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Brachytherapy

Brachytherapy is a targeted high-dose radiation treatment that can be delivered via radioactive "seeds" or wires that are placed directly in or near the tumor or via an applicator device placed at the tumor site. The biggest benefit of brachytherapy is that it delivers a high dose of radiation directly to the tumor and reduces damage to surrounding healthy tissue.

While it cannot be used for every kind of cancer, when it can be used, brachytherapy may reduce side effects and allow for shorter treatment times, providing patients with a better quality of life.

An experienced radiation oncology team at Johns Hopkins specializes in brachytherapy. As part of a larger multi-disciplinary oncology team that consultatively diagnoses and treats cancer, our team of radiation oncology specialists, including physicians, medical physicists, dosimetrists, nurses, and therapists, creates an individualized radiation therapy plan developed for each patient’s specific needs.

The safety and well being of our patients and their families are always the primary concern of every member of the radiation oncology team. We have developed a comprehensive safety program that is unique to Johns Hopkins. As an international leader in radiation safety, our standards for safety serve as an example for other academic and community-based radiation practices. Our safety program not only complies with state and national protocols, it goes well beyond those protocols by integrating innovative safety techniques developed by experts on our staff.

Through our clinical research, we offer our patients the most effective and safest therapies available, in addition to clinical trials that patients can choose to participate in.

Several kinds of brachytherapies are designed to treat specific cancers:

Brachytherapy may also be used to treat certain types of cancers that affect children and teens.

To find out more about radiation oncology at Johns Hopkins, call 410-502-8000 or e-mail hopkinsradonc@jhmi.edu.

Endorectal brachytherapy for rectal cancer

Radiation oncologist Joseph Herman, MD, MSc, who specializes in the treatment of anal, liver, pancreatic, and rectal cancers, is working with Johns Hopkins surgeon Susan Gearhart, MD, to study the effects of endorectal brachytherapy, a treatment that delivers radiation directly into the rectum in patients with low-lying rectal cancers. This is the first prospective U.S. study to look at the effectiveness of the treatment and its results so far look promising, says Dr. Herman.

Endorectal brachytherapy uses a cylinder-shaped applicator to deliver focused radiation to the surface of the tumor. After the probe is placed in the rectum, a wire with a radiation source at the tip is slowly inserted into the applicator. As it moves through the applicator, it delivers very focused radiation to the surface of the tumor. This highly focused radiation targets the tumor and lesser amounts reach the nearby tissue surrounding the tumor that could contain cancer cells. Normal tissue such as the bladder, small intestines, and sexual organs are farther away from the probe and almost completely spared from the radiation.

The treatment only takes about 15 minutes and the radiation is completely removed from the body after treatment. Patients receive four days of endorectal brachytherapy without concurrent chemotherapy, in contrast to traditional external beam radiation therapy, which takes 28 days.

Rectal Cancer Clinical Trial | Johns Hopkins Kimmel Cancer Center

A clinical trial for rectal cancer patients will test a technique that delivers high doses of radiation directly to rectal tumors. The study will evaluate the effectiveness of endorectal brachytherapy, which is given 15 minutes a day over four days before patients undergo surgery.

Benefits include:

  • Less damage to normal tissue around the tumor site
  • Likely decreases the risk of bowel complications and secondary cancers
  • Less time between diagnosis and surgery (seven weeks as compared to 12)
  • No chemotherapy during radiation therapy
  • Faster recovery from surgery with endorectal brachytherapy

High-dose rate intra-operative radiation therapy (HDR-IORT)

High-dose rate intra-operative radiation therapy (HDR-IORT) provides an intensive, targeted dose of radiation to a tumor site after the tumor is surgically removed to sterilize the area where the tumor was located. IORT is often given after standard radiation therapy and has been shown to decrease the chance of the cancer coming back or recurring. HDR-IORT is particularly effective at treating recurrent tumors as well as large tumors that adhere to normal tissues. It can also be used to target tumors in places that would be hard to reach with other radiation treatments.

Because it requires both expertise and special equipment, Johns Hopkins is one of the few centers that offers HDR-IORT treatment. Our doctors and staff in the Department of Radiation Oncology are experienced in treating patients with high-dose rate intra-operative therapy.

Other benefits of high-dose rate intra-operative radiation therapy include:

  • Immediate radiation treatment
  • Precisely targeted to the site so that surrounding healthy tissues and organs are not damaged
  • Possibly fewer side effects than traditional external beam radiation treatment

At Johns Hopkins, the radiation oncology team uses HDR-IORT to treat:

Prostate seed implants

At Johns Hopkins, prostate seed implants are used to treat low- to intermediate-risk cancers. A multi-disciplinary team of doctors works with each patient to determine the best course of treatment for that patient.

As with other types of brachytherapy, prostate seed implants are targeted doses of radiation “seeds” that are placed directly at the tumor site. Patients receive either general or local anesthesia during the procedure.

A team of specialists, including the radiation oncologist, will decide whether a high or low dose of radiation is needed:

  • With low-dose rate brachytherapy (also called LDR brachytherapy), the seeds will be implanted and stay at the site, emitting a low dose of radiation for several weeks, after which the seeds become inert, no longer emitting radiation.
  • With high-dose brachytherapy (also called HDR brachytherapy), the seeds are implanted and left in place for 30 minutes to emit a high dose of radiation, after which they become inert, as with LDR brachytherapy.

Prostate seed implants offers these benefits:

  • Reduced damage to surrounding tissue
  • Fewer complications and shorter treatment time than standard radiation
  • Less risk of incontinence and impotence
 

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