On this page...
Introduction
This information has been written for patients who have been referred for High Dose Rate (HDR) brachytherapy to the oesophagus (gullet). 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.
Endo-oesophagus means ‘inside the oesophagus’ (gullet). The radiation is therefore directly inside your oesophagus (gullet) to kill the cancer cells. The 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 symptoms you may have been experiencing, most probably difficulty swallowing food and drink, or other symptoms such as pain or bleeding.
Your first appointment will be a visit to the endoscopy department, where a special tube, called a nasogastric tube, will be placed into your oesophagus through your nose. The endoscopy department will ring you about your appointment and tell you where to go when you arrive at the hospital. They will give you detailed information about having a nasogastric tube inserted. They will also give you further information regarding what you may eat and drink before your appointment.
You may either be given sedation and so will become sleepy and not fully aware of this part of the procedure, or a local anaesthetic spray will be used to numb the back of your throat to insert the nasogastric tube. Once the nasogastric tube is in place you will be transferred to the radiotherapy department.
All your brachytherapy planning and treatment will take place in the brachytherapy suite in the radiotherapy department at UCH. The brachytherapy radiographers will insert a very fine tube, also called catheter, inside the nasogastric tube in your nose. They will then take X-ray pictures to ensure that the catheter is in the correct position of the area to be treated.
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 and the nasogastric tube.
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 have difficulty swallowing.
- You may have mild nausea.
- You may feel some slight chest pain or heartburn.
If you are concerned about any of these side effects, please speak to your clinical team.
The nasogastric tube and treatment catheter will be removed, and you are free to go home. If a local anaesthetic spray has been used to numb the back of your throat you will not be allowed to eat or drink for four hours. 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.
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
Telephone: 020 3447 3042
Website: www.
OPA Cancer Charity
Telephone: 0121 704 9860
Email: enquiries@opa.org.uk
Website: www.opa.org.uk
Guts UK
Website: www.gutscharity.org.uk
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.
Macmillan Cancer Support t
Telephone: 0808 808 0000 (Freephone)
Email: cancerline@macmillan.org.uk
Website: www.macmillan.org.uk
Cancer Research UK
Telephone: 0808 800 4040
Website: www.
Carers UK
Telephone: 0808 808 7777
Email: adviceline
Website: www.
UCLH cannot accept responsibility for information provided by other organisations.
Services
Page last updated: 18 July 2024
Review due: 30 September 2025