Radium Implants

Good question, complex answer. I'll do my best.

In early stage cervical cancer, surgery is often possible but sometimes an organ-preserving approach is preferable and radiation can be used alone. In more advanced disease, surgery isn't possible but cure still is, so radiation is combined often with chemotherapy.

In these cases, radiation can be given partly with external x-rays, but to focus the dose some internal radiation treatment is also given. Usually, this is intracavitary brachytherapy (meaning close treatment in a cavity) by placing radioactive sources into the vagina, cervix and uterus.

Historically, radium was used. In the past 20 years, most of the brachytherapy has been with Cesium-137. Treatment required going to the operating room to place the applicator that would hold the radioactive sources, then determining how much Cesium to place internally for a period of 2-3 days while hospitalized. This is often referred to as LDR (low dose rate) brachytherapy because it's delivered slowly over time.

More recently there has been a move toward pulsed doses of HDR (high dose rate) brachytherapy with an Ir-192 source. This seems to be an equally effective approach with more radiation safety than LDR, but there are supporters for both approaches. The treatments are short but often more internal treatments are needed with HDR. Good question, complex answer. I'll do my best.

In early stage cervical cancer, surgery is often possible but sometimes an organ-preserving approach is preferable and radiation can be used alone. In more advanced disease, surgery isn't possible but cure still is, so radiation is combined often with chemotherapy.

In these cases, radiation can be given partly with external x-rays, but to focus the dose some internal radiation treatment is also given. Usually, this is intracavitary brachytherapy (meaning close treatment in a cavity) by placing radioactive sources into the vagina, cervix and uterus.

Historically, radium was used. In the past 20 years, most of the brachytherapy has been with Cesium-137. Treatment required going to the operating room to place the applicator that would hold the radioactive sources, then determining how much Cesium to place internally for a period of 2-3 days while hospitalized. This is often referred to as LDR (low dose rate) brachytherapy because it's delivered slowly over time.

More recently there has been a move toward pulsed doses of HDR (high dose rate) brachytherapy with an Ir-192 source. This seems to be an equally effective approach with more radiation safety than LDR, but there are supporters for both approaches. The treatments are short but often more internal treatments are needed with HDR.