Using Flexitron HDR
The aim of this patient information is to explain what brachytherapy is and the treatment procedure.
Brachytherapy is a type of radiotherapy treatment used for treating cancer of the cervix, uterus or vagina. It is normally carried out as an outpatient procedure unless there are transport difficulties or you have nobody at home to look after you.
What is Flexitron HDR?
This is the name of the machine that delivers the internal radiotherapy. It uses a small radioactive pellet that passes into thin, hollow tubes called applicators. The radioactive pellet does not touch you. You will not be radioactive following the treatment.
What will happen?
Prior to your brachytherapy you will have an appointment with a radiographer who will fully explain the procedure and answer any questions you may have. You will require a short general or spinal anaesthetic for the brachytherapy so a pre-op assessment will be carried out during this appointment to make sure you are suitable.
The preparation and treatment for the brachytherapy are carried out in the same room, within the brachytherapy suite. Family and/or friends will not be able to enter this area.
Preparation
During the procedure the doctor will carry out an examination and insert the applicators into your uterus via the vagina. The applicators are held in place by gauze packing. A catheter will be put into your bladder during this procedure and will be removed following treatment.
When the procedure has finished you will have a CT scan to determine the position of the applicators. This will be used to plan and to calculate your treatment time. On your first treatment only you will also have an MRI.
Whilst your treatment is being planned a nurse will stay with you, give you additional painkillers, if required and take your observations.
What happens during treatment?
You will remain in the same position until the end of the treatment session. This will be lying on your back with legs flat. A radiographer will be with you until the treatment is switched on. There can be no members of staff in the treatment room during treatment but you will be watched continually on a closed circuit TV.
How long is the radiation treatment?
The treatment time is usually in the region of 15 minutes or less for each session. The entire session from anaesthetic to removal of applicators following treatment is 4 to 5 hours.
How many treatments will I have?
The treatment is usually given three or four times, one per week and one week apart, usually on a Thursday. The doctor will explain to you how many treatments you need.
What happens when the treatment is finished?
A radiographer will remove the applicators. An anaesthetic is not required for this but gas and air can be given. You will then be taken to the recovery area of the brachytherapy suite. If you are an in patient a porter will return you to the ward. If you are an out patient you may dress and will be cared for by a recovery nurse. You will be offered toast and a drink but can bring your own snack if you wish to. You will be able to leave the department when you have passed urine.
Problems you may have after your treatment
You may have some diarrhoea for a few days after each treatment. You may also feel the desire to pass urine more often.
Vaginal Dilation after Radiotherapy Treatment
This information is provided in addition to any information given to you by your consultant.
Radiotherapy to the vaginal area can cause the vagina to become shorter, narrower and less elastic than before treatment, as well as being drier due to loss of vaginal secretions.
Vaginal dilation will reduce the amount of scar tissue formation by gently stretching the tissues, helping to keep the vagina more supple and future medical examinations more comfortable. Dilation can be achieved by using a dilator, sexual intercourse, or a combination of the two.
A radiographer will discuss the use of dilators after you have been given your last brachytherapy treatment and will provide you with a dilator pack. A vaginal dilator is a smooth plastic tube and your dilator pack will contain 4 different sizes.
Useful websites
www.jostrust.org.uk www.cancerresearch.org.uk
www.macmillan.org.uk www.daisynetwork.org.uk
www.infertilitynetwork.uk www.maggiescentres.org
www.mariecurie.org.uk www.nhsdirect.nhs.uk
Telephone Numbers
If you have any queries regarding your brachytherapy treatment contact the relevant gynae-oncology specialist nurse or brachytherapy specialist.
Gynaecology nurses: Lincoln 01522 573126 Boston 01205 445431
Advanced Practitioners Radiographers: Brachytherapy 01522 572243
Monday to Friday 8.00am to 4.30pm
Consultant via secretary:
Lincoln: 01522 572218 Boston: 01205 445262/446432
Radiotherapy Department
Lincoln County Hospital