Dorothy FarrarAfterloading
Afterloading is a special form of radiation therapy . It forms an important part of brachytherapy.
What is afterloading?
Afterloading is part of brachytherapy, a special form of radiation therapy used to treat cancerous tumors . In this procedure, which translates to “reloading technology” in German, an enclosed radiation source is placed in or near a tumor in order to be able to treat it with radiation.
Afterloading is also known as short-distance therapy, therapy with sealed sources of radiation or internal radiation therapy. Afterloading makes it possible to counteract the cancer cells of a tumor without destroying healthy tissue, because this is largely spared from the radiation. There is also no risk of radiation damage to doctors and medical staff.
A radiation source was used directly on a tumor for the first time in 1901. The scientists involved found out that the irradiation caused the tumor to shrink. In the early 20th century, some medical professionals turned to radium sources for therapy to treat cancers such as prostate cancer .
However, the radioactive radiation risk for medical staff at the time was significantly higher. So it was necessary not only to bring the radiating material into the patient’s body, but also to fix it, so that there was contact with the rays.
Over time, however, it was possible to improve brachytherapy or afterloading and to significantly reduce the risk of radiation. Today, with the help of computer technology and imaging processes, the radiation doses can be placed exactly to the millimeter. When the tumor is destroyed, the surrounding tissue is not affected.
If the therapy is carried out on internal hollow organs such as the female genital organs or the esophagus , an applicator is inserted into the respective opening in the body, allowing the tumor to be reached as closely as possible.
application and function
Brachytherapy and afterloading are used to treat different types of cancer. These primarily include prostate cancer, cervical cancer , breast cancer and skin cancer . Other indications are tumors in the airways such as the bronchi or trachea , tongue , lips , throat and floor of the mouth, digestive tract, esophagus , bile ducts , bile, rectum, anus , soft tissue and brain tumors .
Treatment of the urinary tract such as the penis , bladder or urethra and the female genital organs such as the vagina , vulva and uterus is also possible.
By placing the radiation source close to the tumor, the dose of radiation can be limited to a small volume. Even when the patient moves, the radiation sources remain in their original position. In this way, the doctors ensure that the tumor is exposed to optimal radiation. In addition, since the risks of damage to the adjacent healthy tissue are limited, the patient’s chances of recovery are increased. In addition, the organs are preserved.
Afterloading unfolds its positive effect when the growth of the cancer tumor is localized and no metastases (secondary tumors) form. In some cases, radiation therapy may even be the only treatment option.
methods and procedures
Next to seed implantation, afterloading is the most important method of brachytherapy. In this procedure, a brief invasive procedure is performed on the tumor tissue. This is peppered with non-radiating instruments such as hollow needles, hollow tubes or hoses.
The tubes are then connected to a radiation source made of radioactive material such as iridium or cesium. The radiation source is automatically inserted into the tumor. After a certain period of time has elapsed, the radiation source is removed. This usually involves using a radiation device such as a 121Ir HDR afterloader.
A seed implantation is when radioactive implants measuring approximately 4.5 millimeters are inserted into the tumor. This allows them to destroy him from the inside.
In brachytherapy, a distinction is made between several methods such as interstitial brachytherapy, in which afterloading is used, intracavitary brachytherapy, intravascular brachytherapy, in which the radiation sources are used directly in blood vessels, and contact therapy . With this method, the doctor places the radiation source directly on the surface to be treated.
What does the patient have to consider?
A detailed clinical examination of the patient takes place prior to afterloading. The doctor gets clarity about the tumor characteristics. Various imaging methods are used to determine its shape and size, such as an X-ray examination, sonography (ultrasound examination), computer tomography ( CT ) or magnetic resonance imaging (MRI) .
process and implementation
Afterloading begins with the introduction of an applicator into the hollow organ to be treated. The applicator is advanced directly to the tumor. There is a connection between the applicator and the afterloading device via a hose. A radioactive iridium source is housed in this device.
Depending on the type of cancer involved, different types of applicators can be used. For example, in the case of tumors in the lungs or esophagus, there is the option of connecting the applicator or the tube to an endoscope.
To make sure that the applicator has a stable hold, the doctor will check it with x-rays or ultrasound . Once the applicator is in an ideal position, afterloading can begin. For this purpose, the treatment room is left by the medical staff. However, the patient remains in their visual and auditory contact at all times.
Radiation can be remotely controlled via a computer. Guided by an elastic wire, the radiation source is shifted via the hose to the applicator. Arriving at the treatment site, the radiation is carried out step by step according to a special plan.
Who bears the costs?
Statutory and private health insurance companies cover the costs of afterloading. This is a medically effective procedure.
Risks, dangers and complications
Afterloading can lead to unwanted side effects such as irritation of the intestines or the urinary bladder in some patients. Some patients also suffer from fatigue after the treatment, which is also known as “radiation hangover”. Usually, these side effects wear off soon enough. In some cases, there is also a risk of impotence or incontinence .
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.