Brachytherapy, a type of internal radiation therapy, is a
treatment offered at the Bristol Cancer Institute. It is given
following a course of external radiotherapy and chemotherapy to
women with locally advanced cervical cancer. It involves placing a
number of applicators inside the cervix and vagina and passing a
radioactive source into the applicators to deliver a dose of
radiation to kill cancer cells.
Some centres give brachytherapy in 3-4 day case procedures.
Others give treatments with 1 or 2 inpatient stays, with
applicators remaining in place for up to 48 hours. These regimes
are thought to be equally as effective in controlling the cancer,
but we do not know what difference this makes to patient
experience.
A number of reports have indicated that a significant proportion
of women experience high levels of physical and/or psychological
distress during and after brachytherapy. The causes of distress
appears to be highly complex, with contributing factors such as
anxiety, poor pain control, recall of pain, isolation, immobility
while applicators are in place and the prolonged invasiveness of
the procedure. One study showed that over 4 in 10 patients were
suffering from post-traumatic stress symptoms associated with
brachytherapy 3 months afterwards. It is therefore important to
develop an intervention to reduce distress during and after
brachytherapy.
The aim of this study is to develop an intervention to improve
patient experiences of this highly effective but potentially
distressing treatment. A systematic literature review will inform
an application for a larger research project to develop the
intervention.
