Brachytherapy with Anesthesia

This handout will explain brachytherapy with anesthesia and how to prepare for it. Write down any questions you have. Bring this handout and your questions with you for each visit.

What is brachytherapy?

Brachytherapy is a type of internal radiation treatment. It gives a high dose of radiation to a small area within the uterus, cervix, or vagina. Small, hollow tubes are placed by your doctor. A tiny, radioactive source, attached to a wire, is inserted through the tubes. The wire is left in place for 5-20 minutes. The wire then moves out of the tube and goes back into its storage case. The tubes are taken out and the treatment is complete.

This is done in the Radiation Oncology Clinic. Most patients have 5 treatments and are scheduled 1-2 times per week. Each treatment takes 6-8 hours from start to finish. This is a surgical procedure. It is done under anesthesia. You will be asleep and remain comfortable.

Before the Treatment

Getting ready for the first treatment requires several tasks. These tasks are done in a pre-procedure visit that takes 2-4 hours.

A medical history and physical exam will be done by the radiation doctor.

Your current medicines must be reviewed. The review includes the names, doses, and number of times you take them per day.

You may need lab work, an ECG, or a chest x-ray.

You may also visit the Pre-procedure Assessment Safe Service (PASS) Clinic. They will review your records to prepare you for the anesthesia. You will be asked about any prior events with anesthesia.

You will be called 2 days before your procedure with your pre-op instructions and time of arrival.

Arrange for someone to drive you to and from the hospital. You will not be able to drive for 24 hours. For your safety, someone (age 16 or older) needs to stay with you for the rest of the day and overnight. You should not drive or make important decisions until the next day.

Day of Your Treatment

Do not eat or drink anything after midnight or your treatment may be canceled.

Follow medicine instructions that you were given at your pre-op appointment.

Enter through the hospital door, not the clinic, door. Follow the gray stone path to the D elevator. Take the D elevator to the 3rd floor. Turn left to the First Day Surgery Unit door. Bring your parking stub with you.

You will change into a hospital gown. The nurses will take your blood pressure, pulse and may check your blood sugar level.

They will insert a small IV into a vein in your hand or arm. This IV will be used for medicines and fluids.

You will be taken to the Radiation Oncology department on a cart.

A member of the anesthesia team and your radiation doctor will talk to you.

You will be asked to lie down on a narrow treatment table.

You will have medicines to put you to sleep. Then, the doctor will get you ready for the treatment.

Treatment

Loose cotton stockings will be put on your legs to keep them warm. Compression leggings that inflate and deflate will be put on your lower legs. These are used to help blood flow.

During the treatment, you will lie on your back. Your legs will be put up into leg rests.

The doctor will do a pelvic exam. Your skin will be cleaned with a special soap. A small tube (Foley catheter) will be put into your bladder to collect urine. This tube is removed before you go home.

The instruments used for the treatment are put into place by the radiation doctor. The placement is checked with ultrasound.

You will go for either a CT ,View-Ray or MRI scan. The scans are used to make sure the instruments are in the right places. This helps plan for your treatment.

After the images are done, the radiation treatment is planned. This is done by the medical physicist. They will use a prescription from the radiation doctor. A computer program is used to plan the treatment. It is checked and approved by the radiation doctor.

The radiation that is used comes from a tiny piece of radioactive matter. It is about the size of a piece of pencil lead. It is attached to a wire and kept inside a lead-lined storage box.

The doctor connects one end of the thin hollow cables to the storage box. The other ends of the cables are attached to the ends of the instruments. During the treatment, the radioactive matter moves out of the storage box and into the instruments. It stays there until the prescribed dose of radiation is given (about 5 – 20 minutes).

Once complete, the radioactive matter returns to the storage box. It does not remain in your body. The treatment part of the procedure is now over. All of the instruments are removed. Your legs are lowered back onto the table.

You will be woken up and moved to the post-anesthesia care unit and checked for about an hour. After you are more awake, you are moved to the discharge unit. Your recovery time can last from 2-3 hours.

Once you are fully awake, you will be given something drink. Family members or friends can visit. You will be prepared for discharge. The radiation doctor may wish to talk to you and answer any questions you have. You may remember bits and pieces of the procedure, or you may remember nothing at all.

After Your Treatment

You may have some minor vaginal bleeding or discharge for the first 24 hours. It should not be more than a normal menstrual period. We can provide you with a sanitary pad or you can bring one from home; do not use tampons.

Do not douche during the time you are getting treatments. Douching can disrupt the body’s natural chemical balance.

You may have some vaginal cramping after the procedure. This should stop by the end of the day. Ibuprofen (Advil® or Motrin® IB) or naproxen (Naprosyn® or Aleve®) may help. Follow the directions on the bottle.

You may have some irritation or burning when you urinate. You should drink 8-12 glasses of fluids each day for the next 1-2 days. Let us know if these symptoms do not go away.

Your memory of the treatment may be fuzzy. This is a short-term side effect of the anesthesia.

After your treatment, you may resume your normal diet.

You are not radioactive after this treatment.

You will be given a vaginal dilator or vibrator at one of your visits. You will be told how to use it. You will need to use it because the treatments cause the vagina to narrow and shorten. Your health care team will tell you how long you will need to use it.

It is safe to have sex between treatments.

When to Call

• Fever above 100ºF.

• Pain that is not relieved with medicine.

• Bleeding more than a normal menstrual period.

• Burning with urination or blood in the urine lasting more than 24 hours.
  

Who to Call

Radiotherapy

(608) 263-8500

Your radiation doctor is _______________

Phone number is _____________________

Your coordinator is___________________

Phone number is _____________________

If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.