Skin brachytherapy is a radiotherapy technique which is performed for certain types of skin cancers. Treatment is delivered using a machine known as a ‘Flexitron’. Brachytherapy provides an effective alternative with minimal side effects for selected patients who cannot or choose not to be treated with surgery.
The radiation comes from a small solid radioactive source that is stored in the Flexitron. During treatment the radioactive source travels down a tube, into a specially prepared mould, and delivers the radiation as per your specific patient plan and is then automatically returned to the machine.
Mould room visit
During this appointment the doctor will draw marks on your skin to show the area that needs treatment. In order to deliver your treatment to the same area each day, you will need to have a specialised mould made. This is to help locate the area for treatment and attach the applicators to ensure that your treatment is delivered accurately. The mould room radiographers will make your mould by taking an impression of the treatment area using Plaster of Paris bandages. This is messy but doesn’t hurt, and will take approximately 45 minutes.
You may need to have a CT scan as part of the treatment planning process. This will be confirmed with you at your first mould room appointment.
You can expect to be at your mould room appointment for approximately 1 ½ hours.
Your first treatment appointment will be approximately 2 weeks after the mould room visit.
Figure 2: Example of a hand mould
Figure 3: Example of a scalp mould
The mould room is located in Clatterbridge Cancer Centre - Liverpool, floor 0. Please check in at reception then take a seat in the waiting area, where a radiographer will collect you for your appointment.
Where is the treatment given?
Brachytherapy treatment is carried out in the brachytherapy suite at Clatterbridge Cancer Centre - Liverpool, floor 1. Please check in at reception then take a seat in the waiting area, where a radiographer will collect you for your treatment.
Preparation for treatment
You do not need to do any special preparation prior to your brachytherapy appointment. You can eat and drink normally and take any medication you normally would before you attend.
You may drive yourself to and from the appointment, however you may prefer to have someone drop you off and pick you up. Please refer to the trust website regarding the visitor policy at the time of your appointment to check if someone can accompany you into the hospital.
Parking information can be found on the trust website. If you require hospital transport, please inform staff during your first visit to the hospital or use the telephone number listed on the back of this leaflet.
What to expect when you attend
On the day of your first treatment, you will attend the mould room again for a final fit check of your mould, which will take around 15 minutes. You will notice the mould contains the plastic tubes, it is through these that the radioactive source will pass to deliver your treatment.
Once this appointment is finished you will then be brought to the brachytherapy suite to begin treatment. For your subsequent treatments, you can make your way straight to the waiting area for the brachytherapy suite on floor 1.
For your treatment, you will be taken through to the treatment room where you will be seen by the brachytherapy radiographers. Your mould will be fitted to the area and attached to the treatment machine using a number of tubes (catheters).
Figure 4: Treatment room in the brachytherapy suite
Each day the radiographers will need to do machine checks before delivering the treatment. They do not stay in the room while you are having your treatment, but they watch you during your treatment via CCTV.
During the treatment, the radioactive source moves from the machine down the tubes in your mould a number of times. You will not feel anything, but you will hear some noises from the machine. The time it takes to deliver your treatment varies depending on the size of the area that is being treated, but it is typically 5-20 minutes.
When the treatment has finished, the radioactive source automatically returns to the machine. The radiographers will then re-enter the room, disconnect the machine and remove your mould. You are then free to leave. The whole appointment takes about 30 minutes.
You are NOT radioactive following your brachytherapy treatment and are therefore fine to be around children and anyone who is pregnant.
Taking care of your skin
Information on how to take care of your skin is in the Radiotherapy Skin Reactions – Information for Patients leaflet, produced by the Society of Radiographers, which should be given to you in addition to this leaflet.
Possible side effects after your treatment
Radiotherapy skin reactions are variable in appearance and usually start towards the end of the treatment course, and can last for 4-6 weeks after. Your skin may become red and sore, like sunburn. The area may become crusty and scab over, and in some circumstances the radiographers may need to remove the scabs in order to deliver the treatment correctly.
Any side effects, you may experience will be monitored regularly by the radiographers while you are on treatment.
Radiotherapy for skin cancer only affects the area treated. You will not feel sick from the treatment, or lose your hair, unless your skin cancer is in an area covered by hair.
You may feel tired but you should be able to continue your usual activities or work throughout your treatment.
Side effects may continue for some weeks after completion of treatment.
Possible late side effects
Following brachytherapy, your skin in the treated area will always be more sensitive to the sun, therefore it is important that you either keep the area covered or use a high factor sun block if the area would normally be exposed.
Your skin may always be discoloured compared to the surrounding skin. It may be less or more pigmented, slightly red, or you may be able to see fine blood vessels.
Very rarely will there be a risk of the skin/scar/bone breaking down over many years.
These will be discussed in depth during your consent appointment
Follow-up
It is important to attend your follow-up appointments. The first appointment is about 6 weeks after finishing treatment. You will receive your follow-up appointment through the post. If you do not receive an appointment letter within 2 weeks of finishing treatment, please contact your Cancer Doctor’s Secretary.
Useful Contacts
The Clatterbridge Cancer Centre
Telephone 0151 556 5000
Macmillan Cancer Support
www.
Cancer Information and Support at:
Clatterbridge Cancer Centre - Liverpool 0151 318 8805
Clatterbridge Cancer Centre - Wirral 0151 556 5570
Clatterbridge Cancer Centre - Aintree 0151 556 5959
Email: ccf-tr.
Brachytherapy Clinical Specialist Radiographer
Direct dial 0151 556 5342
The Clatterbridge Cancer Centre Hotline
0800 169 5555
If you are unwell during or up to 8 weeks following your cancer treatment please call The Clatterbridge Cancer Centre Hotline. Your call will be answered by a dedicated nurse advisor. This line is available 24 hours a day, 7 days a week.
CCC Hospital Transport Booking desk - 0151 556 5746/5315
