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Brachytherapy for cervical cancer

Brachytherapy is internal radiotherapy. Radioactive material is placed inside the body, so it can destroy the cancer cells.

We know that brachytherapy can sound and look scary, and may have a big emotional impact on you. However you feel, we are here to support you. You may find it helpful to give us a call on 0808 802 8000 before or after treatment, or speak with our 1:1 service.

Get support >

What is brachytherapy?

Brachytherapy is internal radiotherapy. Radioactive material is put into your vagina to give radiotherapy directly to the cervix and the area close by. It is also called intrauterine brachytherapy. 

This might sound frightening, but your healthcare team carefully plan the treatment to make sure it causes as little harm to the rest of your body as possible.

How is brachytherapy used?

Having brachytherapy depends on the stage of your cervical cancer and what treatments you have had before.

Radiotherapy is often used together with chemotherapy to treat cervical cancer. This is called chemoradiation. You may be offered brachytherapy along with chemoradiation.

Read about chemoradiation > 

You may have brachytherapy to help reduce the risk of the cancer coming back after surgery. This is called adjuvant treatment.

Not everyone needs this after surgery. You may only need it if:

  • the cancer has spread to your lymph nodes
  • the cancer was larger and more likely to spread.

You may have brachytherapy if you have locally advanced cervical cancer that can’t be treated with surgery. This is called radical treatment.

Making decisions about treatment

A team of healthcare professionals, called a multidisciplinary team or MDT, will discuss your test results, diagnosis and medical history to help decide which treatments are best for you.

It is important that you are involved in any decisions about your treatment. You need to know and understand all the information about the treatment, including the benefits and risks. 

You may also want to think about how having the treatment might impact on your life, including:

  • being able to have a child or more children (fertility)
  • being able to keep working (employment)
  • your finances, for any support you might need
  • other commitments or responsibilities you have. 

Read about making treatment decisions >

Brachytherapy can damage your ovaries. This you almost definitely won’t be able to get pregnant and have a child or more children after treatment.

Read more about fertility and cervical cancer > 

You will probably feel very emotional about this, which can make it hard to think about some practical steps you could take. But it is important to discuss these options with your healthcare team before you start treatment. Before treatment, you may be able to:

  • freeze and store eggs
  • freeze and store embryos – these are eggs that have been fertilised 
  • ovarian transposition.

Read about ways to have a child or more children > 

This may delay treatment, so you will need to consider any risks of doing that. Your healthcare team can explain how it might affect your individual situation. Unfortunately, egg and embryo freezing is not always possible and these services are not available in every hospital.

Ovarian transposition

Ovarian transposition is a surgery to move your ovaries away from where the radiotherapy part of your treatment will be aimed. It is done to try and prevent early menopause, which means you may still be able to have a child or more children.  

You have it before brachytherapy starts. Whether it can be done will depend on:

  • the stage of the cancer 
  • the risk of the cancer having spread to the ovaries. 

Unfortunately, ovarian transposition does not always work. You may have the surgery but still go through early menopause and be unable to have children. 

Read about fertility preservation on the Macmillan Cancer Support website >

Your immune system protects the body from infection by finding and killing germs, bacteria or viruses. Brachytherapy doesn’t usually have a big impact on the immune system. 

Having radiotherapy usually means you need to go to the hospital a lot for appointments. Your hospital is doing as much as possible to reduce the risk of getting or becoming ill with COVID-19. When your healthcare team are supporting you to make treatment decisions, they will consider the risk of COVID-19 as part of this. In most hospitals we have spoken to, radiotherapy is continuing as usual for cervical cancer patients. But your healthcare team may talk to you about: 

  • delaying your treatment     
  • using telephone calls and video calls to avoid face to face appointments where possible.
  • having a test to check for COVID-19 before each treatment session. 

Your healthcare team may ask you to self-isolate for about 2 weeks before and after radiotherapy. They will let you know what you should and shouldn’t do during this time. 

If you are having chemotherapy as well as radiotherapy (chemoradiation), your immune system may be weaker and you might be asked to follow different guidance.

Read about chemoradiation and COVID-19 >

Preparing for brachytherapy

Your brachytherapy treatment will usually start after you have already been through chemotherapy, radiotherapy, and possibly surgery. The physical impact of this, combined with the emotional impact of a cervical cancer diagnosis and everything you are going through, should not be underestimated. 

