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Introduction
This information has been written for patients who have been referred for High Dose Rate (HDR) brachytherapy to the bronchus. It explains what the treatment involves, describes side-effects you may experience during and after treatment, and how best to cope with them.
We understand that this is a worrying time for patients and their families. We hope this leaflet answers your questions and eases some of the worries you may have. If you still have any questions or concerns after reading this, please ask your radiotherapy doctor (also called a clinical oncologist), specialist nurse or radiographer involved in your care. We are here to help.
We want to involve you in all the decisions about your care and treatment. If you decide to go ahead with treatment, by law, we must ask for your consent and will ask you to sign a consent form. This confirms that you agree to having the procedure and understand what it involves.
Staff will explain all the risks, benefits and possible alternatives before they ask you to sign a consent form. If you are unsure about any aspect of your proposed treatment, please do not hesitate to speak to the team looking after you.
During your time with us we aim to provide the highest standards of care and support you in your decisions regarding your treatment. We will respect your dignity, individuality and personal preferences.
Your care will be managed and given by doctors, therapeutic radiographers and nurses. You will meet both male and female healthcare professionals during your treatment. If you have any concerns about this, please talk to the radiographers about it. We try to be sensitive to your needs, so please do not hesitate to discuss things with the team caring for you.
HDR brachytherapy is a form of radiotherapy given by directly introducing a radioactive source into the part of your body which requires treatment.
Brachytherapy can deliver a high dose of radiation to the part of your body your clinical oncologist wishes to treat, whist reducing the dose to surrounding healthy tissues.
Endobronchial means “inside the lung”. The radiation is therefore delivered directly inside your lung to kill the cancer cells. Your doctor will pass a very fine tube called a catheter into the area of the body to be treated. The catheter is then connected to the Flexitron unit. The Flexitron unit contains a small radioactive pellet which is programmed to travel down the catheter. When the required amount of radiation treatment has been delivered, the pellet is automatically returned to the unit.
In this way the cancer receives the treatment without affecting other parts of your body. This treatment should relieve some of the distressing symptoms that you may have been experiencing, such as breathlessness, coughing or bleeding.
The brachytherapy radiographers will ring about your appointment, explain what will happen and answer any questions you may have. If you are taking any anticoagulant medication (e.g., Warfarin) please make sure you inform our doctors as this may need to be stopped before treatment.
Make sure you have a responsible adult to escort you home, and to stay with you overnight. If you are being treated as an outpatient you may be a little drowsy after the treatment, due to the medication you will be given.
- No food or milk for six hours before the procedure.
- No chewing gum for four hours before the procedure.
- No water or clear fluids for two hours before the procedure. To determine if the fluid is clear enough, newsprint should be visible through a glass of the liquid.
- If you are diabetic, please discuss this with your doctor.
All your brachytherapy planning and treatment will take place in the brachytherapy suite in the radiotherapy department at UCH. The whole procedure will take about two hours. If you have had a bronchoscopy before, you will know what to expect for the first part of the treatment.
You will be given sedation or sometimes a general anaesthetic. You will feel very sleepy throughout the rest of your treatment. A local anaesthetic spray is used to numb the back of your nose and throat. A bronchoscope is then passed down your nose. A fine tube (catheter) is then passed through the bronchoscope and into your lung so that it is positioned by the cancer.
The radiographers will then take X-ray pictures to ensure that the catheter is in the correct position of the area to be treated. The bronchoscope is then taken out, leaving the catheter in place. This is taped to your nose to prevent it moving. You should not experience any discomfort or be aware of the catheter.
The catheter is then connected to the Flexitron unit. You will be left alone in the room while the radiation treatment is being delivered. The treatment itself will only take about 10-15 minutes.
A nurse and radiographer will be with you except when the treatment is on. However, there are television monitors so that the team can observe you very closely from outside the room during this time.
The radiation is painless, and you will not feel anything unusual or different while the treatment is being delivered. Once the treatment is finished the doctor, radiographers and nurse will re-enter the room to remove the catheter.
The side effects are often mild and usually temporary. After a few days these should settle down and you should benefit from the treatment within two to three weeks.
- Your throat may feel sore.
- You may cough more for a few days after treatment.
- You may cough up some blood.
- You may feel breathless.
- You may feel some slight chest pain or discomfort.
If you are concerned about any of these side effects, please speak to your clinical team.
You may find that you are still sleepy after the treatment. You must not eat or drink for at least one and a half hours after treatment, as your throat will still be numb.
You should avoid alcohol, driving, operating machinery and signing legal documents for 24 hours after treatment.
You will have a follow-up appointment with your clinical team 4-6 weeks after treatment. This may be a telephone consultation, or if face-to-face, will be held in the UCLH Macmillan Cancer Centre.
Brachytherapy Radiographers
Telephone: 020 3447 3782
Email: uclh.
My Lung Clinical Nurse Specialist is:
They can be contacted on: 020 3447 2161
Out of hours oncology advice number (available 24 hours) Mobile: 07947 959020
If you have any concerns that you would like to discuss in confidence, please contact our PALS (Patient Advice and Liaison Service) for information and advice.
Email: PALS@uclh.nhs.uk
Telephone: 020 3447 3042
Website: www.
Roy Castle Lung Cancer Foundation
Telephone: 0333 323 7200
Website: www.roycastle.org
British Lung Foundation
Telephone: 0300 222 5800
Website: www.
Maggie’s (Providing cancer information and support in centres across the UK and online)
Website: maggies.org
Live Though This (cancer support for LGBTIQ+ community)
Website: outpatients.org.uk
Life After Cancer
Website: www.life-aftercancer.co.uk
Macmillan Cancer Support
Telephone: 0808 808 0000 (Freephone)
Email: cancerline
Website: www.macmillan.org.uk
Cancer Research UK
Telephone: 0808 800 4040
Website: www.cancerresearchuk.org
Carers UK
Telephone: 0808 808 7777
Email: adviceline
Website: www.carersuk.org
UCLH cannot accept responsibility for information provided by other organisations.
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Page last updated: 18 July 2024
Review due: 30 September 2025