Bile duct cancer treatment with brachytherapy

The essence of brachytherapy is implanting a radiation source no larger than a grain of rice directly into the bile duct near the tumor. The radioactive seeds irradiate the tumor for a certain period, destroy the DNA of cancer cells, and disrupt their ability to divide. The radiation dose is calculated using computer programs to balance powerful radiation and minimize the risk of damage to the body. The advantage of brachytherapy for cholangiocarcinoma over "classical" radiation therapy is that there is no irradiation of the liver tissues. In addition, the zone of intense radiation is within less than one centimeter. Therefore, healthy cells suffer minimally. At the same time, internal irradiation is possible at doses tens of times higher than those at typical radiotherapy. Under local anesthesia, radioactive grains are injected into the tumor zone in the bile duct lumen. During the procedure, doctors use thin tubes (catheters or cannulas) made of metal or plastic. Then, three-dimensional tumor images are loaded using ultrasound and CT, and the correct location of radiation seeds is checked. At this time, the patient is alone in the treatment room and communicates with the physician (through an interpreter) via a hands-free device. Therefore, medical personnel does not contact the radiation source directly.