Brachytherapy (Internal Radiotherapy)

Brachytherapy places a radioactive source inside or directly beside a tumour, rather than aiming beams from outside the body. Because the dose falls off steeply within millimetres, a high dose reaches the cancer while the bladder, bowel and other nearby organs receive much less.

It is a standard part of curative treatment for cervical cancer, an established option for localised prostate cancer, and is also used for womb, breast, skin, eye and some head and neck tumours. It only works for tumours that are well defined and physically reachable, and it is often combined with external radiotherapy rather than replacing it.

What Brachytherapy (Internal Radiotherapy) involves

Planning starts with ultrasound, CT or MRI to map the target. Hollow applicators, needles or catheters are positioned in or against the tumour: through the perineum under ultrasound for the prostate, through the vagina into the cervix and womb for gynaecological cancer, or through the skin into the breast. Imaging with the applicators in place is used by the physicist to calculate how long the source must dwell at each position. In high-dose-rate treatment a single iridium source on a cable is then driven by a remote afterloader into each channel for a few minutes while staff wait outside, and is withdrawn afterwards. In low-dose-rate prostate treatment, 60 to 120 tiny iodine seeds are implanted permanently and lose their activity over months.

Who is a good candidate for Brachytherapy (Internal Radiotherapy)?

Suitability is decided by a radiation oncologist from stage, tumour size, anatomy and urinary or bowel function.

• Locally advanced cervical cancer, as the boost after chemoradiotherapy, where it clearly improves cure rates
• Low and favourable intermediate risk prostate cancer as sole treatment, or as a boost with external beams in higher risk disease
• Womb cancer after hysterectomy, to treat the top of the vagina
• Selected early breast cancers after lumpectomy, as partial breast irradiation
• Some skin cancers and eye melanomas where surgery would be disfiguring

It is usually not the right choice if:

• Cancer that has spread widely, except for symptom control
• Prostate glands that are very large or men with severe urinary obstruction, unless treated first
• A recent large TURP defect in the prostate
• Tumours that cannot be reached or encompassed by applicators
• People unfit for the anaesthesia needed for applicator placement

Technique options

• High-dose-rate (HDR): Temporary source, treatments of minutes, in 1 to 6 fractions. Nothing radioactive remains in you.
• Low-dose-rate (LDR) seeds: Permanent prostate implant in a single session; brief precautions around infants and pregnant women.
• Intracavitary: Applicators in a natural cavity, such as tandem and ring or ovoids for the cervix, or a vaginal cylinder.
• Interstitial: Needles placed through tissue for bulky or irregular tumours, often combined with intracavitary applicators.
• Surface moulds and eye plaques: Custom applicators for skin lesions; a small plaque stitched to the eye for ocular melanoma.

What happens during your treatment

Applicator placement takes 30 to 90 minutes under spinal or general anaesthesia; a vaginal cylinder for womb cancer needs none. Each HDR delivery lasts 5 to 20 minutes and you feel nothing from the radiation itself. Between fractions given on the same admission you stay flat in bed with the applicators in place and pain relief.

Preparing for your trip

HDR cervical treatment is usually 3 to 5 fractions over 1 to 2 weeks at the end of about 5 weeks of chemoradiotherapy, so the whole course is the realistic travel commitment. Prostate seeds are one session with 2 to 3 days nearby; prostate HDR is 1 or 2 sessions a week or two apart.

• Tell the doctor about medication, allergies, pregnancy or breastfeeding, and any history of cold sores, keloid scars or autoimmune disease
• Avoid alcohol, aspirin and anti-inflammatory painkillers for a few days beforehand if your own doctor agrees, to reduce bruising
• Arrive without make-up on the treatment area and avoid sunbeds and strong sun for two weeks before

Recovery and results

After prostate treatment, expect urinary frequency, urgency and a slow stream for weeks to a few months, usually helped by an alpha blocker, plus bruising behind the scrotum. After gynaecological treatment, cramping, discharge and tiredness last 1 to 2 weeks; vaginal dilators are advised afterwards to limit narrowing. Normal light activity resumes within days. Follow-up is with PSA tests or examination and imaging over years.

• Back to everyday activity: A few days
• When results show: Tumour response is judged over 3 to 6 months
• How long they last: Depends on cancer type and stage

Safety, risks and revision policy

Side effects are concentrated in the organs next to the implant, and some appear months or years later.

• Urinary irritation, and in a few percent of men retention needing a temporary catheter
• Rectal irritation, bleeding or, rarely, ulcer or fistula
• Erectile dysfunction developing gradually after prostate treatment
• Vaginal dryness, shortening or narrowing after gynaecological treatment
• Bleeding, infection or perforation of the womb from applicator placement
• Seed migration to the lung, which is nearly always harmless
• Breast firmness, fat necrosis or skin change after breast treatment

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Brachytherapy (Internal Radiotherapy) in Türkiye

Clinic-Y does not publish a single price for Brachytherapy (Internal Radiotherapy), because the honest figure depends on your case. What moves it:

• HDR versus permanent seeds, and the number of fractions
• Imaging used for planning: MRI-guided adaptive planning costs more
• Anaesthesia and inpatient nights
• Whether external beam radiotherapy and chemotherapy are part of the same course

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions