including prostate, breast, and gynecological cancers.

High Dose Rate (HDR) Brachytherapy

The term brachytherapy comes from the Greek word brachy which means “short distance.” Unlike external beam radiation, which treats the tumor from the outside in, brachytherapy treats cancer from the inside out by using a sealed radioactive source inserted into hollow treatment catheters or specially designed applicators placed into or a short distance from the tumor.

Under controlled conditions a computerized robot positions the source with millimeter precision at multiple points throughout the array of implanted catheters or the channels of the intracavitary applicator to give a high dose to a limited volume. This significantly avoids normal, healthy tissues, delivering the treatment directly to the cancer site. After treatment the catheters and or applicators are removed. No radioactive material is left inside the patient.

Interstitial HDR Brachytherapy Implant

In this method, long narrow flexible plastic catheters are surgically implanted into the tumor site (e.g. prostate). This is done in the operating room under anesthesia. After observation in the recovery room the patient is transported to the Brachytherapy Department where a CT scan is done to give a virtual image of the implanted catheters and the surrounding anatomy. Using this information, a treatment plan is created to locate the treatment points throughout the array of catheters. Once the calculations are completed the patient is moved to the treatment room and the catheters are attached to the treatment machine called an afterloader. This computerized robot runs a miniature radiation source into the each of the catheters in sequence. The dwell positions and dwell times are programmed to lay down an optimized dose to the target and avoid the adjacent normal tissues. Treatment lasts about twenty minutes. Then the machine is unhooked and the patient stays overnight in the hospital. The next treatment is in the morning and a third that afternoon. Then all the catheters are removed and the patient goes home. There is nothing left inside the patient. This entire process is typically repeated a week later depending on the tumor type.

Intracavitary HDR Brachytherapy Application

In this method, a specially designed multichannel applicator is placed into a body cavity (e.g. vagina) in our outpatient clinic under conscious sedation. X rays or CT scans are then done to see the applicator and delineate the target and the surrounding normal tissue. Using this information, a treatment plan is created to locate the treatment points throughout the channels of the applicator. Once the calculations are completed the patient is moved to the treatment room and the catheters are attached to the treatment machine called an afterloader. This computerized robot runs a miniature radiation source into the each of the channels in sequence. The dwell positions and dwell times are programmed to lay down an optimized dose to the target and avoid the adjacent normal tissues. Treatment lasts about twenty minutes. Then the applicator is removed and the patient goes home. Typically this treatment is three to six outpatient visits and may be combined with external beam radiation treatments.

Mammosite Breast Brachytherapy

The MammoSite® Radiation Therapy System treatment is specific to the breast and is a category of treatment called accelerated partial breast irradiation. After breast conservation surgery or lumpectomy of an early breast carcinoma the surgeon places a balloon multicatheter device in the lumpectomy cavity. The balloon is inflated to conform to the cavity. In our department CT scans are done to see the device and the surrounding tissue. Then a treatment plan is generated to optimize the dose to the high risk cavity and spare the surrounding normal breast. The treatment machine is attached to the balloon catheter and treatment is given twice a day for five days as an outpatient. Then the catheter device is removed. The treatment is completed in one week compared to conventional external beam radiation which treats the entire breast from the outside with daily treatments spread out over six to seven weeks.

Combined Therapy

The Brachytherapy Department coordinates with a multi-disiplinary team of Alta Bates Summit physicians to create an integrated care strategy for your treatment if multiple levels of treatment are required.

For more information about High Dose Rate Brachytherapy, please call the Brachytherapy Department at (510) 869-8875.