The brachytherapy team looking after you will explain your treatment and possible side effects to you in detail. If you do not understand any words or phrases, please ask a member of the team. It does not matter how many times you ask your questions.
Treatment is normally given over three appointments on three consecutive weeks. You will need to come to the hospital early in the morning as we do the planning and treatment all in the same day.
The brachytherapy treatment is delivered through tubes called applicators. The applicator is inserted into your vagina in our dedicated brachytherapy theatre. You will have an epidural anaesthetic injection before this happens so that you cannot feel the procedure. After the applicator is in place, you will have either a computerised tomography (CT) or magnetic resonance (MR) scan. This allows us to take images of your cancer so that we can plan your treatment accurately.
There is a wait of two to three hours between the scan and the treatment whilst the physicists, oncologists and dosimetrists plan your individualised brachytherapy treatment.
The treatment takes approximately 10 minutes. You will be alone in the room when you are having the treatment, but the radiographers can see and hear you at all times. We have a radio and CD player in the room so you can listen to music if you want to. Please feel free to bring a CD to listen to.
Once the treatment is finished, the applicators are removed. No radiation source is left inside your body. You can go home once you have had something to eat and drink, and the effects of the epidural have worn off.
Please note
You cannot drive for 24 hours after the procedure so someone will need to collect you from the department.
Useful Resources:
Using dilators after pelvic radiotherapy for patients with a female pelvis
Guidance on using dilators after pelvic radiotherapy for patients with a female pelvis.
Using dilators after pelvic radiotherapy
Using dilators after pelvic radiotherapy for patients with a female pelvis.
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Hello, my name is Vash and I’m a specialist therapy radiographer in brachiotherapy.
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Brachotherapy is a type of internal radiotherapy used to treat some cancers.
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And my name is Megan and I’m a therapeutic radiographer in radiotherapy.
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One of the possible late side effects of radiotherapy or brackchotherapy to the pelvis is vaginal stenosis. This is when
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the vagina can become narrower, shorter, and tighter due to the scar tissue forming after treatment. You may notice
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this as discomfort during sexual intercourse or during an internal examination. You might also experience dryness, reduced stretch, or tenderness.
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The good news is that there are ways to help prevent and reduce these effects.
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One of the most effective methods is regularly and gently stretching the vaginal tissue using vaginal trainers,
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also called dilators. Vaginal trainers are smooth tubes that come in different sizes. The hospital provides a set of
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four sizes. We recommend starting with a smaller size and gradually increasing when it feels comfortable. You don’t need to use the largest size. A
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comfortable size is enough. We usually advise starting once any treatment side effects like soreness or spotting have
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settled. This is typically around 2 to four weeks after treatment. You should aim to use the trainers three to four
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times per week for about 10 minutes each time. We recommend continuing for around 2 years after treatment. If you have
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regular penetrative sexual intercourse, you may not need to use them as often.
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Using vaginal trainers is not mandatory, but we do strongly recommend it. Many patients seen later in clinic feel that
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using them earlier could have helped to prevent long-term problems. Before you begin, wash the trainer with warm soapy
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water and rinse it well. Find a comfortable position. This could be lying on your bed with your knees
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relaxed apart or standing with one leg raised. Apply lubricant to the trainer.
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This can be prescribed by your GP. Avoid oil based products like Vaseline or baby oil as these can cause irritation.
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Gently insert the trainer into the vagina as far as is comfortable. Take your time and try to stay relaxed. Once
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the trainer is inserted, there are two important movements to follow. First, a gentle in andout motion. Slowly move the trainer in and out for about 5 minutes.
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Second, a gentle rotating motion. Keep the trainer in place and rotate it in circular movements for another 5 minutes. These movements help stretch the tissue and keep the vagina flexible.
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When you finished, gently remove the trainer, then wash it again with warm soapy water. Rinse well and allow it to
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dry. Using the trainer shouldn’t be painful, but you may feel some discomfort at first. You might also notice light spotting or light bleeding
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when you begin. This is usually normal and should improve over time. If it becomes very painful or bleeding is heavy, please contact your healthare
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team. As the trainer becomes easier to use, you may consider moving up to the next size. The standard hospital set is
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made of plastic, but there are other options available. Some people find silicone trainers more comfortable or
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gentler to use. You can explore these options yourself or speak to your specialist nurse for advice. Sexual
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intercourse using your fingers or a vibrator can also stretch the vaginal tissue. However, we still recommend continuing to use the trainers
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regularly. Lubricants can also help with dryness during both trainer use and sexual activity. Regular use of vaginal
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trainers can help prevent long-term tightening and maintain vaginal health.
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This can make future examinations and sexual activity more comfortable. If you have any concerns or questions, please
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speak to your doctor, nurse, or specialist team. Thank you for watching.