If you’ve been diagnosed with cancer, your treatment plan may include radiation therapy. While many people are familiar with external beam radiation therapy, fewer have heard of brachytherapy.
Brachytherapy is a specialized treatment that uses a substance to deliver highly focused radiation therapy directly to or very near a tumor. The goal is to treat the tumor as precisely as possible with less disturbance to surrounding healthy tissues. Brachytherapy is an effective treatment for several types of cancer, including tumors in areas that are difficult to reach with surgery. It can also be used to treat certain noncancerous conditions, such as keloids and coronary artery restenosis.
Radiation oncologists at the UT Southwestern Harold C. Simmons Comprehensive Cancer Center are among the few in North Texas who offer brachytherapy. We are also the only North Texas center that performs intraoperative radiation therapy, a technique that applies high-dose brachytherapy during tumor removal surgery.
Brachytherapy has evolved significantly in recent years. Modern techniques are designed to shrink or eliminate tumors in fewer treatment sessions as well as preserve organ function and the appearance of the treatment site. The number of treatments typically ranges from one to 10, depending on the condition. In some cases, brachytherapy can also reduce the need for additional surgery.
It’s normal to have questions when you’re starting a new type of cancer treatment. Let’s review six common questions patients ask about brachytherapy as well as some of the latest advancements in this safe, effective treatment option.
1. How does brachytherapy work?
Unlike external beam radiation therapy, which delivers radiation from a machine outside the body, brachytherapy uses tiny capsules, pellets, seeds, or wires implanted in the body or at the skin surface for superficial cancers.
This allows us to deliver a highly focused dose while limiting radiation exposure to nearby healthy tissue. Because of this precision, brachytherapy tends to cause fewer side effects than more traditional external beam radiation.
Most treatments are outpatient procedures, and patients return home the same day. In some cases, patients might stay in the hospital for a few days to get several treatments of HDR brachytherapy.
There are two main types of brachytherapy in current practice:
- High-dose-rate (HDR) brachytherapy delivers short, intense bursts of targeted radiation. A temporary radioactive source connected to a safety cable is placed in or near the tumor for as little as a few minutes at a time. The radiation devices are removed after the session, so there is no risk of "being radioactive" once the patient goes home. Treatment may be completed in one or just a few sessions.
- Low-dose-rate (LDR) brachytherapy delivers radiation over time through implanted “seeds” or devices designed to stay in the body permanently. After treatment, the sources will gradually decay to a point where they no longer release radiation.
In the case of invasive cancers, patients receive general or local anesthesia during placement of the radioactive source. For tumors at the surface, anesthesia is typically not necessary. We use imaging guidance such as ultrasound, an MRI, or a CT scan to place the radiation device in exactly the right spot using a needle or a thin, flexible catheter.
2. What conditions can brachytherapy treat?
Historically, brachytherapy was most associated with prostate cancer and certain gynecologic cancers. Advances in technology have significantly expanded the range of diseases we can treat today, including:
In some cases, brachytherapy may be used as the primary treatment. In others, it may be combined with surgery, external beam radiation therapy, or other cancer treatments.
Brachytherapy is also used outside of cancer care. UT Southwestern is home to the only coronary brachytherapy program in North Texas, treating patients with coronary artery disease that persists despite previous treatments such as stents or laser therapies.
3. Will I be radioactive after treatment?
In most cases, the answer is no. People tend to associate brachytherapy with permanent radioactive implants. While some treatments do involve radioactive seeds or plaques that remain in place, most brachytherapy procedures use temporary radiation exposure.
With HDR brachytherapy, the radioactive source is removed after treatment. Once the procedure is complete, there is no radioactive material left behind. That means patients can safely spend time with family members, friends, and pets without special precautions.
Most patients do not need to worry about remaining “radioactive” after treatment. Talk with your care team about any specific restrictions that may apply to your treatment plan.
