Watch a video describing interstitial brachytherapy
Interstitial catheters may be recommended for your treatment plan. Interstitial catheters are hollow narrow tubes that hold radiation and temporarily stay in the tumor during an inpatient hospital stay.
Before the interstitial procedure, you'll be given an appointment to meet with an anesthesiologist in the pre-admitting testing center about one week before the procedure. At the time of the pre-procedure appointment, we may perform blood tests, a chest x-ray or other radiologic imaging, an EKG or additional studies.
Most patients receive general anesthesia before the procedure. An epidural catheter may be placed before the procedure, in order for you to adjust your pain medication during the course of your inpatient hospitalization.
You will be asked not to eat or drink anything after midnight the night before the procedure. You will also need to have a bowel preparation the night before the procedure.
On the day of the procedure, you should go first to the admitting department on the first floor. The anesthesiologist will bring you into the procedure room and place you under anesthesia.
A foley catheter is first placed into the bladder. The interstitial applicator is then inserted. After insertion of the applicator, you will be scanned on a CT simulator, a treatment plan is generated, and then treatment is administered either in the brachytherapy suite for HDR treatments or in a radiation safe inpatient room for LDR treatments. If you're staying overnight, you will be given Lomotil and will be on a low residue diet to rest the bowel. You will have a catheter in your bladder until discharge.
You may have an epidural catheter or intravenous pain medication by pump for the management of any pain that you may have during your stay. This will be assessed and monitored by the anesthesiologist involved in your care. You will be on bed rest until the implant is removed. While on bed rest, you will have elastic stockings and compression boots on both legs to prevent a blood clot from forming.
After the interstitial procedure, you may experience some spotting or bleeding from your vagina. You may experience some vaginal cramping after the procedure. This should stop by the end of the day. You may have some burning when you urinate for a day or two because a catheter was placed in your bladder during the procedure, which can cause some irritation. You should drink 8-10 cups of non-caffeinated beverages such as water, fruit juices, etc. for the next couple of days. Your vagina may become irritated, and douching with a hydrogen peroxide douche may be recommended by your physician.
The radiation sometimes causes the tissue in the vagina to tighten and narrow. You will be given a dilator to prevent narrowing or tightening of the vagina from radiation.
Other side effects will be discussed with you by your physicians, some of which may be specific to your situation. You may notice that you are more tired, especially if the implants follow a course of external radiotherapy. Some patients feel exhausted and have little energy the first few weeks after the last implant. But the energy level gradually improves and you will be able to resume your usual activities.