Skin brachytherapy treatment

Brachytherapy treatment to the skin is delivered using a machine known as a Microselectron. It contains a miniature source of radiation which can be brought close to the skin to treat tumours, and held in place using a specially prepared plastic mould.

To make sure that your treatment is delivered to the same area each day, a plastic mould is made of the area to be treated. A plaster bandage impression of the treatment area is taken, and from this a plastic treatment mould is prepared. This is carried out in the mould room at the hospital. During this time, the process of the mould preparation will be explained to you in detail.

• To make the mould, you will normally need 3 outpatient appointments. These are usually on the Monday and Wednesday a couple of weeks before your treatment starts. Each of these visits will take about 1 hour.
• Your doctor will explain the treatment and ask you to sign a consent form.

The doctor will draw marks on your skin to show the treatment area - these marks must be kept so please take care when washing. The marks may rub off onto your clothing, so it's a good idea to wear older clothes.

To plan your treatment, we need to do a CT scan of the area with you wearing the mould. We will arrange this scan for the week following your mould fitting. We will give you the date during your visit to the mould room.

As soon as your mould is ready, we will phone you to confirm the start date of your treatment.

Before your first treatment, the radiographer will explain the treatment and give you some written skin care instructions that you can keep and refer to at any time.

If you have any queries at all about your mould room preparation, please ring 0161 446 3525. 

Brachytherapy treatment delivers radiotherapy accurately to the tumour and to a small area of normal tissue around the tumour. This very accurate and localised treatment means that we treat the area that we need to which reduces side effects and gives a good long-term cosmetic effect.

The size and shape depends on the area of your body being treated and your doctor will discuss this with you in detail.

• You should not have many side effects during treatment, but a few days after treatment the skin will become red and sore. There may be a little bleeding and discharge from the treated area.
• Occasionally as with any area of broken skin, you may get an infection. If this happens, there will be a green or yellow discharge from the treated area that may have an unpleasant smell. Contact your GP who will prescribe antibiotics.

Skin tumours on the lower legs may be very slow to heal, taking several months. Sometimes, the treated area on the leg may heal but the tissues may later break down and take several months to heal again. This 'delayed healing' is not common in other areas.

The treatment site should not be painful, but if you have any concerns please contact us on 0161 446 3521 or 0161 446 3983.

A small number of people may need further treatment if the tumour comes back.

Surgery may be an alternative treatment. However, we have discussed treatments with you, and advised you that skin brachytherapy is the best way to treat your tumour. There is also a better cosmetic and overall result with this treatment than with surgery.

If you would like to discuss this further, please feel free to ask for a further consultation with your doctor before treatment starts.

You have a malignant skin cancer which will grow and spread, causing unpleasant symptoms if left untreated. If the tumour is not treated now, it will grow and more extensive treatment will be needed to treat it.

You will have 8 treatments in total - given over 4 days. There will be a minimum of 6 hours between each treatment.

When you arrive, please report to brachytherapy and molecular radiotherapy unit (BMRU) (department 16). It is on the main corridor near The Christie Restaurant. Please ring the bell on the door and the staff will come and collect you.

• The room where you will have your treatment is also used for other types of treatment which can sometimes over-run; so please be prepared for a delay in the afternoons. We will keep you informed about this.
• We will confirm that you have transport available for the daily treatments.
• We will give you your treatment appointments for the week when you come for your first appointment.

It is very important not to be late as it can affect or cancel the treatment.

If you are going to be late, or you are unable to attend, please phone 0161 446 3520.

Please note - these times are a guide only and may vary from day to day.

No, the treatment is completely painless but your skin may become sore after the treatment.

The treatment times vary from one patient to the next, but the actual treatment normally only takes a few minutes. The whole session including fitting the mould usually lasts about 15 to 20 minutes. The staff will tell you about your treatment time on your first visit.

No one can stay in the room with you. However, the radiographers who are treating you will be watching you on a television outside the room. If you need them, just raise your hand and they will come to you immediately.

• The radiographers will explain the sort of skin reaction you may expect to see over the next few weeks. You may not notice any reaction straight away, but the treated area may become red and/or itchy by the end of your treatment.
• If necessary, you can take mild painkillers such as paracetamol.
• Do not use tight bandaging as it is important to allow air to the treated area. If you have any discharge from the treated area and you want to protect your clothes, your district nurse will put on a suitable dressing.

The radiographers can give you additional advice on how to care for your skin when you are at home.

• We will send you an outpatient appointment for your next visit to see a doctor. This will be approximately six weeks after your last treatment, by which time any reaction should have settled down.

• If you have any queries regarding your treatment, please ring the sealed sources department on 0161-446 3983.
• If you were an inpatient and have any problems with skin care, please contact your ward via the switchboard on 0161 446 3000. If you were an outpatient please contact us on 0161 446 3983.

Cancer information centre at The Christie - Tel: 0161 446 8100

There is a wide range of information available.

Macmillan Cancer Support www.macmillan.org.uk

For information and advice, Freephone 0808 808 00 00

• www.skincancer.org
• www.skincarephysicians.com
• www.bad.org.uk
• www.nice.org.uk