Frequently Asked Questions

What is brachytherapy and how it is performed?

Brachytherapy is an established medical procedure that is commonly used for gynaecological and prostate cancer. Brachytherapy delivers gamma rays to kill the tumor cells similar to external beam irradiation with linear accelerators (VMAT, IMRT, TOMOTHERAPY etc), however with brachytherapy radiation is delivered directly into the tumor cells via plastic or metal applicators placed in the tumors. Hence, there is less exposure of the normal tissue to radiation compared to external beam radiotherapy that is commonly used. With the current technology and computer algorithm, precise calculation is made possible, and this technique can be applied to cancers in other body parts such as tongue, liver, muscle, oesophagus and rectum. At PPUSM we perform a wide range of brachytherapy procedures to various body parts.

What is HyBIRT brachytherapy technique for tongue cancer treatment

HyBIRT technique is a unique technique innovation by the PPUSM team which combined the upfront brachytherapy for 5 days duration followed-by standard external beam radiation (EBRT) for 33 days for tongue preserving cancer treatment. By delivering nearly 50% of radiation dose needed to control the tongue tumor with highly focused brachytherapy the subsequent dose of EBRT can be reduced significantly. With this method 2 important aspects can be achieved:

1) Ensuring adequate high dose is given to the tumor with brachytherapy and lower dose with EBRT to the neck region in ensuring that the chances of the cancer coming back is very low

2) Since nearly 50% of the radiation dose to the tongue is already delivered by brachytherapy, rest of the mouth will receive lower dose of radiation with EBRT which translates into lower toxicity (side effects). Studies have shown that patients have a better quality of life (QOL) with this approach.

Will my tongue be removed if I undergo brachytherapy during HyBIRT protocol

Brachytherapy component of the HyBIRT protocol is a minimally invasive treatment for the treatment of tongue cancer. While you still need to undergo general anesthesia, the procedure does not involve the removal of your tongue. Experienced surgeons and radiation oncologists in brachytherapy will insert the brachytherapy needles directly into the tumor in the tongue in order to deliver precise radiation dose and ensuring complete tumor regression. The needle insertion in operation will take around 1 -2 hours depending on the complexity of the procedure. The HyBIRT technique is described here.

Can I have normal tongue function after undergoing HyBIRT technique

While HyBIRT technique do preserve the tongue, the normal function of the tongue depends on many factors such as the stage of the disease and age of the patient. The earlier treatment is started, a smaller the area will be irradiated and this will translate into better functional outcome of the tongue. Early detection and prompt treatment improves outcome.

How much does the HyBIRT treatment will cost?