Intracavitary Radiation Using Cylinders Patient Education

Intracavitary radiation is a method of delivering a high dose or radiation to a small area. This involves placing small, round, hollow applicators inside the vagina. A radioactive source is inserted inside the applicator and left there for several minutes, until the correct amount of radiation has been given. The treatment is given at the Cancer Care Institute. Most patients will have one treatment per week over a four- to five-week period. Each procedure takes about one to two hours.

Before the Procedure

• Medications may be given during the procedure. They may make you sleepy. You will not be allowed to drive for 24 hours after the procedure. Please make arrangements for someone to drive you home and to stay with you the rest of the day.
• If you take prescription medications every morning, you may take them with a small amount of water the morning of the procedure.
• Do not have anything to eat or drink six hours prior to the procedure.
• You and your doctor will determine if you need medication during the procedure. This procedure will not always require medication.
• If you have medication, an IV will be started. A nurse will monitor your blood pressure, heart rate and oxygen level, give medicines and provide for your care during the procedure.

The Procedure

During the procedure, you will lie on your back with your legs up in stirrups. You will remain in this position until the treatment is completed. Medicines may be given to make you feel comfortable. The doctor will do a pelvic exam to determine which applicator to use.

The applicators that are inserted into your vagina and cervix vary in size. Your doctor will choose the one that fits you best.

The perineum (the area between the vagina and the rectum) is washed with Betadine solution (an antibacterial iodine solution). A small catheter is placed into the bladder to drain urine during the procedure. It will be removed when the treatment is completed.

The proper applicators are placed inside the vagina and/or cervix. This can cause cramping. Wet gauze is packed inside the vagina to hold the applicators in place. This may cause some temporary pressure inside the vagina. If you experience pain, medicine will be given to keep you comfortable.

A small flexible catheter is also placed inside the rectum. A small amount of barium is put into the rectum and the catheter is removed.

This part of the procedure takes 15 to 30 minutes.

X-rays

X-rays will be taken to check placement of the applicators. This part of the procedure takes about 15 minutes.

Treatment Planning

Calculating the dose of radiation for your treatment is very complex. The physicist and the radiation oncologist do computerized calculations. This planning helps to determine the amount of time needed to deliver the correct dose of radiation to the tumor site.

This part of the procedure takes about 30 to 60 minutes. You may still feel sleepy during this time, if you have received medication. You will continue to rest on the treatment table. A nurse will stay with you. It is important to lay still during this time.

The Radiation Treatment

Before the treatment starts, cables from the treatment machine will be attached to the applicator. During the treatment, the radioactive source will move from the machine through the transfer cables and into the applicator. It will stay there for the proper amount of time. You will not feel the treatment as it is given. You will hear a clicking or humming sound from the machine. The treatment lasts 10 to 15 minutes. You will be alone in the room during the treatment, but we will monitor you on a television camera and with an intercom. After the treatment is complete, the applicators and the catheter will be removed. You will be monitored for a short time, given fluids and your IV will be removed. You may go home with an escort as soon as you are feeling less drowsy.

What You Might Expect After the Procedure

• Some vaginal spotting is expected. This should subside within a day. Wear a pad if needed. Avoid using tampons.
• If you have abdominal cramping (similar to menstrual cramps), take ibuprofen (Advil or Motrin IB) or naproxen (Aleve). The cramping should stop by the end of the day.
• If a catheter was placed into your bladder during the procedure, you may have some burning or irritation when you first urinate. Drink eight to 10 glasses of fluid each day for the next one to two days.
• If a small amount of barium was inserted into your rectum, your next bowel movement may be white or gray in color.
• The radiation can cause the vagina to narrow and tighten. You will be given a vaginal dilator along with instructions for use.
• It is safe to have sexual intercourse between treatments. However, if you have had recent surgery, follow your surgeon's instructions.
• If you were given medication, your memory of the procedure may be "fuzzy." This is a short-term side effect of the medicines. You should not drive or drink alcohol for 24 hours after the procedure.
• You are not radioactive after this procedure.
• You may resume your normal diet after the procedure.

Notify Your Radiation Oncologist for Any of the Following:

• Fever above 101 degrees Fahrenheit
• Abdominal pain
• Burning with urination or blood in the urine for longer than 24 hours

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