Brachytherapy at Siteman

The Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine operates one of the largest and most comprehensive brachytherapy programs in the United States, delivering more than 1000 treatments annually. Our program also serves as a national training site for brachytherapy procedures.

What is brachytherapy?

Brachytherapy involves inserting radioactive “seeds” directly into a tumor. These seeds are smaller than a grain of rice and are left in the body for a few hours or days. In some cases, the seeds are left in the body permanently and the radioactivity will diminish over time.

The benefit of brachytherapy is that radiation oncologists can deliver extremely high radiation doses with pinpoint accuracy without damaging surrounding healthy tissue. By also combining this procedure with image-guided technologies, such as positron emission tomography (PET) scans, doctors here have found that can more precisely control where brachytherapy is implanted. They can also lower the radiation dose as they see the tumor shrink and can modify the treatment plan at any point.

How is brachytherapy given?

There are three types of brachytherapy, each given in different ways:

Low-dose rate (LDR) implants: a radiation source is inserted into the tumor area through hollow needles, tubes or fluid filled balloons. The source stays in place for one to seven days, depending on your treatment plan. Once your treatment is finished, the source will be removed.

High-dose rate (HDR) implants: a radiation source is inserted for 10 to 20 minutes and then removed. Depending on your treatment plan, you may receive treatment twice a day for two to five days or once a week for two to five weeks.

Permanent implants: small seeds of radioactive material are placed directly into a tumor or tumors. The seeds are left in place permanently, with the radioactivity dropping over time, usually over several weeks or months.

Who should consider brachytherapy?

Brachytherapy is most effective for patients whose tumors are small and haven’t spread. It is often used to treat cancers of the breast, cervix, eye, head and neck, and prostate, among others.