Your doctor will explain if you need this type of treatment when your radiotherapy treatment is first planned. Most internal treatments are carried out soon after patients finish their course of radiotherapy but this may depend on side effects.
The doctor will place applicators or tubes into your vagina or cervix under a general anaesthetic in the radiotherapy theatre. Some patients who are having treatment just to the top of the vagina may have the applicators placed into the vagina while they are on the ward. You will then go to the brachytherapy room on a specialist ward where the applicators are attached to the treatment machine. The machine puts radioactive sources into the applicators which treat the tumour. You will not feel this but the machine may make some noises as it is doing this.
You will have this treatment as an inpatient and you can normally expect to be in hospital for about 2 days and 1 night. The following information will help you understand what you can expect while you are in hospital.
Supporting Women After Cancer Needs (SWAN) clinic
Before brachytherapy treatment, we will give you an outpatient appointment for the SWAN advice clinic to see one of the specialist nurses. They will address any particular concerns or questions that you may have about the treatment, vaginal dilators, sex, fertility and menopause. If you have not previously had radiotherapy then your consent to the treatment will be covered at this appointment. If you would find it helpful to visit the treatment room before coming in to hospital, then this can usually be arranged at this appointment. Some patients find it helpful to bring their husband or partner to this appointment.
If you are going to be admitted at 8am on the day of your internal treatment, you will be required to attend a pre-clerking clinic appointment before admission to hospital. At the clinic, you will see a nurse clinician who will take down details of your medical history, examine your heart and lungs, arrange basic blood tests and an ECG (electro-cardiogram) of your heart to ensure you are fit for an anaesthetic.
You will also be seen by one of the ward nurses who will do a nursing assessment and will be able to answer any questions you may have about your planned stay in hospital. Most patients require an MRI scan, you will be asked to fill out a questionnaire to see if this is safe for you. Some patient e.g. those with a pacemaker fitted, can not have MRI scans. In this case, a CT scan may be used.
On the day of theatre, you will attend the Brachytherapy & Molecular Radiotherapy Unit (BMRU) (department 16) where you will be shown to your room.
It is important to tell the staff if you are having any bowel problems. This because if these are severe, your treatment may need to be delayed. We will ask you not to have anything to eat or drink for about 6 hours before your procedure.
An anaesthetist may visit you on the morning of theatre to discuss your anaesthetic and types of pain control. Prepare a bag to take with you containing things you may need while having treatment, such as dentures, a watch, nightie, soap bag and items such as magazines or puzzle books. It is a good idea to have a bath or shower on the day of your treatment and you will be asked to put on a gown. This is a good time to go to the toilet. The nurse may also give you a pre-med to relax you before you go to theatre. We walk you to theatre where the anaesthetist will give you a general anaesthetic to put you to sleep.
While you are asleep, in the radiotherapy theatre, the doctor will insert the applicator and insert a catheter to empty your bladder while you are having treatment.
When you are recovered from the anaesthetic, you will be moved to the MRI scanner for a scan to ensure that the applicators are correctly placed before treatment is started. A nurse will collect you from the theatre and take you to the treatment room on the BMRU where she will make you comfortable. During this time, the brachytheapy team will be using your scans to plan the best way to deliver your treatment, this can take some time. When your plan is ready, the brachytherapy team will come and connect the applicators inserted into your vagina to the treatment machine.
Treatment times vary but are usually around 17 hours long.