Read about preparing for treatment >

Preparing physically

Before starting brachytherapy, it is important to talk with your healthcare team about any physical symptoms your previous treatment has had. You want to start brachytherapy feeling as well as possible, so anything they can suggest or prescribe to help manage these symptoms will help. 

You will also need to rest as much as possible. You will probably be feeling very tired and weak already, and brachytherapy can make this worse. 

Preparing practically

It might help to think about things you may need support with, including:

  • work – think about taking time off before, during and after
  • childcare or other caring commitments – think about whether friends and family can help out or if you can arrange outside support, like a childminder
  • help around the house – think about whether a cleaner or meal deliveries would be helpful to take some extra pressure off you. 

You may have already have figured out transport to and from the hospital. But if you haven’t, try to arrange this ahead of time. It is worth speaking to the hospital to find out if they can offer help with transport.

If you are worried about finances and getting support, there are organisations that can help:

Preparing emotionally 

The idea of having brachytherapy can be worrying. You may have searched for images or experiences that have scared you. We want you to know that we understand these feelings and are here to support you through your treatment. 

Part of feeling emotionally ready for brachytherapy is preparing for the way it may feel. You will probably find that having brachytherapy is uncomfortable – it may even be painful.  You must let your healthcare team know if you are uncomfortable or in pain. They will give you pain medication to help and will do everything they can to make you more comfortable.  

It might help to figure out what helps you feel relaxed. This can be useful before and during brachytherapy. You could try:

  • listening to relaxation or guided imagery podcasts
  • listening to relaxing music
  • practicing mindfulness exercises.

The NHS recommends different phone apps to support your mental health, including some for relaxation.

Visit the NHS website > 

You may find it helpful to talk to someone else who has had brachytherapy. While it’s important to remember that everyone’s experience is different, hearing someone describe their treatment could be helpful. We have a wonderful community on our online Forum. Many of them have already had treatment and want to offer support to those who are about to have it. You can post any questions you have or simply read through the messages that are already there.

Join our Forum > 

If you find that waiting to have brachytherapy, or having it, has a big impact on your mental health, it is important to get support as soon as possible. You do not have to struggle with anything alone – whether you have a low mood because of your diagnosis or feel traumatised after treatment.

Read about cervical cancer and mental health > 

More information and support about brachytherapy

Brachytherapy can have a huge impact on your physical and emotional wellbeing. You may be dealing with the effects of other treatments, such as radiotherapy, as well as continuing to process a cervical cancer diagnosis and all that can bring.

Your healthcare team, both at the hospital and at your GP surgery, are there to support you with any questions or worries you have. Remember that we are here for you too, whether you are waiting for brachytherapy, in the middle of treatment, or years past it. Our trained volunteers can listen and help you understand what’s going on via our free Helpline on 0808 802 8000

Check our Helpline opening hours > 

 

Sometimes connecting with others who have gone through a similar experience can be helpful. Our online Forum lets our community give and get support. You can read through the messages or post your own – whichever feels most comfortable.

Join our Forum > 

If you have general questions about brachytherapy, our panel of medical experts may be able to help. They can’t give you answers about your individual situation or health – it’s best to speak with your GP or healthcare team for that.

Use our Ask the Expert service >

Thank you to all the experts who checked the accuracy of this information, and the volunteers who shared their personal experience to help us develop it. 

