Brachytherapy (internal radiotherapy)

What is brachytherapy (internal radiotherapy)?

Brachytherapy is a way of giving radiotherapy from inside the body. A sealed radioactive source is placed in or right next to the cancer, often through thin tubes called applicators, a needle, or as small permanent 'seeds'. Because the radiation acts over a very short distance, a high dose can be aimed at the tumour while more of the surrounding healthy tissue is spared than with some external radiotherapy.

It is used for several cancers, most commonly cancers of the prostate, cervix, womb and vagina, and sometimes for cancers of the skin, breast, eye, oesophagus or other sites. It may be used on its own, or alongside external radiotherapy, surgery or other treatments, as part of a plan agreed by a multidisciplinary team (MDT).

Brachytherapy is a treatment, not an operation, although placing the applicators or implant may need a local, spinal or general anaesthetic. Whether it is given with the aim of curing the cancer (curative intent) or of controlling symptoms (palliative intent) depends on your diagnosis and stage. Your clinical oncologist should be clear about which applies to you.

It is not right for every cancer or every person. Like all radiotherapy it can cause early side effects in the treated area and, less often, late effects months or years later, so the expected benefit is always weighed against these.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Brachytherapy compared with external radiotherapy

Neither is automatically 'better'. The right choice depends on the cancer type, its position and your own situation, and the two are often combined.

Preparing for your treatment

• Talk through why brachytherapy is being recommended, whether the aim is to cure or to control symptoms, and what the alternatives would mean for you.
• Tell your team about all your medicines, especially blood thinners, as some may need adjusting before applicators or seeds are placed.
• Ask whether you will need a local, spinal or general anaesthetic, and whether you should not eat or drink beforehand if so.
• Ask whether you will go home the same day or need a stay in a shielded room, so you can plan time off and support at home.
• For pelvic or gynaecological treatment, ask about bladder and bowel preparation and what to expect during applicator placement.
• If a permanent-seed implant is planned, ask about the radiation-safety rules afterwards, including contact with young children and anyone who is or might be pregnant.
• Arrange a lift home if you have had sedation or an anaesthetic, and bring a list of questions.

What happens

What happens depends on the type of brachytherapy and the area being treated. For many treatments, thin applicators, tubes or needles are first placed in or next to the cancer, sometimes under a local, spinal or general anaesthetic, with scans used to check their position.

For high dose rate treatment, a machine then moves a radioactive source into the applicators for a few minutes while you are alone in a shielded room, watched on camera and able to talk to staff. The source is removed at the end, the applicators are taken out, and nothing radioactive is usually left behind.

For low dose rate treatment, the source stays in place for longer and you stay in a shielded room with limited close contact until it is removed. For a permanent-seed implant, the seeds are placed and left in the tissue, and you go home with radiation-safety advice.

Throughout, the team plans the dose carefully so the tumour gets a high dose and nearby organs get as little as safely possible. You should be told what you will feel, how long it takes and what happens before you go home.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

The most important things to understand are which organs sit near the treated area, what early and late side effects are realistic for your specific cancer, and whether the aim is cure or symptom control. Ask your clinical oncologist how the expected benefit compares with these risks for you, and what the plan is if the cancer does not respond. Late effects can appear long after treatment, so long-term follow-up matters.

Published figures to discuss

Side-effect and outcome rates vary widely with the cancer type, stage, dose, technique and whether brachytherapy is combined with other treatments, so a single set of numbers would be misleading. Early effects in the treated area are common but usually settle; late effects are less common but important and can appear months or years later. Because robust figures that apply to every person do not exist for 'brachytherapy' as a whole, we describe the pattern and the importance of long-term follow-up rather than invent precise percentages. Ask your clinical oncologist for figures specific to your cancer and centre.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

Brachytherapy is a treatment rather than an operation, but you may feel sore or tired afterwards, and radiotherapy keeps acting on the cancer for weeks to months. 'Recovery' is mostly about settling of early side effects and waiting for the planned follow-up to judge the response.

• Feeling tired for a while after treatment
• Soreness or mild bleeding or discharge from the treated area in the first days
• Needing to pass urine more often, or some bowel upset, after pelvic treatment, easing over weeks
• No immediate change in the cancer itself, because radiotherapy keeps acting over weeks to months
• Following radiation-safety advice for a set period if you have permanent seeds

Aftercare

• Follow any written instructions about wound or applicator-site care, hygiene and activity for the area treated.
• If you have permanent seeds, follow the radiation-safety advice exactly, including any limits on close contact with young children and anyone pregnant.
• Drink plenty of fluids if you have had pelvic or prostate treatment, and take any prescribed medicines as directed.
• Use any recommended measures (such as vaginal dilators after gynaecological treatment) to reduce late narrowing, if advised.
• Avoid strenuous activity in the first days if you have had applicators or an implant placed, as advised.
• Attend all follow-up appointments, even when you feel well, so the response and any late effects are monitored.
• Keep your treatment record, as some permanent-seed implants can set off radiation detectors for a time.

