HDR Brachytherapy is a High-dose rate internal radiation therapy. It is used to treat cancer by delivering high doses of radiation directly to the tumour. The treatment is commonly used for prostate cancer, cervical cancer, breast cancer, and certain other malignancies. By placing the radiation source inside or very close to the cancer, HDR brachytherapy helps maximise the radiation effect on cancer cells while minimising damage to surrounding healthy tissues. Dive into an article and learn more about what is HDR Brachytherapy?
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What is HDR Brachytherapy?
HDR brachytherapy is a form of brachytherapy. where a radioactive source is temporarily inserted into the body. It remains in the body for a short time and will be removed after treatment. Unlike low-dose-rate (LDR) brachytherapy, where radioactive seeds remain permanently in the body, HDR brachytherapy does not leave radioactive material inside the patient after the procedure.
During HDR brachytherapy, thin catheters or specialised applicators are carefully inserted near the tumour to deliver targeted radiation treatment. A remotely controlled machine then delivers radiation through these devices for a specific duration, usually only a few minutes. Once the treatment session is complete, the radioactive source is withdrawn.
How does HDR brachytherapy work?
High-dose rate brachytherapy works by delivering concentrated radiation directly to cancer cells. Radiation damages the DNA inside cancer cells, reducing their ability to grow and divide. Since the radiation is delivered directly near the tumour, specialists can target the cancer with greater accuracy and administer a stronger dose while reducing exposure to surrounding healthy tissues.
Advanced imaging technologies such as ultrasound, CT scans, and MRI are commonly used during treatment planning to ensure accurate applicator placement and optimal radiation delivery. This precision helps protect nearby organs and healthy tissues from unnecessary radiation exposure.
Cancers treated with HDR brachytherapy
HDR brachytherapy is used in the treatment of several cancers, including:
- Prostate cancer
- Cervical cancer
- Uterine cancer
- Vaginal cancer
- Breast cancer
- Skin cancer
- Head and neck cancers
- Certain soft tissue tumours
Among these, prostate cancer is one of the most common conditions treated with HDR brachytherapy. It may be used alone or combined with external beam radiation therapy (EBRT) depending on the stage and risk category of the cancer.
HDR brachytherapy for prostate cancer
HDR brachytherapy has become an established treatment option for localised prostate cancer. During the procedure, thin hollow needles or catheters are inserted through the skin between the scrotum and anus into the prostate gland under ultrasound guidance. A radioactive source is then temporarily delivered through these catheters for a few minutes before being removed.
Depending on the individual treatment plan, patients may undergo:
- HDR brachytherapy alone
- HDR brachytherapy combined with EBRT
- HDR brachytherapy with hormone therapy in selected cases
The treatment is usually performed under spinal or general anaesthesia. Some patients may require one session, while others may undergo multiple sessions over a few days.
What are the advantages?
High-dose rate brachytherapy may provide several advantages when compared with traditional radiation treatment methods.
- Precise Radiation Delivery
Because radiation is delivered directly to the tumour, HDR brachytherapy allows highly focused treatment with minimal radiation exposure to surrounding healthy tissues.
- Higher Radiation Dose to the Tumour
The technique enables doctors to safely deliver higher doses of radiation directly to cancer cells, which may improve cancer control.
- Shorter Treatment Duration
Many high-dose rate brachytherapy treatments can be completed within one or a few sessions, reducing the overall treatment timeline compared to some external radiation therapies.
- No Permanent Radioactive Implant
Unlike permanent seed implants used in LDR brachytherapy, High-dose rate brachytherapy removes the radioactive source after each treatment session.
- Reduced Damage to Healthy Tissue
The targeted nature of high-dose rate brachytherapy helps reduce radiation exposure to nearby organs such as the bladder and rectum in prostate cancer treatment.
What is the procedure for High-dose rate brachytherapy?