References

  • https://www.macmillan.org.uk/cancer-information-and-support/treatments-and-drugs/radiotherapy-for-cervical-cancer Accessed 15.10.2020
  • Falcetta FS, Medeiros LRF, Edelweiss MI, Pohlmann PR, Stein AT, Rosa DD. Adjuvant platinum‐based chemotherapy for early stage cervical cancer. Cochrane Database of Systematic Reviews. 2016(11). https://dx.doi.org/10.1002/14651858.CD005342.pub4.
  • British Gynaecological Cancer Society. British Gynaecological Cancer Society (BGCS) Cervical Cancer Guidelines: Recommendations for Practice. (https://www.bgcs.org.uk/wp-content/uploads/2020/05/FINAL-Cx-Ca-Version-for-submission.pdf; last accessed 4 August 2020)
  • Marth C, et al. on behalf of the ESMO Guidelines Committee. Cervical cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2017. 28(s4): iv72-iv83. Available at www.annalsofoncology.org/article/S0923-7534(19)42148-0/pdf; last accessed 16 August 2020
  • British Gynaecological Cancer Society. British Gynaecological Cancer Society (BGCS) Cervical Cancer Guidelines: Recommendations for Practice. (https://www.bgcs.org.uk/wp-content/uploads/2020/05/FINAL-Cx-Ca-Version-for-submission.pdf; last accessed 4 August 2020)
  • British Gynaecological Cancer Society. British Gynaecological Cancer Society (BGCS) Cervical Cancer Guidelines: Recommendations for Practice. (https://www.bgcs.org.uk/wp-content/uploads/2020/05/FINAL-Cx-Ca-Version-for-submission.pdf; last accessed 4 August 2020)
  • Ghadjar P, Budach V, Köhler C, Jantke A, Marnitz S. Modern radiation therapy and potential fertility preservation strategies in patients with cervical cancer undergoing chemoradiation. Radiat Oncol. 2015;10:50. Published 2015 Feb 22. doi:10.1186/s13014-015-0353-4
  • Cibula D, Pötter R, Planchamp F, Avall-Lundqvist E, Fischerova D, Haie Meder C, et al. The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology guidelines for the management of patients with cervical cancer. Radiother Oncol. 2018;127(3):404-16. 
  • Farthing AJ and Ghaem-Maghami S on behalf of the Rotal Collage of Obstetricians and Gynaecologists (RCOG).  Fertility Sparing Treatments in Gynaecological Cancers. 2013. Available at www.rcog.org.uk/globalassets/documents/guidelines/scientific-impact-papers/sip_35.pdf
  • Chowdhury MA, Hossain N, Kashem MA, Shahid MA, Alam A. Immune response in COVID-19: A review [published online ahead of print, 2020 Jul 14]. J Infect Public Health. 2020;S1876-0341(20)30567-0. doi:10.1016/j.jiph.2020.07.001
  • Elledge CR, Beriwal S, Chargari C, Chopra S, Erickson BA, Gaffney DK, et al. Radiation therapy for gynecologic malignancies during the COVID-19 pandemic: International expert consensus recommendations. Gynecol Oncol. 2020;158(2):244-53. Epub 2020/06/22. doi: https://dx.doi.org/10.1016/j.ygyno.2020.06.486. 
  • Elledge CR, Beriwal S, Chargari C, Chopra S, Erickson BA, Gaffney DK, et al. Radiation therapy for gynecologic malignancies during the COVID-19 pandemic: International expert consensus recommendations. Gynecol Oncol. 2020;158(2):244-53. Epub 2020/06/22. doi: https://dx.doi.org/10.1016/j.ygyno.2020.06.486. 
  • British Gynaecological Cancer Society. BGCS framework for care of patients with gynaecological cancer during the COVID-19 Pandemic. May 2020 https://www.rcog.org.uk/globalassets/documents/guidelines/2020-05-05-bgcs-covid-19-framework-v3.pdf; last accessed 16 August 2020)
  • Uwins C, Bhandoria GP, Shylasree T, et al COVID-19 and gynecological cancer: a review of the published guidelines International Journal of Gynecologic Cancer Published Online First: 23 June 2020.
  • Miriyala R, Mahantshetty U. Brachytherapy in cervical cancer radiotherapy during COVID-19 pandemic crisis: problems and prospects. J Contemp Brachytherapy. 2020;12(3):290-3. Epub 2020/07/23. doi: https://dx.doi.org/10.5114/jcb.2020.96873.
  • Humphrey P, Bennett C, Cramp F. The experiences of women receiving brachytherapy for cervical cancer: A systematic literature review. Radiography (Lond). 2018;24(4):396-403
  • Humphrey P, Bennett C, Cramp F. The experiences of women receiving brachytherapy for cervical cancer: A systematic literature review. Radiography (Lond). 2018;24(4):396-403

We write our information based on literature searches and expert review. For more information about the references we used, please contact [email protected].

Read more about how we research and write our information >

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“The first couple of radiotherapy sessions were emotionally tough."
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Date last updated: 
04 Nov 2020
Date due for review: 
01 Nov 2023
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