4. Who is a good candidate for brachytherapy?
There is no one-size-fits-all answer to this question. The best treatment depends on factors such as the tumor’s size, location, and stage as well as the patient’s overall health. Most of the time, it is considered for treatment of cancers that have not spread to other organs.
In general, brachytherapy is an option to deliver focused radiation therapy while preserving nearby organs and healthy tissue. For example, brachytherapy may be considered for tumors located in areas such as the face or scalp, where surgery could affect the patient’s appearance. In the prostate, traditional radiation therapy may significantly affect sexual or urological function; brachytherapy may reduce the risk of unwanted side effects.
Also, brachytherapy can often be completed faster and in fewer sessions than external beam radiation therapy – days compared to weeks for some conditions. This can benefit patients who must travel for care or who have limited time for appointments.
5. Can brachytherapy help patients avoid surgery?
One of the primary goals of brachytherapy is to preserve organ function and quality of life whenever possible. For certain skin cancers and tumors in delicate areas of the body, brachytherapy may provide an alternative to surgery that could affect appearance or function.
UT Southwestern researchers are studying how brachytherapy can help patients with rectal cancer avoid needing a temporary or permanent colostomy. We launched a rectal cancer brachytherapy program in 2025 and are currently involved in a clinical trial studying whether highly targeted radiation can eliminate certain early-stage rectal cancers while preserving normal function and avoiding major surgery for selected patients.
Related: Read “No colostomy bag after colorectal cancer surgery? Avoid it with this advanced procedure”
6. How do I know if brachytherapy is right for me?
Not every patient is a candidate for brachytherapy, and it is not always the best choice. The best way to find out is to talk with a specialist who is familiar with all available treatment options.
At UT Southwestern, each patient gets a personalized care plan developed by a team of radiation oncologists, surgeons, medical oncologists, and other experts. We discuss established and emerging approaches and help patients understand the potential benefits, risks, and expected outcomes of every option. Our goal is to reduce or eliminate the patient’s cancer with the least impact on their quality of life.
If you’ve been diagnosed with cancer and are exploring treatment options, ask the doctor whether brachytherapy should be part of the conversation. For some patients, it may offer a highly targeted treatment that preserves function, shortens treatment time, and helps maintain quality of life.
Latest advances in brachytherapy
Brachytherapy is giving more patients with complex cancers hope. Technological advancements are helping to further transform it into a highly personalized approach to cancer care.
Robotic technology for precise treatment
At UT Southwestern, specialists have combined robotic bronchoscopy technology with brachytherapy to reach and treat tumors deep within the lungs and airways. Using a robotic bronchoscope, doctors can navigate the lung's branching airways and precisely locate a tumor. Once the target is identified, a brachytherapy device can deliver radiation directly to the cancer from inside the airway itself.
3D printing to create customized treatment devices
Just a decade ago, 3D printing was expensive and only available in limited settings. Today, it’s much more affordable – and it’s becoming a mainstay in treating tumors that do not fit a standard approach.
Not every tumor develops in a location that's easy to treat. In the past, patients with tumors on irregular areas that are highly visible such as the scalp, face, ears, or fingers had limited options beyond surgery or lengthy courses of external radiation therapy – treatments that could cause scarring or functional deficits.
With 3D printing, we can create custom applicators designed to match a patient's unique anatomy to provide less invasive, more precise care. For example, we’ve designed 3D-printed devices that conform to the shape of a patient's scalp or finger to deliver radiation therapy precisely to the treatment area while minimizing exposure to surrounding healthy tissue.
Brachytherapy has come a long way since the earliest iterations of placing radioactive seeds for prostate cancer treatment. Today’s approaches have expanded the versatility of this treatment option, and technological advancements are regularly opening new doors for patients.
By combining advanced imaging, robotics, and highly targeted radiation delivery, we're creating new options for patients with tumors in locations that were once difficult to access or treat.
To talk with an expert about brachytherapy, make an appointment by calling 214-645-8525 or request an appointment online.
