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Internal Radiation Explained
Brachytherapy — What Internal Radiation Actually Involves
Brachytherapy places a radiation source directly inside or right next to a tumour — a technique NCCN and ASTRO guidelines recommend as standard care for many cervical, prostate and breast cancers, not a fallback option. Because the source sits so close to the tumour, it can deliver a high, precise dose while sparing more of the healthy tissue around it.
Medically reviewed by Dr. Kirti Ranjan Mohanty, Radiation Oncologist, MBBS · MD (Radiation Oncology), Senior Consultant · Last reviewed August 2026
- Guideline-standard, not outdated — NCCN and ASTRO recommend brachytherapy as part of standard care for many cervical, prostate and breast cancers, not an older substitute for modern technology.
- Most courses use HDR today — high-dose-rate brachytherapy delivers the dose in minutes, then the source is withdrawn; nothing radioactive stays inside you afterward.
- Dose falls off sharply nearby — because the source sits at the tumour, healthy organs a few millimetres away receive far less dose than external radiation would give them.
- Coordinated at an NABH-accredited partner centre — CION Cancer Clinics coordinates your treatment plan, your oncology team and your care throughout.
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The direct answer
Where Is the Radiation Source Placed During Brachytherapy?
The source is placed inside your body — directly inside or immediately next to the tumour. That means inside the cervix and uterus for cervical cancer, inside the prostate gland, or inside a small tube placed in breast tissue after a lumpectomy. A radiation oncologist positions it using ultrasound, CT or MRI guidance, then delivers the planned dose from that exact spot.
This is the core idea behind brachytherapy: instead of aiming radiation at the tumour from outside the body, as external beam radiation does, the source is brought to the tumour itself. The applicator or catheter used to hold the source is placed during a short procedure, usually under sedation or local anaesthesia, and most patients go home the same day.
What patients ask first
Is Brachytherapy Painful?
Placing the applicator can cause brief discomfort or pressure, but it is managed with sedation or local anaesthesia, so most patients feel little to no pain during that step. The radiation delivery itself is painless. An HDR session typically takes a few minutes on the table; the applicator placement and planning around it take longer.
Afterward, mild soreness at the applicator site is common and usually settles within a few days, similar to recovery from any short outpatient procedure. It is not the same as the skin reactions some patients experience with a long course of external radiation — brachytherapy works from inside, so the skin surface is rarely affected.
Did you know?
Brachytherapy is one of the oldest forms of radiotherapy — used clinically for more than a century — and it remains a guideline-recommended technique today for exactly the same reason it always has been: placing the source at the tumour lets doctors deliver a higher dose there while sparing more of the tissue around it.
Side by side
HDR vs LDR Brachytherapy: What's the Difference?
Both are standard, guideline-supported approaches — neither is "better" in general; your radiation oncologist recommends the one that fits your cancer type and situation. Here's how they actually differ.
| Factor | HDR (High-Dose-Rate) | LDR (Low-Dose-Rate) |
|---|---|---|
| How the source is delivered | Loaded briefly through an afterloader machine, then withdrawn | Placed as tiny permanent seeds, or a temporary implant left in longer |
| Time the source stays in place | Minutes per session | Seeds: permanently, decaying over weeks; temporary implants: hours to a couple of days |
| Number of procedures | Often several short outpatient sessions over 1–2 weeks | Usually a single seed-placement procedure |
| Hospital stay | Outpatient — home the same day, each session | Seeds: outpatient; some temporary implants need a short inpatient stay |
| Radioactivity after the session | None — source is fully withdrawn every time | Seeds: low-level radioactivity present, decreasing over following weeks |
| Precautions needed at home | None related to radioactivity | Written precautions on close contact with pregnant women and young children, given by your team |
| Commonly used for | Cervical, endometrial, some breast and skin cancers | Prostate cancer (seed implants), select early breast cancers |
The fear behind the question
Is the Radiation Source Removed After Treatment?
For HDR brachytherapy, yes — the source is fully withdrawn after every session, and you are not radioactive in any way that affects your family. For LDR permanent seed implants, tiny seeds stay in place and lose their radioactivity naturally over the following weeks, with simple precautions from your team in the meantime.
HDR uses a shielded afterloader unit that pushes the source through the applicator by remote control, holds it for the calculated time, then withdraws it completely — nothing stays behind. LDR seed implants, most often used for prostate cancer, are designed to decay on their own; your team explains, in writing, what that means for close contact with pregnant family members and young children over that period. Your radiotherapy is delivered at an NABH-accredited partner centre; CION Cancer Clinics coordinates your treatment plan, your oncology team and your care throughout.
