The treatment is given in the Brachytherapy Department, Rutherford Suite, Level -1 Bexley Wing. The department is a combined treatment and out patient Day Case Unit. You will receive treatment as an out patient and your visit will usually be less than 30 minutes.
The healthcare team looking after you will explain your treatment and the side-effects in detail. If you hear any words or phrases that you do not understand, please ask your doctor or a member of your healthcare team what it means. It does not matter how many times you ask.
What is Brachytherapy
Brachytherapy is a type of interventional radiotherapy and uses a radioactive source. The source is placed close to the vaginal walls or near to the scar area in the vagina following surgery. The treatment area receives a high dose of radiation whilst the dose to surrounding normal tissue is lower.
Vaginal vault brachytherapy treatment
A hollow cylinder called a vaginal cylinder, an example of one of these is shown in the picture below.
It is inserted with the rounded end first, into the vagina. The cylinder is held in place by a small clamp, which does not touch you. It is used mainly in the treatment of cancer of the endometrium (the lining of the uterus or womb) or vagina.
Will this be the only treatment I receive?
This treatment is sometimes given after external beam radiotherapy but can be used as the only treatment.
What does the treatment involve?
Brachytherapy treatment will be given in 3 treatments over a period of 8-14 days. Whenever possible you will be treated at the time of day that suits you, this cannot always be arranged or guaranteed due to the workload of the department. Your brachytherapy treatment will start immediately after you complete your course of radiotherapy.
Brachytherapy will be given daily over three days.
The brachytherapy radiographers will arrange a time to meet you during your external radiotherapy to explain your brachytherapy treatment to you.
Before the start of your treatment you will attend an out-patient clinic where treatment and any side effects will be explained and you can discuss. You will be asked to sign a consent form once you are happy to commence. You may have an internal examination to assess how you have healed from surgery.
On the first day of treatment the radiographer will place the cylinder in your vagina. There is no need to perform any further internal examinations during the treatment. Lubricating jelly will be used to make the examination and cylinder placement as comfortable as possible.
In some cases we may perform a CT or MRI scan with the tube in place. This will be discussed at the consent stage.
Your treatment may start a few days after this.
During the treatment
A radiographer will show you to a changing room. You will be given a gown and asked to remove your clothes from the waist down. Your clothes and valuables can be locked away in a locker. You will keep the locker key with you until the treatment has finished.
You will be lying comfortably on a soft couch, whilst the treatment is taking place, shown in the photograph below. The cylinder is connected to the treatment machine using a hollow flexible cable. You may experience a little discomfort because you have a cylinder in the vagina.
The cylinder is held in place with a small clamp which rests on the treatment couch. The muscles in the vagina may try to push the cylinder out, this sensation is perfectly normal.
Treatment lasts for approximately 10 minutes during which time you will be alone in the treatment room. You will be monitored by the radiographers via several CCTV in the room and treatment can be stopped if you are uncomfortable. The CCTVs do not record any images and are just present for patient monitoring. The treatment room does have a radio and Bluetooth speaker. If you wish to bring your phone that also fine.
Treatment is deliverd by a treatment machine called the HDR. Your treatment plan will be uploaded to this machine. Once switched on, a radioactive pellet travels from the machine into the cylinder and gives the prescribed amount of radiotherapy to the vagina and then returns to the machine. The treatment itself is painless but you may notice a slight vibration as the pellet moves through the cylinder. This treatment will only take a few minutes.
After the treatment
The radiographer removes the cylinder and you can wipe away any excess lubricating jelly. You will be taken back to the changing room where there is a sink to wash your hands and you can get dressed and go home.
Side-effects
You may experience mild discomfort with the vagina, more frequent bowel movements and a burning pain on passing urine.
The side effects should be minimal but may occur up to two weeks after treatment. If these do not pass quickly or become severe, please contact our service (telephone number on the next page) for further advice.
Radiotherapy may cause dryness, loss of elasticity and narrowing of the vagina. You may be able to help to reduce this by using a vaginal dilator after treatment has finished. The brachytherapy radiographer will discuss this further during your treatment. There is also a leaflet ‘Vaginal Care after pelvic radiotherapy’ to explain how to use the dilators.
When will I see the doctor again?
Brachytherapy Only
You will be discharged back to the team who performed your surgery who will send you an appointment to attend.
The radiographers will follow you up with phone calls at three and six weeks after treatment.
External radiotherapy and brachytherapy.
You will receive a follow up appointment with the Oncology doctors for approximately eight weeks after treatment.
Hotel Bexley Wing
The hotel is located on the 8th floor of Bexley wing and offers single and double rooms each with an en-suite, tea and coffee making facilities and digital television. Single rooms with wheel chair access are also available. 23 patients are able to stay free of charge. There is a charge for relatives if they are staying in their own room. For further details please contact the Hotel Co-ordinator on 0113 206 7687. Out of hours please contact the Non-surgical Oncology Nurse Practitioner through main switch board on 0113 243 3144.
Car Parking
Parking for radiotherapy planning and treatment is free. On entering the car park take a ticket and park as usual (disabled parking spaces are on Level 0). When exiting use the left hand lane next to the ticket office. Take your parking ticket and appointment letter to the attendant. They will process your ticket so that when you insert it at the barrier no charge will be made. If you need assistance or are unable to leave your car please press the button on the barrier.
Student radiographers
The radiotherapy department is a training centre for therapeutic radiographers of any gender. They are supervised at all times. If you do not wish students to be present, please speak to a member of staff. This will not affect your treatment or care.
Contact numbers
Brachytherapy Radiographers
Tel: 0113 206 7744 Monday to Friday 8.00am – 6.00pm
Support Services
Leeds Cancer Support – Complementing care provided by your clinical team, offering access to information and a wide range of support, in a welcoming environment for all. We can be found in the information lounges in Bexley Wing and also in the purpose built Sir Robert Ogden Macmillan Centre.
The Sir Robert Ogden Macmillan Centre – This centre offers a variety of free health & wellbeing and supportive therapies for patients, their family members, and carers. These include hypnotherapy, mindfulness coaching, acupuncture (for hot flushes) and Pilates.
Stopping smoking – NHS Free Smoking Helpline: 0300 123 1044 Monday to Friday 9am to 8pm, Saturday and Sunday 11am to 5pm. Website: www.nhs.uk/smokefree
Live Through This – A cancer support and advocacy charity for the LGBTIQ+ community. Email: [email protected] Website: https://livethroughthis.co.uk
Maggie’s Centre – A warm, welcoming place where you can meet people who are experiencing similar things to you. Next to the multi storey car park. Open Monday to Friday 9.00 am – 5.00pm. Tel: 0113 457 8364 website: www.maggiescentres.org
Macmillan Cancer Support – Freephone: 0808 808 0000 Open 8am to 8pm seven days a week. A textphone service for deaf and hard of hearing people is also available. Textphone: 18001 0808 808 0000 website: www.macmillan.org.uk You don’t need an appointment and all support is free.