Brachytherapy is a form of internal radiation therapy for cervical cancer, involving the placement of tiny radioactive sources directly inside or near the tumor. This precise placement allows a high dose of radiation to target cancer cells while minimizing exposure to surrounding healthy tissues. This article provides guidance on immediate and long-term changes after brachytherapy, when to seek medical advice, and the importance of ongoing monitoring.
Immediate and Short-Term Recovery
Immediately following brachytherapy, patients may experience mild pelvic discomfort, pressure, or cramping. This is often temporary. Many individuals return home the same day after high-dose-rate (HDR) brachytherapy sessions.
Common short-term effects appear within days to a few weeks after treatment. These include a clear, pink, or brownish vaginal discharge, which often resolves as healing progresses. Fatigue is also common, and rest is important during this period.
Urinary changes, such as increased frequency, urgency, or a burning sensation during urination, may occur due to bladder irritation. Similarly, some individuals might notice changes in bowel habits, like increased frequency of stools, mild cramping, or diarrhea. These symptoms usually improve within a few weeks as treated tissues recover.
To manage these immediate effects, rest and good hydration are important. Mild pain relievers, as advised by the care team, can help alleviate discomfort. Temporary activity restrictions, such as avoiding heavy lifting, strenuous activities, and sexual intercourse for about two to four weeks, are recommended to support healing.
Managing Long-Term Changes
Some changes after brachytherapy can persist for months or even years, requiring ongoing management. Vaginal changes are common, including dryness, which can be addressed with moisturizers or lubricants. Radiation can lead to scar tissue, potentially causing the vagina to become narrower or shorter, a condition known as vaginal stenosis.
Vaginal dilators are often recommended to help maintain vaginal elasticity and prevent narrowing, which can also improve comfort during sexual activity. Changes in sexual function or comfort (dyspareunia) are possible, and open communication with a healthcare provider can help explore solutions like pelvic floor physical therapy.
Bladder changes may include persistent urgency or frequency, sometimes referred to as radiation cystitis. Occasional blood in the urine can also occur, though less common. Bowel changes might involve continued alterations in stool consistency or frequency, rectal discomfort, or minor bleeding, often referred to as radiation proctitis.
Strategies for managing these long-term issues include specific lifestyle adjustments and, when appropriate, medications prescribed by the healthcare team. Lymphedema, or swelling in the legs, is a possibility if combined with external beam radiation, though less common with brachytherapy alone. Persistent fatigue can also extend for several months, requiring continued self-care and support.
Recognizing When to Contact Your Care Team
It is important to know when to seek medical attention during recovery. Contact your healthcare provider if you experience severe or worsening pain not relieved by medication. Heavy vaginal bleeding, defined as more than spotting or bright red blood, also requires prompt medical evaluation.
A fever of 100.4°F (38°C) or higher can signal an infection. Other concerning symptoms include severe nausea, vomiting, or an inability to keep fluids down. Significant changes in urination, such as an inability to urinate, severe pain during urination, or persistent blood in the urine, should also be reported.
Contact your care team for severe or persistent diarrhea, particularly if accompanied by bloody stools. Signs of deep vein thrombosis (DVT), such as swelling, pain, or redness in a leg, are serious indicators. Any new, concerning, or rapidly worsening symptoms should prompt a call to your healthcare provider.
Ongoing Medical Monitoring
Regular follow-up appointments are a structured part of post-brachytherapy care. These visits monitor recovery, address lingering or new side effects, and check for signs of cancer recurrence. The first follow-up appointment typically occurs six to eight weeks after treatment completion.
Subsequent appointments usually involve visits every three to six months for the first two years, then every six to twelve months for the next three years, and annually thereafter. These appointments often include physical examinations, such as pelvic exams, to assess the treated area.
Your healthcare team may also recommend imaging scans or blood tests, including tumor markers, as needed. Maintaining open communication with your care team during these visits is important for discussing any concerns or new symptoms. This monitoring supports long-term survivorship and overall well-being.