Brachytherapy in India

Brachytherapy

Brachytherapy involves placing a radioactive material directly inside or next to the tumor. “Brachy” is Greek word meaning short. Brachytherapy allows use of a high dose of radiation while reducing the risk of damage to nearby healthy tissue and increasing the likelihood the cancer is destroyed.  Doctors may place Brachytherapy seeds inside a body cavity, such as the vagina, or insert seeds into body tissue using hollow needles. Brachytherapy may be used alone or with radiation given externally. Radioactive seeds may be left permanently in place or removed after some time.

Brachytherapy History

In 1901, Pierre Curie suggested to Danlos at St. Louis Hospital in Paris that a small radium tube be inserted into a tumor thus heralding the birth of Brachytherapy. In 1903, Alexander Graham Bell made a similar suggestion, completely independently, in a letter to the Editor of Archives Roentgen Ray. It was found in these early experiences that inserting radioactive materials into tumors revealed that radiation caused cancers to shrink.

In the early twentieth century, major Brachytherapy work was done at the Curie Institute in Paris and at Memorial Hospital in New York. Dr. Robert Abbe, the chief surgeon at St. Lukes Hospital of New York, placed tubes into tumor beds after resection, and later inserted removable Radium sources thus introducing the after loading technique as early as 1905. Dr. William Myers at Ohio State University developed several radioisotopes, including Gold-198, Cobalt-60, Iodine-125, and Phosphorus-32 for clinical Brachytherapy. These were implanted surgically by Drs. Arthur James (surgeon) and Ulrich Henschke (radiation oncologist).

Finally, while Brachytherapy was initially used only for treatment of cancer, it has now been found to be useful in non-malignant diseases (for example, in the prevention of vascular rest enosis) as well. It is clear that Brachytherapy is the optimum way of delivering conformal radiotherapy tailored to the shape of the tumor while sparing surrounding normal tissues.

Conditions Treated with Brachytherapy

• Prostate Cancer
• Head and Neck Cancer
• Skin Cancer
• Breast Cancer
• Gallbladder Carcinoma
• Uterine Carcinoma
• Vaginal Cancer
• Lung Cancer
• Rectum Cancer
• Eye Cancer

Brachytherapy is an effective option for some people who have prostate cancer or cervical cancer, and may be preferred for some women who have uterine (endometrial) cancer. Doctors recommend Brachytherapy for people who are at risk for tumor re-growth in the upper vagina after removal of the uterus.

Success Rate of Brachytherapy

The results of prostate Brachytherapy are comparable to those of radical prostatectomy for five to seven years after treatment. The long-term data (longer than 10 years after treatment) are limited. Studies demonstrate success rates of 74% at seven years, with success being defined by either a PSA of less than 0.5ng/ml or the absence of three consecutive rises in PSA in patients who received Brachytherapy and external beam radiation therapy (EBRT). Survival rates for men who receive this procedure are from 81% to 93%. Given the aggressiveness of most cancers, especially if not treated early, this is a very high success rate.

Preparation for Brachytherapy

Doctor will determine which preparations need to be done prior to your Brachytherapy procedure. These may include:

• Bowel preparation
• Pre-treatment ultrasound, MRI or CT scan
• Blood tests
• Electrocardiogram (EKG)
• Chest X-rays

Doctor may also use computer programs to plan the Brachytherapy before the actual treatment procedure. A few days before procedure, you will be given specific instructions on how to prepare for your Brachytherapy procedure.

Brachytherapy Types

Different types of Brachytherapy can be defined according to the source placement, dose rate and dose delivery time.

Source placement

The two main types of Brachytherapy treatment in terms of the placement of the radioactive source are interstitial and contact.

• In the case of interstitial Brachytherapy, the sources are placed directly in the target tissue of the affected site, such as the prostate or breast.
  
  
• Contact Brachytherapy involves placement of the radiation source in a space next to the target tissue.

Dose rate

The dose rate of Brachytherapy refers to the level or ‘intensity’ with which the radiation is delivered to the surrounding medium and is expressed in Grays per hour (Gy/h).

• Low-dose rate (LDR), Brachytherapy involves implanting radiation sources that emit radiation at a rate of up to 2 Gy.hr-1.[  LDR Brachytherapy is commonly used for cancers of the oral cavity, oropharynx,  sarcomas and prostate cancer
  
  
• Medium-dose rate (MDR), Brachytherapy is characterized by a medium rate of dose delivery, ranging between 2 Gy.hr-1 to 12 Gy.hr-1.
  
  
• High-dose rate (HDR), Brachytherapy is when the rate of dose delivery exceeds 12 Gy.hr-1. The most common applications of HDR Brachytherapy are in tumors of the cervix, esophagus, lungs, breasts and prostate. Most HDR treatments are performed on an outpatient basis, but this is dependent on the treatment site.
  
