Brachytherapy: Getting rid of cancer is an inside job

“The closer we can get the radioactive source to the cancer, the better the chances of a full recovery. There are virtually no side effects; the patient gets to live a normal life again.” Dr. Apichart Panichevaluk, senior radiation oncologist at the Horizon Regional Cancer Center, summarizes the benefits of brachytherapy for patients who must undergo radiation therapy. 
“As a radiation oncologist, my role is in the latter stages of cancer treatment. Most patients are rather apprehensive when they hear that they are to undergo radiation therapy. It is therefore very important to reach a correct understanding with the patient,” Dr. Apichart explains the importance of preserving patient morale in the face of radiation therapy. “My first task is to make the patient feel at ease in their first meeting with a radiation oncologist. We get to know each other, and then I would explain their cancer in detail. Where is it? How advanced is it? What kind of treatment has already been done? I stick to the facts, and I discuss them openly with the patient. That way, we can both agree on the best avenue of treatment for the patient. When the patient is on board with their own understanding of what’s going on, treatment can proceed with confidence.”

Caring in the aftermath

The length of radiation treatment is measured in months. Sometimes it must be combined with other treatment modalities, such as chemotherapy, and other medications. “The patients who receive radiation therapy are with us for so long we start seeing each other as relatives!” Dr. Apichart laughs. “The longer they’re here, the more they understand just how much we really care. We’re not just here to treat them and send them on their way. The treatment can be tortuous, there’s no denying that. You can’t fake compassion for people who are in that much pain. Everyone here wants the patient to get better as soon as possible.”
It is equally important for the patient to fully understand the side effects of their treatment. “Generally, the side effects during treatment include pain in the mouth and throat. This happens to everyone. After the treatment certain bodily functions may also be impaired, such as the ability to produce saliva, causing a constantly dry mouth. These days there are some technologies that help to counter that.”

Brachytherapy is simply more effective

Brachytherapy is a technique used in radiation therapy, whereby a radioactive source is placed within or as close to the cancerous tissue as possible. This makes it a highly precise approach, with a very small amount of damage to the surrounding healthy tissue. The resulting side effects are also accordingly low. “The challenge with brachytherapy lies in exposing the cancerous tissue to the most radiation possible. We consider ourselves to be experts in that art, especially for prostate cancer, one of the most commonly treated cancers here at the Horizon Regional Cancer Center.
“Poor treatment of the prostate can impact the functionality of many surrounding organs, such as the bladder, which sits just above the prostate. Brachytherapy is therefore suited to patients with a high risk of such complications. But it is absolutely crucial that the patient is informed of and understands all the details of treatment, such as the fact that a 15cm needle must be used to insert the radioactive element into the targeted area within the patient’s body while ultrasound imaging is used to ensure accurate placement. It can sound so simple, yet so daunting. But the sooner we can gain the patient’s trust and confidence, the better the chances of a successful treatment.”
“When it comes to pre-treatment preparation, we just tell the patient to prepare to come and fall asleep and wake up. That’s it. The process of inserting the radioactive element or removing doesn’t take long at all, though it varies depending on the size of the tumour and various other factors. But the most important thing is that once the source is removed, there’s no residual radiation for the patient to contend with. The patient can hug loved ones. They can also urinate as normal because no nerves were severed. Erectile function may not even be affected; a huge benefit that is not underestimated by the patients who opt for brachytherapy. I’d say that our brachytherapy equipment and program is probably the most advanced and up-to-date in the world right now.” Dr. Apichart proudly beams at the achievements of his team in treating patients with brachytherapy to date.

Combining experience with readiness

Aside from the expertise of our radiation oncologists who have all been through the learning curve of successfully treating more than 50 cases of cancer, the multidisciplinary team is another indispensable factor in the effectiveness of brachytherapy. “We have a multidisciplinary medical team always on standby for our patients. The anesthesiologists who ensure that the operations go smoothly. The surgeons who identify the tumor structures and locations in the patient’s body that need to be navigated. The internists who calculate the overall safety of the operation and medicine intake during and after the operation. The technicians who assist the doctors in operating the equipment. All of these professionals come together for the most comprehensive treatment, and ultimately for the good health and quality of life of our patients.”
“Prostate cancer, once diagnosed, need not be feared. The chances of being cured and living a normal life afterwards are higher than 90%. If you understand this, and can access the right technology for this, there’s simply no need to worry.” Dr. Apichart said in closing.
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