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 often 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 and external beam radiotherapy.
 
How does the treatment work? 

A tube is inserted into your vagina while you are asleep under a general anaesthetic. The tube is called an applicator. The applicator is held in place by a small corset. As you will be unable to pass water normally while the applicator is in place a catheter will be passed into your bladder to drain the urine away. When you return to your side room on the ward the applicator is connected to the Selectron machine using long tubes. The machine can then deliver treatment to you internally through the tubes. 

Where will I have the treatment? 

You will be admitted to Ward 37 at the Northern Centre for Cancer Treatment, which has special rooms for this treatment.  You will normally come into hospital on a Monday, go to theatre on Tuesday and usually go home on Wednesday or Thursday. 

What happens on the ward?

A nurse will admit you. This will involve explaining the process, offering you the opportunity to ask any questions you may have. They will need to ask you some questions to assess how well you are feeling and to see if we can help you in any way.  You will also be seen by the ward doctor who will again 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 will 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?

While you are asleep the doctor will examine you and insert the applicator and catheter. You will be returned to the ward when you are awake. We will then be able to tell you how long your treatment will last (approximately 20 hours if you have had external radiotherapy, longer if the Selectron is your only treatment). Treatment times vary for individuals and are worked out after you have had the tubes inserted. You may have special stockings on to reduce the risk of blood clots in the legs; they will stay in place during your treatment.

How does Selectron treatment feel?

The treatment itself is not painful. During the treatment you need to remain lying flat in your bed. You may feel some stiffness and backache caused by lying in bed. You may feel a little sick from the anaesthetic.

You may find the applicator uncomfortable. The amount of discomfort varies from person to person and we will work with you to keep this to a minimum. Please let us know how you feel so that we can help you. You will have a buzzer to call the nurses if you feel unwell and a phone to speak to them when they answer the buzzer. 

If necessary we will give you medication to stop you from having bowel actions this will be given the day before theatre.

Can I have visitors? 

Unfortunately visitors are not allowed into your room while you are having the treatment.  Every time someone enters your room the treatment is stopped. This is so that the nurses can come in to see you without exposing them to radiation. If we stop the machine too often your time in the room will be prolonged. The nursing staff will attend to you every two hours to make sure you are comfortable. They will check the applicator and give you any other help they can. The nurses are also able to check on you with a camera, which is in the room.

What can I do? 

You can watch television. You can read. Some people find it easier to listen to music or listen to audio books. There is no telephone in the room.
If you gently tighten and relax the large muscles in your legs and bottom you will help to improve your circulation. Do this several times an hour. This gentle exercise will not disturb the applicators. Deep breathing exercises are also helpful to prevent problems caused by lying flat and you will be shown how to do these.
 
What can I eat and drink?

You can eat and drink anything you like which does not upset your bowels. However you will need to remain lying down to eat, so remember this when you choose your food.  Practical foods such as sandwiches and light meals are easier to manage. 

What happens when the treatment finishes?

The machine switches off automatically when the treatment has finished. The nurses will remove the applicator, catheter and corset on the ward. This is a quick and simple procedure. It does not usually hurt. Once the applicator is removed you can sit up a little in bed. You are advised to call for a nurse when you first get out of bed, as you may feel a little dizzy. When you feel like it you can have a bath and walk around. 

What happens next?

You can go home when the staff are happy that everything is well and you have passed urine. The district nurse will be asked to visit you at home.  You will be sent an appointment to see the hospital doctor in an outpatient clinic about 6-8 weeks after you go home. After this you will be seen approximately every 3 months for a couple of years.

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 helps this. If the pain does not improve contact your doctor. You may have some vaginal irritation or soreness. Regular bathing and 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 you 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 it may be an infection. To reduce the risk of infection bathe yourself daily, wear cotton pants and avoid wearing tight trousers or tights. 
   
• Vaginal scarring:  The nurse will speak to you about this and give you information about vaginal dilatation. If you wish she will also discuss any possible difficulties 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 Specialist or doctor about this.

Useful Contacts:

If you would like to talk to anyone about this procedure please contact:

Janet Pickering, Gynae Oncology Nurse Specialist

Telephone:  (0191) 256 3295 or (0191) 233 6161 bleep 1780 or
 
contact Ward 37 and ask for the Nurse in Charge

Telephone:  (0191) 256 3537