What should you know about manual afterloading brachytherapy?

Brachytherapy delivers radiation close to a tumour rather than from a machine across the room. An applicator is placed in or next to the treatment area, and the radioactive source is then loaded into it by hand. The source is removed after the planned exposure, so the applicator and source are separate parts of the process.

This approach is different from an automated afterloader, which moves the source into the applicator from a shielded device. Brachytherapy may be used for cancers of the cervix, womb, vagina, or prostate, but the method depends on the site, treatment plan, and available equipment.

Your team will explain preparation, positioning, pain relief or anaesthesia, and how long the applicator remains in place. Follow instructions about eating, drinking, medicines, and arranging transport. Tell the team about pregnancy, allergies, blood-thinning medicines, infection symptoms, and any difficulty lying still.

After treatment, follow wound, hygiene, activity, and follow-up instructions. Ask whether the source is removed before you leave and whether any temporary discharge, soreness, urinary change, or bowel change should be expected. Permanent seeds are a different material and should not be assumed to apply to manual afterloading.

Contact the treatment unit promptly for fever, heavy bleeding, worsening pelvic or urinary pain, inability to pass urine, foul-smelling discharge, or severe abdominal pain. Seek urgent help for fainting, uncontrolled bleeding, severe breathing difficulty, or sudden weakness. Use the emergency number supplied by your treatment centre if symptoms are severe.

Which applicator will be used, and where will it sit? Will I need anaesthesia or sedation? Is the radioactive source temporary, and when is it removed? What symptoms are expected afterward? Who should I call outside clinic hours?