You are going to have Selectron treatment for your cancer. This section tells you what to expect.

We hope it answers some of the questions you may have.

Please tell us if there is anything you don’t understand. We are here to take care of you and we don’t mind how many questions you ask!

What is Selectron (brachytherapy)?

Brachytherapy is a type of radiotherapy, which is given internally (inside the body). The machine we use in Newcastle is called a selectron machine. We therefore call it selectron treatment.

Selectron treatment can be used as the main treatment or as part of a combination of treatments which may include surgery, external beam radiotherapy and chemotherapy.

How does the treatment work?

A tube is inserted into the womb through the vagina under anaesthetic in theatre. You may have a general anaesthetic where you are asleep or a spinal anaesthetic. A spinal anaesthetic involves putting anaesthetic into the spine to take away feeling. This means you will not be able to feel anything from the waist down while you undergo the treatment. Your Doctor will decide which type of anaesthetic is the most appropriate one for you.

The tube that is inserted into the vagina is called an applicator, the applicator is held in place in the vagina with gauze packing and tape. As you will be unable to pass water normally while the applicator is in place, a catheter will be placed into your bladder to drain the urine away.

You will be taken for CT planning when you leave Theatre and then into a special room to have your treatment. In this room the applicator is connected to the Selectron machine using a long thin tube. The machine can then deliver treatment to you internally through the tube.

Where will I have the treatment?

If you are having the treatment as a Day Case then you will be admitted to Day Case Theatre at the Freeman Hospital. If you are having the treatment as an in-patient then you will be admitted to Ward 34 or 35 at NCCC. This type of treatment is given on a Thursday morning. Your Doctor or Nurse will tell you whether you will need to be given treatment as an in patient or as a day case.

What happens when I am admitted for treatment?

A nurse will admit you. This will involve explaining the process, offering you the opportunity to ask any questions you may have. You will also be assessed by an anaesthetist. If you are admitted as an in-patient to Ward 34 or 35, then you will also be seen by the ward doctor who will ask you questions and examine you.

You will have a blood sample taken and may have an ECG test (a heart tracing). You may need to go for an x-ray and see the anaesthetist. This is to assess how fit you are for treatment

Please bring with you any medication that you are taking and show this to the doctor or nurse.

You may be given some white stockings to wear before you go to theatre. This is to prevent the possibility of blood clots in your legs.

What happens in theatre?

When you are in theatre the doctor will examine you and insert the applicator into your vagina and cervix and the catheter into your bladder. The applicator will be secured with gauze packing and elastic bandages around your thighs. As soon as everything is in position and you are awake and comfortable you will be taken from theatre to the radiotherapy department on a trolley.

What happens in the Radiotherapy Department?

In the radiotherapy department you will have a CT scan to determine the length of treatment you need. Treatment times vary for individuals and are worked out after you have the applicator inserted. The whole process of going to theatre, planning your treatment and having the treatment usually takes about 2 hours. CT planning takes about half an hour. The actual treatment time is only about 10 minutes.

The internal radiotherapy treatment will be given to you in a special treatment room. A tube will be attached to the vaginal applicator. The machine can then deliver treatment to you internally through the tube.

How does Selectron treatment feel?

During the treatment you will remain lying flat on the treatment trolley. If you have had an anaesthetic into your spine – you will not feel any sensation from your waist downwards. Otherwise you may feel some backache or discomfort from the vaginal packing. The doctor will give you painkilling medication. If you experience pain you must let us know so that we can help you.

Can I eat and drink?

 You will be going to theatre on Thursday morning so you will not be able to eat or drink after bedtime on Wednesday night.

What happens when the treatment finishes?

The machine switches off automatically when the treatment has finished. The doctor will remove the vaginal packing, the applicator and the catheter in the treatment room. This is quite straight forward and does not usually hurt. Once everything is removed you will be taken back to the  day case theatre ward or the in patient ward on the trolley. Here you will be given something to eat and drink.

If you are having your treatment as a day case, before you are discharged the nursing staff will make sure you are well enough to go home.

What happens next?

You will be sent an appointment to see the hospital doctor in an out patient clinic about 6 -8 weeks after your treatment finishes. You will have regular review appointments at the hospital for some years after this type of treatment.

What are the after effects?

• Bowel - The treatment may cause diarrhoea. Changing your diet or taking medication can help this. We also advise that you drink lots of fluids. Your nurse or doctor can help you with this.
• Bladder - The treatment may cause some irritation when passing water. You can help this by drinking plenty of fluids. You may need some medication if it does not get better or if your urine is cloudy or smelly. Your nurse or doctor can help you with this.
• Pain/discomfort - You may get some crampy abdominal pain. Taking mild painkillers and warm baths often help with this. If the pain does not improve contact your doctor. You may have some vaginal irritation or soreness. Regular bathing or using a lubricant such as KY jelly or Replens can relieve this. Do not use any other creams as these may make the soreness worse.
• Fatigue - You may find you feel very tired. This is quite normal and we advise your to rest during the day as often as you can if you need to. Return to work when you feel ready.
• Vaginal discharge/bleeding - You may have a bloody or brown discharge following the treatment, this is normal. If the discharge is smelly or pale green report it to your doctor as this may mean you have an infection. To reduce the risk of infection bathe yourself daily, wear cotton underwear and avoid wearing tight trousers or tights.
• Vaginal scarring - Your doctor or nurse will speak to you about this and give you information about using vaginal dilators. If you wish they will also discuss any possible difficulties you may have with sexual intercourse.

For most women these effects are short term, but occasionally some women may develop long term bowel, bladder or vaginal problems.

Please speak to your nurse or doctor about any concerns you may have in relation to any side effects you experience from treatment.