The exact procedure may vary depending on the type of cancer being treated, but the general process includes:
1. Pre-treatment Planning
Patients undergo imaging tests such as MRI, CT scan, or ultrasound to help doctors plan the treatment accurately.
2. Anaesthesia
The procedure is typically performed under spinal or general anaesthesia to ensure patient comfort.
3. Placement of Applicators
Thin needles are carefully inserted into the tumour area under image-guided precision
4. Radiation Delivery
A computer-controlled machine moves the radioactive source into the applicators for a carefully calculated amount of time.
5. Removal of Radioactive Source
The radioactive source is fully taken out of the body once the treatment is completed.
6. Recovery
Based on the overall health condition and treatment type, patients may return home the same day or after short-term observation.
Side effects of High-dose rate brachytherapy
Like all cancer treatments, High-dose rate brachytherapy may cause side effects. These vary depending on the treatment area, radiation dose, and individual patient factors.
Common side effects in prostate cancer
- Frequent urination
- Burning sensation during urination
- Difficulty passing urine
- Blood in urine
- Temporary urinary retention
- Fatigue
- Erectile dysfunction
- Bowel irritation or rectal discomfort
Many patients notice gradual improvement in side effects, while long-term urinary or sexual symptoms can occasionally remain.
What is the recovery rate after the procedure?
Recovery after high-dose rate brachytherapy is generally quicker than many surgical cancer treatments. Patients may experience mild soreness, fatigue, or urinary symptoms for a few days following the procedure.
Doctors usually recommend:
- Drinking plenty of fluids
- Avoiding heavy lifting for a short period
- Taking prescribed medications as advised
- Attending follow-up appointments and PSA monitoring for prostate cancer patients
Recovery experiences can vary between individuals. Some patients return to normal activities within a few days, while others may take longer depending on the extent of treatment. Community experiences shared by prostate cancer patients often describe manageable recovery periods and gradual improvement in symptoms over time.
How effective is the procedure?
High-dose rate brachytherapy has shown strong outcomes in appropriately selected patients, particularly for localised prostate cancer. Studies and clinical experience indicate that it can provide excellent cancer control while maintaining acceptable side effect profiles. It is often considered an important alternative to surgery or external radiation therapy for certain patients.
Treatment success depends on several factors, including:
- Cancer stage
- Tumour location
- Gleason score in prostate cancer
- PSA level
- Overall patient health
- Combination with other therapies
Who is a suitable candidate?
HDR brachytherapy may be suitable for patients with:
- Localised prostate cancer
- Certain gynaecological cancers
- Small or localised tumours
- Patients seeking a minimally invasive radiation option
However, not all patients are ideal candidates. Doctors carefully evaluate imaging results, cancer stage, urinary symptoms, and overall health before recommending treatment.
Consult our urologist for any kind of queries!!!
Conclusion
High-dose rate brachytherapy is a precise and effective cancer treatment that delivers high doses of radiation directly to the tumour while minimising exposure to nearby healthy tissues. With shorter treatment times and promising long-term outcomes, it remains an important treatment option for prostate cancer and several other cancers. Patients should consult their specialist to determine whether HDR brachytherapy is suitable for their condition.
FAQ
Is HDR brachytherapy painful?
The procedure is usually performed under spinal or general anaesthesia, so patients typically do not feel pain during treatment.
How long does HDR brachytherapy take?
Each treatment session may take a few minutes for radiation delivery, although the complete procedure can take several hours, including preparation and planning.
Is the patient radioactive after HDR brachytherapy?
No. The radioactive source is removed after treatment, so patients are not radioactive afterwards.
What is the difference between LDR and HDR brachytherapy?
HDR brachytherapy uses temporary high-dose radiation delivered over minutes, while LDR brachytherapy uses permanent radioactive seeds that release radiation slowly over time.
Can HDR brachytherapy cure prostate cancer?
HDR brachytherapy can provide excellent long-term cancer control for many patients with localised prostate cancer when appropriately selected for treatment.