Braving the Brachytherapy

Brachytherapy was the last treatment that I received for cervical cancer. It took me about 5 sessions to complete this cycle. It is an outpatient procedure which I come back to the center every 1 to 2 days.

Intracavity Brachytherapy is one treatment for cervical cancer. 

This type of radiation treatment is internal which involves inserting a radioactive source inside the body near the tumor. The duration of this treatment may take up from a few minutes up to 20 minutes  – depends on the severity of the cancer. Different cancer has varying degrees of invasiveness. 

Radiation exposure to healthy tissues and nearby organs is minimized. It precisely targets the affected area reducing serious side effects.

The entire treatment process on my case took about 4 hours spent at the outpatient clinic. The preparation for this treatment include : pre-medication, foley catheter insertion, device insertion, CT scan, Xray, delivery of radioactive treatment, removing of device and of foley catheter. With this treatment, it does not make my family or anybody I interact with to become at risk for radiation exposure.

Undergoing brachytherapy is extremely challenging. Each person has different levels of pain tolerance. Consider that I have a high tolerance for pain, and I do not usually take pain medication unless I need it badly, this procedure has tested my resilience. 

During the first session, I had to go through the operating room for the smit sleeve placement while being sedated. The smit sleeve is a plastic device attached to the cervix to maintain an access for the radiation device inserted during brachytherapy. It stays in place during the entire treatment process, and removed only when the brachytherapy sessions has been completed. Removing the smit sleeve can be done at the doctor’s clinic and does not necessarily need to be in the operating room.

While in the operating room under sedation, after the smit sleeve has been in place, the device for brachytherapy and a foley catheter has also been inserted. It took about an hour for that procedure to accomplish. On the way to the recovery area, while the anesthesia slowly wears off, the pain becomes unbearable. It was an uncomfortable feeling, in an uncomfortable position, while laying down on the hospital bed, while being transferred from one area to another. I was given 2 doses of fentanyl and it helped a lot in alleviating the pain. The recovery nurse who was assigned to me was even wonderful. She was so sweet to offer her well wishes and prayers for me. This reminded me that the skills for empathy and compassion contributes to a patient’s health recovery.

To confirm the accurate position of the device, CT Scan was done. After it has been confirmed, the radiation oncologist, dosimetrist, and medical physicist plans the prescribed dose needed to be delivered during treatment. Xray was also done before the treatment starts. Getting the Xray and the radioactive dose took about 15 minutes.   

For the succeeding sessions, I did not have to go through the operating room for the device insertion. Sedation was not necessary at the time. The process of inserting the radiation device occurred at the outpatient cancer center. And was pre-medicated with a narcotic pain reliever and a calming medication to help me tolerate it.

Getting to experience the device being inserted for 4 more sessions was extremely horrible. This was especially hard for patients who has never experienced giving birth. Because the process of inserting the device, for me it felt like getting a vaginal delivery in reverse. It took a lot of strength on me to go through this process. The support that I received around me was truly humbling. My radiation oncology doctor, radiation oncology nurse, medical physicist, and my mom who was all there calming me down as the process of device insertion has been completed. It was not an easy process, however to make it a little bearable, calming the muscles on the pelvic area will make it easier for the device to slide through.

Aside from the pre-medicines that I took, I would listen to a calming music before and during the radiation device insertion.

Once the radiation was done, the process of removing the device was not as unsettling as the insertion process. After the treatment, I could continue on with my day without any residual pain.

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