Vaginal HDR (High Dose Rate) Brachytherapy
If you are going to have internal radiotherapy - also known as High Dose Rate (HDR) Brachytherapy - for cancer, this page explains what you can 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 Vaginal HDR Brachytherapy ?
Brachytherapy is a type of radiotherapy, which is given internally (inside the body).
Brachytherapy can be used as the main treatment or as part of a combination of treatments that may include surgery and external beam radiotherapy.
How is the treatment given?
Brachytherapy is given at the radiotherapy department at Newcastle Freeman Hospital.
You will need to lie on a bed for the treatment. A tube called an applicator is inserted into your vagina. The applicator is held in place by a clamp on the bed. The applicator is connected to the treatment machine using a long tube. The machine can then deliver treatment to you internally through the tube. The treatment is not painful but the applicator may be a little uncomfortable.
Each treatment lasts approximately five to ten minutes (plus five minutes to insert the applicator). Treatment times vary for individuals and are worked out by your oncologist.
What happens when the treatment finishes?
The machine switches off automatically when the treatment has finished. The nurse will remove the applicator. This is a quick and simple procedure. It does not usually hurt. Once the applicator is removed you can sit up.
How many treatments will I need?
You will need to have this treatment on two (possibly three) separate occasions usually 24 hours apart. You will be able to attend as an out patient and go home when the treatment is over.
What happens next?
You will be sent a follow up appointment to see your oncologist in an out-patient clinic about eight to twelve weeks after treatment. After this you will be seen at regular intervals for up to five years (approximately every three months for the first two years then at every six months for the next three years).
At your appointment the oncologist will ask questions about how you are feeling and may need to do an internal examination. Occasionally you may need to have a blood test or scan but this does not happen routinely. If you have any questions please ask, we are here to help you.
What are the possible side effects?
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 oncologist about this.
The treatment can cause diarrhoea. This may last for a few weeks. Changing your diet or taking medication can help this. We also advise that you drink lots of fluids. If symptoms persist contact your GP or your specialist nurse for advice.
The treatment may cause some irritation when passing urine. You can help this by drinking plenty of fluids. Your urine may be cloudy or smelly this is often a sign of infection. You may need some medication if it does not get better. If symptoms persist contact your GP or your specialist nurse for advice.
You may get some “cramp” like pain. Taking mild painkillers and warm baths often helps this. If the pain does not improve contact your GP. You may have some vaginal irritation or soreness. Regular bathing and using a lubricant such as KY jelly or Replens can relieve this (these can be bought at the chemist). Do not use any other creams unless you have asked your team as these may make the soreness worse. If symptoms persist contact your GP or your specialist nurse for advice.
You may find you feel 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. Light exercise such as walking can also help to improve fatigue.
You may have a slight discharge following the treatment this is normal. If the discharge persists or is smelly or pale green / yellow report it to your GP as it may be an infection. To reduce the risk of infection bathe regularly, wear cotton underwear and avoid wearing tight trousers or tights.
The risk of this is slightly greater following brachytherapy than if you have only had external beam radiotherapy. The specialist 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.
Reactions following treatment differ from person to person. These emotions are part of the process that people go through in trying to come to terms with their illness. You can contact your specialist nurse if you would like someone to talk to or the other sources of information listed.
Please speak to your specialist nurse or oncologist about any concerns you may have in relation to the procedure or any side effects you experience from treatment.
Gynae-Oncology Nurse Specialist, Northern Centre for Cancer Care, 0191 213 8338
Northern Centre for Cancer Care Macmillan Information and Support Centre, 0191 2138611
Opening hours Monday to Friday from 9am to 4.30pm
Macmillan Cancer Relief, Head office 020 7840 7840, freephone 0808 800 1234, www.macmillan.org.uk
Leaflet to Download
Vaginal HDR (high dose rate) brachytherapy.pdf