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Having brachytherapy treatment

Having brachytherapy for cervical cancer involves the treatment being planned, the applicators being positioned, and the treatment being given.

We know that you may feel nervous about having brachytherapy or worried about any effects of the treatment. We are here to support you, whether you want to talk through options, understand more about brachytherapy, or simply have someone listen to what’s going on.

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When will I have brachytherapy?

You will usually have brachytherapy after you have finished a course of chemotherapy and external radiotherapy (chemoradiation). It is given straight after this other treatment.  

Where will I have brachytherapy?

You will have brachytherapy in a hospital. Depending on the type of brachytherapy you have, you might have it:

  • as an outpatient – you don’t stay in hospital overnight, but would visit the hospital on different days
  • as an inpatient – you would stay in hospital overnight or for a few days to have it.

Brachytherapy dose rate

A dose rate is how much radiotherapy is given over a set time. 

There are different dose rates for brachytherapy. These different doses all work just as well as each other.

High-dose-rate (HDR) brachytherapy is the most common type of brachytherapy. You have a high dose of radiotherapy in a short time. It usually lasts for about 10 to 15 minutes. 

HDR brachytherapy is usually given over 1 or 2 days. In some cases, it may be given more than once a day. 

Different hospitals have different processes for HDR brachytherapy, so you need to speak with your healthcare team about your treatment plan.

A low dose of radiotherapy is delivered to the cancer every few hours for a set amount of time – sometimes between 10 to 30 minutes. This set time is the ‘pulse’.  

Low-dose rate (LDR) brachytherapy is not commonly used for cervical cancer. You have a low dose of radiotherapy over a longer time – sometimes for a few days. 

Different hospitals have different processes for LDR brachytherapy, so you need to speak with your healthcare team about your treatment plan.

Brachytherapy if you have your womb

If you have not had surgery to remove your womb, you will have intrauterine brachytherapy.

Planning brachytherapy

Brachytherapy planning will usually be done in an operating theatre in the hospital. 

Your healthcare team for brachytherapy might include:

  • a clinical oncologist – a doctor who specialises in treating cancer with radiotherapy

  • a therapeutic radiographer – an expert in delivering radiotherapy to people with cancer.

You may meet a specialist brachytherapy radiographer. They are the same as a therapeutic radiographer, but with a specialism in delivering brachytherapy.

You will either have a:

  • a general anaesthetic – you will be asleep and won’t feel anything  

  • a spinal anaesthetic – you may be asleep or awake but won’t feel anything.

These anaesthetics are only for positioning the applicators. You will not need an anaesthetic during the treatment, as you won’t be able to feel it.

Some people feel worried about having a general anaesthetic. If you feel this way, you could speak to your healthcare team and anaesthetist before, to find more about what will happen and talk through any concerns. 

The doctors and therapeutic radiographers place applicators made up of tubes and needles into your vagina. The applicators go up through the cervix and into the womb. They may also put applicators next to your cervix. The radiotherapy is delivered through these applicators. 

They will also put gauze packing into your vagina. This holds the applicators in place. You will have a tube (catheter) in your bladder so you won’t have to get out of bed to go to the toilet. 

Read about catheters on the NHS website > 

Once the applicators and tubes are in place, you will need to stay in bed lying flat, although your head and shoulders will be raised slightly with a pillow. 

You will be taken back to the brachytherapy suite or recovery ward in the hospital. Once you are awake, the applicators may feel uncomfortable and you might feel some pressure. Tell your healthcare team so they can give you pain medication to help.

You will have a CT or MRI scan to check the tubes and applicators are in the right position.

It can take a few hours for your healthcare team to make a treatment plan. You will probably have to wait in a brachytherapy suite or recovery ward while this happens, still lying flat on your back.  

We know that you might feel anxious during this wait. Our community have suggested taking some things that will keep you entertained. It might be hard to read books or magazines while lying on your back, but you could listen to music or podcasts on your phone or another device.

There will be nurses and other healthcare staff to talk to if you feel worried or have any questions. Remember that they are there to support you and make you as comfortable as possible. 

Having the treatment

Once your treatment plan is ready, you will go to the brachytherapy room and the applicators will be attached to a machine. During treatment the radiographers leave the room, but they will be able to see and speak to you. 

The dose rate you are having will decide:

  • how long you have treatment for
  • whether you can have treatment in a day or need to stay in hospital. 

Read about dose rates > 

Lying flat during treatment and while the applicators are in can be difficult. Your healthcare team will make sure you are as comfortable as possible. 

If you have to stay in hospital

You may have to stay in hospital while having brachytherapy treatment. At the moment, you may not be able to have visitors because of the COVID-19 pandemic. We know this can be tough, so we have some suggestions for keeping in touch:

  • Before your treatment, arrange to keep in touch by phone or video call.
  • Make sure your phone or other electronic devices are fully charged
  • Check if you can bring things with you that remind you of home or family, such as photos, cards or letters.

After treatment

After each treatment is finished, you may:

  • go home – the applicators will be taken out before you leave
  • stay in the brachytherapy suite or go back to a ward – the applicators may be taken out or left in place until treatment is finished. 

If you have had to stay in hospital, your healthcare team will remove the applicators and catheter. They will do this quickly and you can have pain medication to help. 

As long as your healthcare team are happy you feel okay, you can usually go home that day or the next day.

You will not be radioactive. This mean it is safe to be around other people, including children and pregnant women.

Read about the risks and side effects of brachytherapy > 

Brachytherapy if you do not have your womb  

You may have 2 treatments on different days, which can last between 10 to 15 minutes.

Planning brachytherapy

Your doctor or therapeutic radiographer examines you to check what size applicator they can use for the treatment. The applicator is a tube which comes in different sizes. 

They put an applicator (tube) inside your vagina. They will use a gel so it’s as comfortable as possible.  

You may have a CT scan to check the applicator’s position. Then they will remove the applicator so you can go home.

Having the treatment

You will normally come back to hospital for treatment within a week. 

Using the information from the CT scan, your radiographers will position you on a hospital bed and connect the applicator to the brachytherapy machine. The process is the same every time you come for treatment.

After the treatment

After every treatment, your healthcare team will remove the applicator. As long as your healthcare team are happy that you feel okay, you can then go home. The process is the same every time.

Recovering from brachytherapy

It can take a long time to recover and feel like yourself again after brachytherapy. The exact time will depend on:

  • the side effects you have
  • your general health. 

Generally, it takes a few months to recover from brachytherapy. But you may have long-term effects that can last for many years or, in some cases, for the rest of your life. 

Read about risks and side effects of brachytherapy > 

You will need to rest to help your recovery. Try to limit your normal activities until you start feeling better, as these can take a lot of energy. Remember to be kind and gentle to yourself – recovery takes time and you may also be recovering from surgery or chemoradiation too. 

If you are struggling with your emotions before, during or after brachytherapy, you are not alone. We know that lots of women and people who have had a cervical cancer diagnosis or treatment feel sad, down or depressed.  Sometimes this can last a long time after treatment has finished.  

Read about mental health and cervical cancer > 

More information and support with 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

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 >

"The nurses who looked after me were so good – I’ve never experienced anything like the care they gave me."
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Date last updated: 
04 Nov 2020
Date due for review: 
01 Nov 2023
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