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Tandem and ovoid brachytherapy

The Susan F. Smith Center for Women's Cancers at Dana-Farber provides a variety of services to help patients and their families cope with the many physical, emotional, and spiritual challenges of a cancer diagnosis and its treatment. We are committed to helping patients regain a sense of control over their lives and feel their best throughout treatment and beyond.

Watch a video about tandem and ovoid brachytherapy 

You may hear about the use of a tandem, a small metal tube, which is placed inside your uterus to provide treatment to that area if you have not had a hysterectomy. The ovoids are round hollow metal holders that are placed adjacent to cervix for some patients with cervical cancer.

Before a tandem and ovoid procedure, an appointment will be made for you to meet with an anesthesiologist in the pre-admitting testing center approximately one week before the procedure. At the time of the pre-procedure appointment, blood tests, a chest x-ray or other radiologic imaging, an EKG or additional studies may be performed.

If you will be receiving anesthesia, you should not 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 if you are being admitted for three to four days, or to the radiation oncology waiting area. The anesthesiologist will bring you into the procedure room and place you under anesthesia.

A foley catheter is first placed into the bladder. The applicator is then placed into the cervix and uterus. After insertion of the applicator, you will be scanned on a CT simulator, a treatment plan is generated, then treatment is administered, either in the brachytherapy suite for HDR treatments, or in a radiation safe inpatient room for LDR treatments.

During your hospital stay, if you are staying overnight, you'll be given Lomotil (to stop bowel movements) and will be on a low residue diet to rest the bowel. You will have an indwelling catheter 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.

After the 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.

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.

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