You need to follow some safety procedures when you have internal radiotherapy.
Why safety procedures are needed
Hospitals follow particular safety guidelines while you have a radioactive implant in place.
They also follow similar guidelines for a few days after you have treatment with a radioactive drink or injection. This is so that the hospital staff and your friends and family are not exposed to the radiation.
Each hospital has slightly different routines but the same safety rules apply across the UK.
Before your treatment
You usually have an appointment in the radiotherapy unit or ward, or the nuclear medicine department, a few days before your internal radiotherapy treatment.
The staff explain the treatment to you. You can also ask the nurses, medical staff, or nuclear medicine practitioners any questions that you have.
It might help to make a list of your questions so that you don't forget something important. Or you can print out the questions for your doctor and add your own questions to the list.
How the radiotherapy affects you
If you have a radioactive implant in your body, your doctor puts it as close to the tumour as possible.
The areas close to the implant get a high dose of radiation. But further away from the implant, the levels of radiation are low.
The rest of the body gets a much lower dose and it is normally not enough to harm you.
If you have a radioactive liquid, such as iodine, your urine, sweat or poo (faeces) give out a low amount of radiation for a few days.
The radiation levels gradually fall as the radioactivity breaks down.
Please note that all these safety guidelines are not relevant to every internal radiotherapy treatment. It is helpful to run through this list with your doctor or specialist nurse to see which apply to you.
While having treatment
- You might be in a special side room, away from the main ward for 1 or 2 days.
- The doctors and nurses looking after you only stay in your room for short periods at a time.
- Staff wear badges that monitor their exposure to radiation and make sure they keep to a safe level.
- Staff and visitors need to stay a little way away from your bed – the further away they are, the less exposure they have to the radiation.
- The nurses might use an instrument called a scintillation counter to monitor radiation levels in anything taken out of the room, such as bed linen.
- You can only have a limited number of visitors.
- Visitors are asked to stay a short time and may need to sit some distance away from you or talk to you from the doorway.
- Children under 16 and pregnant women are not allowed to visit.
- You can take books, magazines, and some electronic devices into the room.
- If you had a radioactive drink, your urine might be slightly radioactive for a few days – you may need to use the toilet sitting down and wear gloves when you wipe yourself.
After your treatment
- You might be given a card to keep with you for a certain period of time in case of medical emergency.
- If a medical emergency occurs, let your doctor know that you have had internal radiotherapy treatment.
- For a few days after a radioactive drink you might need to flush the toilet twice, each time you use it.
- If you had internal radiotherapy seeds for prostate cancer and one comes out when you empty your bladder, don't touch it. Use tongs to pick it up and flush it down the toilet. Tell your doctor.
- You might need to wear a condom during sex for a few months after internal radiotherapy for prostate cancer. This is in case a seed comes out during sex but this very rarely happens.
Safety for visitors
While you are in hospital having an internal radiotherapy treatment, the further away visitors and staff stand from you, the less radiation they are exposed to. This is because the levels of radiation fall very quickly as you move away from the radioactive source.
You might be able to have your door open so that people can stop and chat as they pass by. This depends on the type of treatment you have. Hopefully you won't feel too cut off during the few days you are having your treatment.
Your feelings about the precautions
The radiotherapy safety measures can add to the worries you might already have about your treatment.
People are different in the way they handle their worries. Some find it easier to know everything about their treatment, while others like to know as little as possible.
The staff on the ward are happy to talk to you if you need them to explain anything. It often helps to bring your fears and worries into the open by talking to the staff, or to your family and friends.
After internal radiotherapy treatment
Some people worry that they stay radioactive once the treatment is over. They think they might be a danger to their family and friends. But you won't harm them. Your doctor or nurse will let you know if you need to avoid pregnant women or very young children for a few days.
Temporary radioactive implant
If you had a temporary radioactive implant, all the radiation disappears as soon as the implant is removed. You are then not a risk to anyone around you.
Permanent radioactive implant
You might give off a low level of radioactivity for a few days after having radioactive seeds put in. Your doctor or nurse will tell you about this. They advise you on how to restrict your activity, until the radiation can't be detected outside the body.
You might need to:
- stay in hospital for a few days
- avoid close contact with pregnant women or children
- avoid public transport
Liquid radiotherapy treatment
It usually takes a few for the radioactivity to fade away if you have had a liquid radiotherapy treatment.
The hospital staff make sure that the radioactivity is at a safe level for your friends and family before you go home. After you leave hospital the staff might give you some safety steps to follow for a while, for instance if you are in contact with children or pregnant women.
The safety measures are there to protect you, your family and the hospital staff.
Coping with isolation
Being looked after in a single room can feel lonely. Some people find it frightening. It can help to talk to your nurses about your worries. They can reassure you.
For radiotherapy using implants
Taking in some of your personal things can make the room feel more homely. Books, photographs and an ornament or two can brighten it up.
You can also take in a mobile phone, laptop, electronic tablet or music player to make the time pass more enjoyably.
For treatment using radioactive liquids
You can't take many personal items into the treatment room. This is because the items could become contaminated with radioactivity from your sweat.
Wards, nuclear medicine departments and radiotherapy departments have limited storage space for contaminated articles.
So, the staff will ask you not to take many items that they would need to store until the radioactivity has fallen to a safe level.