What to Expect During HDR Brachytherapy Treatment

First, we’ll schedule an appointment with a radiation oncologist to discuss the type of HDR brachytherapy that will be used. The catheter(s) that will be used to guide the radioactive material to the tumor site must be implanted prior to your first treatment. This can be done at the time of your lumpectomy or shortly thereafter.

Next, your radiation oncologist and treatment team will design a treatment plan tailored to you. A few days after the catheter is inserted, they will obtain CT images of the implant to make sure the catheter is in the right place and to take precise measurements of the treatment area. They will combine this information with sophisticated computer planning software to outline your course of treatment. For breast cancer, HDR brachytherapy is administered on an outpatient basis, typically 2 times daily for 5 days. However, your treatment team will determine the best course of treatment for you.

Prior to each session, an x-ray of your breast will be taken to check the catheter position. Then, you will be taken to the spacious treatment room where you will lie comfortably on an x-ray couch. The therapist will connect your catheter to the HDR machine (called an “afterloader”) which stores the radioactive source. During your treatment, the radiation source will come out of the machine and go into your catheter. The radiation staff will leave the room during treatment, but will watch you closely on a monitor. They can hear you at all times and you can talk to them if you feel uncomfortable or ill. The entire process lasts about 1 hour and is painless.

During your course of therapy, you will be given a surgical bra or a prescription for one. It is for comfort, support and protecting the catheter, and should be worn even during sleep. You may do your normal activities, but should take caution not to get the breast wet, particularly when bathing. You should also avoid carrying or lifting anything with the arm on your affected side.

A follow up exam with your radiation oncologist will be scheduled after your last treatment to discuss success and side effects. If therapy is considered complete, the catheter(s) will be removed with no lasting radiation in your body. From there, your physicians will determine the proper course of ongoing treatment and follow-up care.