  
• Pulsed-dose rate (PDR), Brachytherapy involves short pulses of radiation, typically once an hour, to simulate the overall rate and effectiveness of LDR treatment. Typical tumor sites treated by PDR Brachytherapy are gynecological and head and neck cancers.

Duration of dose delivery

The placement of radiation sources in the target area can be temporary or permanent.

• Temporary Brachytherapy involves placement of radiation sources for a set duration (usually a number of minutes or hours) before being withdrawn. The specific treatment duration will depend on many different factors, including the required rate of dose delivery and the type, size and location of the cancer. In LDR and PDR Brachytherapy, the source typically stays in place up to 24 hours before being removed, while in HDR Brachytherapy this time is typically a few minutes.
  
  
• Permanent Brachytherapy, also known as seed implantation, involves placing small LDR radioactive seeds or pellets (about the size of a grain of rice) in the tumor or treatment site and leaving them there permanently to gradually decay. Over a period of weeks or months, the level of radiation emitted by the sources will decline to almost zero. The inactive seeds then remain in the treatment site with no lasting effect. Permanent Brachytherapy is most commonly used in the treatment of prostate cancer.

Brachytherapy Procedure

In Brachytherapy procedure physicians place the source of irradiation close to the tumor or within a body cavity. Brachytherapy may include placing radioactive sources inside a body cavity such as the vagina, or by putting radioactive material directly into body tissue using hollow needles.

Brachytherapy may be given in addition to external beam radiation, or it may be used as the only form of radiotherapy. In some cases the radioactive sources may be permanently left in place; in other cases, they are removed after a specified time. Placement of radioactive sources may be repeated several times in some situations.

Brachytherapy Advantages

• The precise targeting of the radiation, which spares healthy tissue;
  
  
•  The fact that the procedure can usually be completed in 1-3 hours on an outpatient basis;
  
  
• A substantially lower incidence than surgery or external beam irradiation of both impotence and incontinence; and little to no impact on the patient's quality of life.
  
  
• Patients typically return to their normal activities within 1-2 days with minimal restrictions.
  
  
• Brachytherapy greatly shortens the duration of the treatment, in fact prostate cancer Brachytherapy can often take one and a half days rather than the 5-7 weeks of traditional radiation.

Risks of Brachytherapy

Risks of this treatment approach include some incidence of impotence and incontinence, frequent urination and, occasionally, blood in the urine.      

Alternative to Brachytherapy

There are other alternative to Brachytherapy which can be either radiotherapy like external beam radiation or surgical. External beam radiation therapy (EBRT) is the use of radiation therapy to kill or inactivate cancer cells. Radiation is given in separate, smaller doses known as fractionation.

Brachytherapy in India

There are many advantages of Brachytherapy in India. Some of them are:

• International accredited partner hospitals, patient centered approach with well equipped facilities. English speaking staff, providing personalized and caring service at par with any best hospital in the world.
  
  
• Extensive investments have been made to ensure that all medical centers are equipped with modern facilities, internationally accredited hospitals of India are capable of handling the latest techniques and procedures. These state-of-the-art facilities focus on what matters: more effective, efficient and pleasant solutions for patients.
  
  
• With all medical centers equipped with modern facilities, medical centers in India are able to provide shorter waiting time. Patients may be hospitalized upon arrival, and examinations and work-up tests are usually addressed promptly.
  
  
• The Indian government has made it easier for visitors seeking health treatments to enter the country. With the relevant letter from the medical centre at which you will be receiving your medical treatment, you may enjoy up to six months of visa extension.

Brachytherapy Cost in India

• India offers a low cost brachytherapy for international patients.
  
  
• India's favorable exchange rate and the cost of healthcare services are at an extensively lower cost than that of other countries. If you're coming from a Western country such as the United States or Britain, medical procedures in India will generally cost a fraction of the price as compared to prices back home.
  
  
• Prices in India are reasonable and affordable, be it accommodation, food or even shopping.
  
  
• From comfortable and affordable hotels to five-star accommodations, India provides you with a choice to budget or splurge. Hotels start from as low as USD50 to USD150 per night depending on its star rating. Alternatively, if your family is accompanying you for treatment, there is also an option to rent a serviced apartment.

Brachytherapy in India offered by Indian Medguru Group

Indian Medguru Group the top most medical tourism company in India having all the top most hospitals in its panel delivering best medical services to the patients. You just have to send us a query regarding brachytherapy in India and within 24 hours, a patient coordinator will contact you for further details and interaction. From that point everything will be taken care of by that coordinator, like arranging VISA, accommodation, appointment with the doctor with round the clock services to make your medical tour hassle free. Indian Medguru Group offers well-qualified and professional doctors, surgeons, physicians, and medical staff who aid you in recovery from your ailment and ensure a safe and healthy journey back home.

Brachytherapy in India is available in following cities;