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HDR Brachytherapy

High Dose Rate (HDR) Brachytherapy can deliver large amounts of radiation that shrink or destroy tumors while sparring the healthy surrounding tissue.

When you’re told you’ll be undergoing HDR (High-Dose Rate) radiation, it means you’re getting a very focused and powerful type of internal radiation therapy. Unlike external radiation that comes from a machine outside your body, HDR often involves placing a small radioactive source inside or very close to your tumor for a short time. This allows a very high dose of radiation to be delivered directly to the cancer, while significantly limiting the radiation exposure to surrounding healthy tissues.

Here’s what you can generally expect when undergoing HDR:

The Planning Stage (Preparation and Simulation)

This is a crucial step to make sure your treatment is super precise.

  • Getting Ready: Depending on the type of cancer, you might need to do some preparation. For example, if it’s for prostate cancer, you might be asked to have an enema to empty your bowels so doctors can get clear images.
  • Placing “Applicators”: Thin, hollow tubes, needles, or special devices (called applicators or catheters) will be temporarily placed in or very near your tumor. For some cancers, like prostate or gynecological cancers, this might involve a minor procedure.
  • Imaging Scans: Once the applicators are in place, you’ll have detailed imaging scans (like CT, MRI, or ultrasound). These scans create 3D pictures that help your radiation oncology team confirm the exact position of the applicators and precisely map out where the radiation needs to go.
  • Custom Treatment Plan: Your radiation oncologist and other specialists will use these detailed images to create a highly personalized treatment plan. This plan determines exactly how much radiation will be delivered, for how long, and from where within the applicators, ensuring the cancer gets a powerful dose while protecting nearby healthy organs.

During the HDR Treatment Itself

  • Quick Delivery: Once the plan is ready, the actual radiation delivery is very fast, often lasting only a few minutes.
  • Remote Control: You’ll be connected to a special machine (called an “afterloader”). A tiny radioactive source (often Iridium-192) will travel through the applicators you have in place, following the precise plan. The machine moves the source to different positions within the applicators, delivering radiation to the specific areas.
  • You Won’t Feel It: Just like with other forms of radiation, you won’t feel any pain, heat, or sensation during the treatment.
  • Alone in the Room, But Monitored: Your care team will step out of the room while the machine is delivering the radiation, but they’ll be watching you closely on monitors and can communicate with you through an intercom.
  • Stay Still: It’s very important to remain as still as possible during the treatment so the radiation hits the exact target.
  • Temporary Source: The radioactive source is only in your body during the treatment time. Once the session is over, the source is completely removed from your body. You are not radioactive afterward and are safe to be around anyone.

    After Your HDR Treatment

    • Applicator Removal: Depending on your treatment plan, the applicators might be removed right after your session, or they might stay in place if you’re having multiple treatments over a few days. If removed, you might have some mild discomfort at the insertion site.
    • Fewer Sessions: A big advantage of HDR is that it often involves fewer treatment sessions compared to external beam radiation. You might have just one treatment, or a few treatments over several days.
    • Targeted Side Effects: Because the radiation is so focused, side effects are usually limited to the area being treated and can be less severe than with more widespread radiation. However, you might still experience:
      • Fatigue: Feeling tired is a common side effect of many cancer treatments.
      • Skin Changes: Redness, soreness, or irritation in the treated area.
      • Specific to the Area: If treated in the pelvis (like for prostate or gynecological cancer), you might have temporary urinary changes (like needing to go more often) or bowel changes (like diarrhea or discomfort).
      • Pain/Discomfort: There might be some soreness or discomfort at the site where the applicators were placed. Your team can provide pain relief.
    • Recovery: Most people recover quickly from HDR treatments and can often return to their normal activities within a day or two, though this varies based on the type of cancer and the extent of treatment.
    • Your Team is There for You: Don’t hesitate to tell your doctors, nurses, or therapists about any side effects or concerns you have. They are there to help you manage them and ensure you’re as comfortable as possible.

    HDR is a highly effective and precise way to deliver radiation, often leading to better outcomes with fewer side effects than other methods.