Head and neck cancers
Brachytherapy for treating head and neck cancers
Head and neck cancer is a general term to cover a number of cancers including:
- Eye cancer
- Nasopharyngeal cancer (cancer of the area that connects the back of the nose to the back of the mouth called the nasopharynx)
- Mouth cancer (cancers of the tongue, gums, cheeks, lips and roof or floor of the mouth)
- Esophageal cancer (cancer of the esophagus, also known as the food pipe)
Radiation therapy is a general treatment for melanomas of the eye. It can only be used for small or medium sized tumors. When the tumors are too large the amount of radiation would be so high that the vision of the eye is damaged and you would no longer be able to see with that eye. The result is then the same as with surgery.1
Brachytherapy is suitable for small or medium-sized eye melanomas that have not spread to the eye socket. Brachytherapy is also suitable for people with lymphoma of the eye. The tumors should not be too thick, because the radiation would then not reach the back of the tumor.1
Brachytherapy is given via a small operation under general anesthetic. Very small plates are placed near the tumor, which deliver the radiation to directly kill the cancer cells. The plates (also known as plaques) usually stay in place for about a week and are then removed. You will need to stay in hospital for this period of time.
As the radiation does not travel very deep into the eye, it does not damage other tissues, therefore sight can often be retained. Side effects of treatment include losing your eyelashes, feeling tired or having a dry, sore eye.
Brachytherapy for nasopharyngeal cancer
There are three standard treatment types for nasopharyngeal cancer: radiation therapy, chemotherapy and surgery. Radiotherapy, either external radiation therapy or brachytherapy, can often be used to cure nasopharyngeal cancers that are at an early stage.2
Radiotherapy can also be given together with chemotherapy. Brachytherapy can be used to provide a boost to externally delivered radiotherapy (external beam radiotherapy, EBRT) or to treat cancer that has returned.
There are several devices that can be used to perform the brachytherapy procedure depending on the location and size of the tumor. Your doctor will be able to provide you with further information on how the radiation will be delivered to the tumor.
Brachytherapy for mouth cancer
Cancer of the lip is the most common cancer of the mouth.3
Lip cancers that are localized and have not spread, can be effectively treated with either surgery or radiotherapy. Small tumors that can be removed easily without any permanent cosmetic effects, i.e. scarring, are usually treated with surgery. However, radiotherapy may be a better option for larger tumors as it does not result in scarring and does not interfere with the movement of the lips.
Brachytherapy involves delivering radiation to the tumor via thin tubes called catheters over a couple of days. A lead shield is placed over the teeth and gums to protect them from an unnecessary radiation exposure.
Brachytherapy for tongue cancer
Radiotherapy or surgery are the standard treatment options for tongue cancer.
Brachytherapy can be a preferred option over surgery as tongue function (movement) is not affected and you are therefore less likely to lose your speech.4
Brachytherapy can be used as the only treatment to treat early stage cancer.4 For larger tumors, brachytherapy can be given in combination with surgery, external beam radiotherapy (EBRT) and chemotherapy.
During the procedure a lead shield is placed over the teeth and gums to prevent them from being exposed to unnecessary radiation. Tubes called catheters are used to deliver the radiation directly to the tumor. The catheters are connected to a machine which delivers the radiation. When the treatment is finished, the catheters are removed. Common side effects of brachytherapy are a dry or sore mouth.4
Brachytherapy for esophageal cancer
Brachytherapy is often used for esophageal cancer to slow the growth of the tumor.
Treatment involves having the source of radiation delivered directly to the tumor via a sealed tube that is placed in the esophagus.5 In this way, radiation is delivered directly to the tumor and surrounding healthy tissues do not get exposed to radiation. The radiation is left in place for a specific period of time and treatment can often be provided in one single visit. However, in some cases you may receive multiple sessions of treatment, spread out over a few days.
As brachytherapy delivers the radiation directly to the tumor, the risk of side effects is generally reduced. Side effects may include soreness when swallowing, developing ulcers, or your esophagus may become less stretchy, making it slightly harder to swallow.5
1. Cancer Research UK. Available at: http://www.cancerhelp.org.uk/type/eye-cancer/treatment/radiotherapy/radiotherapy-for-eye-melanomas; accessed 14 July 2015
2. National Cancer Institute. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/hypopharyngeal/Patient/page4#Keypoint17; accessed 14 July 2015
3. Han P, et al. In: Brachytherapy: applications and techniques. Devlin PM (Ed). Philadelphia, PA, LWW, 2007
4. Mazeron JJ, Ardiet JM, Haie-Méder C, et al. Radiother Oncol 2009; 91(2): 150-6.
5. Van Limbergen E and Pötter R. In: The GEC ESTRO Handbook of Brachytherapy. Gerbaulet A, Pötter R, Mazeron J-J, et al (Eds). Leuven, Belgium, ACCO, 2002