• Written aftercare and radiation-safety instructions understood and kept
• A plan for getting home if you have had sedation or an anaesthetic
• Time off and support at home arranged if needed
• Follow-up appointment booked
• Prescribed medicines collected
• Clear contact number for the radiotherapy team saved
• Any dilator or self-care advice understood

⚠ Get urgent help if…

• A high temperature, shivering or feeling generally unwell, which could mean an infection
• Being unable to pass urine, or severe pain on passing urine, after pelvic or prostate treatment
• Heavy or persistent bleeding from the treated area
• Severe or worsening pain in the treated area not helped by the painkillers you were given
• Severe diarrhoea or sudden bowel symptoms after pelvic treatment
• If you have permanent seeds, any concern about radiation safety or a seed you think may have passed out of the body
• Any symptom your team has told you to report straight away

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result is the cancer responding to treatment, but radiotherapy works gradually, so this is judged at planned follow-up over weeks to months rather than on the day. Your team will use examinations, scans or blood tests as appropriate to your cancer.

Brachytherapy cannot guarantee that a cancer is cured or will never come back, even when it is given with the aim of cure. Where the aim is to control symptoms, the goal is comfort and quality of life rather than cure. Your clinical oncologist should be honest about what the treatment is realistically expected to achieve in your case.

How durable the result is depends on the type and stage of cancer and the rest of your treatment plan, not on brachytherapy alone. Some early cancers can be controlled long term, while in other situations brachytherapy is one part of a broader plan or is used to control symptoms. Long-term follow-up is important because both cancer recurrence and late side effects can appear months or years later.

Related tests, treatments or support

Brachytherapy is often combined with external radiotherapy (for example a brachytherapy 'boost' after a course of external treatment), and may be used alongside surgery, chemotherapy, hormone therapy or other treatments. The combination is decided by your multidisciplinary team based on your cancer type and stage. Combining treatments can increase side effects, so the plan should balance benefit and burden.

Follow-up & long-term care

After treatment you stay under the care of your oncology team. Follow-up appointments check how the cancer has responded, manage any side effects and watch for late effects, using examinations, scans or blood tests as appropriate. You should be told who to contact between appointments if you have problems, and private care should be coordinated with your NHS team and GP.

• Attending long-term follow-up so recurrence and late effects are picked up early
• Using vaginal dilators or other recommended self-care after gynaecological treatment, if advised
• Reporting new or persistent urinary, bowel, bleeding or pain symptoms promptly
• Keeping any radiation-safety treatment record if you have permanent seeds

Repeat, follow-on and what comes next

• Radiotherapy works gradually, so the response is judged at follow-up, not immediately.
• Further treatment — more radiotherapy, surgery or systemic treatment — may be needed if the cancer does not respond or comes back.
• Late side effects may need their own treatment months or years later.
• Giving radiotherapy again to the same area is often limited by the dose already received.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• A named contact and clear route to advice for side effects or problems between appointments.
• Written aftercare and, where relevant, radiation-safety instructions you understand.
• A scheduled follow-up plan to assess the cancer's response and watch for late effects.
• Coordination between any private team, your NHS oncology team and your GP.
• Honest, ongoing discussion of what the treatment is achieving and the options if it does not work.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The clinical oncologist's and team's fees for planning and giving the treatment
• The type of brachytherapy and number of sessions
• Whether placing applicators or seeds needs an anaesthetic and theatre time
• Whether you need a stay in a shielded room (more likely with low dose rate treatment)
• Planning scans, imaging and any combination with external radiotherapy
• Follow-up appointments, scans and management of any side effects

• The specialist and facility fees for planning and delivering the treatment
• Anaesthetic and theatre costs if applicators or seeds are placed under anaesthetic
• Whether a hospital stay is included and for how long
• Planning scans and any external radiotherapy given alongside
• Follow-up appointments, scans and who provides them
• What happens, and what it costs, if further treatment is needed or a complication occurs

On the NHS? Brachytherapy is commonly available on the NHS when clinically indicated; private care is mainly used for speed, choice of specialist or self-pay, and should be coordinated with your NHS team.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• Is the aim of my brachytherapy to cure the cancer or to control symptoms?
• Which type of brachytherapy will I have, and will I need an anaesthetic or a hospital stay?
• Which healthy organs are near the treated area, and what early and late side effects are realistic for me?
• If I have permanent seeds, exactly what radiation-safety rules apply and for how long?
• How and when will you check whether the cancer has responded?
• What is the plan, and what are my options, if the cancer does not respond or comes back?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my treatment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this treatment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for brachytherapy (internal radiotherapy)

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: Cancer Research UK — What is brachytherapy (internal radiotherapy)? Cancer Research UK — Internal radiotherapy (brachytherapy) for cervical cancer Macmillan Cancer Support — Brachytherapy for prostate cancer Cancer Research UK — Long-term side effects of brachytherapy for prostate cancer Royal College of Radiologists — Clinical oncology NHS — Radiotherapy

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.