For the broader picture on radioactivity after any radiation treatment, see Are You Radioactive After Radiation Therapy? The Direct Answer.
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The bigger picture
How Does Brachytherapy Fit Into a Full Treatment Plan?
Brachytherapy is rarely the only treatment — it's usually one part of a larger plan built around your specific cancer. For cervical cancer, external beam radiation typically comes first to shrink the tumour and treat nearby lymph nodes, then brachytherapy delivers a final, concentrated boost to the area where the tumour was. For prostate cancer, brachytherapy may be used alone for suitable early-stage disease, or combined with external radiation and hormonal treatment for higher-risk disease. For select early breast cancers after a lumpectomy, brachytherapy can deliver partial-breast irradiation over a shorter course than whole-breast external radiation — an option that suits some, not all, patients.
No single approach is superior for every patient — your multidisciplinary tumour board reviews your imaging, pathology and cancer stage before recommending a specific combination for you.
Step by step
What Happens During a Brachytherapy Procedure?
1
Planning imaging
A CT, MRI or ultrasound scan maps the tumour and the organs around it before the applicator is placed.
2
Applicator or seed placement
Done under sedation or local anaesthesia, guided by imaging, usually as a day procedure with no overnight stay for most patients.
3
Treatment planning
The team calculates the exact dose, timing and duration from images taken with the applicator already in place.
4
Source delivery
For HDR, the source is loaded briefly through the applicator and withdrawn afterward. For LDR, seeds are placed permanently in one sitting.
5
Removal or discharge
HDR applicators are removed once all planned sessions are complete. LDR patients go home the same day with simple written precautions.
6
Follow-up
A review visit and follow-up imaging confirm healing and how the tumour is responding.
Where it's used
Which Cancers Commonly Use Brachytherapy?
Brachytherapy isn't used for every cancer type — it fits tumours that can be reached directly by an applicator or implant. These are the most common uses.
Guideline-standard boost
Cervical Cancer
HDR brachytherapy is the guideline-recommended boost after external beam radiation for most cervical cancers, per NCCN and ASTRO.
Seed or HDR options
Prostate Cancer
LDR permanent seed implants or HDR brachytherapy, used alone for early-stage disease or combined with external radiation for higher-risk disease.
Partial-breast option
Breast Cancer
Select early-stage cases after a lumpectomy can use brachytherapy for partial-breast irradiation, over a shorter course than whole-breast external radiation.
Localized tumours
Skin & Other Sites
Some skin cancers and other localized, accessible tumours can also be treated with a surface or interstitial brachytherapy applicator.
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Common questions
Brachytherapy — Your Questions Answered
Where is the radiation source placed during brachytherapy?
The source is placed inside your body, directly inside or immediately next to the tumour — inside the cervix and uterus for cervical cancer, inside the prostate gland, or inside a small tube placed in breast tissue after a lumpectomy. A radiation oncologist positions it using imaging guidance before delivering the planned dose from that exact spot.
Is the radiation source removed after brachytherapy?
For HDR brachytherapy, yes — the source is fully withdrawn after every session, and you carry no radioactivity home. For LDR permanent seed implants, tiny seeds are left in place and lose their radioactivity naturally over the following weeks, with simple written precautions from your team in the meantime.
Is brachytherapy painful?
Placing the applicator can cause brief discomfort or pressure, managed with sedation or local anaesthesia, so most patients feel little to no pain during that step. The radiation delivery itself is painless — HDR sessions take minutes, and any soreness afterward is usually mild and settles within a few days.
What's the difference between HDR and LDR brachytherapy?
HDR (high-dose-rate) delivers the full dose in minutes through an afterloader machine, then the source is withdrawn — often across a few outpatient sessions. LDR (low-dose-rate) places tiny seeds or a temporary implant that stays in place longer, delivering a lower dose over a longer period, usually in a single procedure.
Which cancers commonly use brachytherapy?
Cervical cancer most often uses HDR brachytherapy as a guideline-recommended boost after external radiation. Prostate cancer commonly uses LDR seed implants or HDR. Some early-stage breast cancers use brachytherapy as partial-breast irradiation after a lumpectomy. Skin and a few other localized tumours can also be treated this way.
Am I radioactive to my family after brachytherapy?
After HDR brachytherapy, no — the source leaves with you at zero radioactivity, and normal contact with family, including children, is safe immediately. After LDR permanent seed implants, a low level of radioactivity remains and decreases over the following weeks; your team gives written precautions on close, prolonged contact with pregnant women and young children for that period.