Brachytherapy: Radioactive Implants to Fight Brain Tumors Mark Pioneering Turn at Miami Neuroscience Institute, Miami Cancer Institute

Brachytherapy is not a well-known term outside of the oncology and neuroscience healthcare fields, but more and more cancer patients are welcoming this treatment option. It refers to internal radiation therapy that uses capsules containing a radiation source implanted within the body. 

It allows for the safe placement of the radioactive source, often in or near a tumor, or the cavity that’s left after a tumor has been removed. Actually, brachytherapy has been around for decades, mostly as a treatment for gynecological and prostate cancers.

Now, brachytherapy is being used more often to treat patients with recurring meningiomas, or brain metastases (cancer that has spread from other parts of the body). It is often the go-to therapy after surgeries and more common external radiation treatments have been exhausted. 

Brachytherapy Expertise at Miami Neuroscience Institute

Before becoming the new chief medical executive at Miami Neuroscience Institute, part of Baptist Health South Florida, earlier this year, Michael McDermott, M.D., (watch video above) played a pioneering role in brachytherapy as it applies to brain tumors, including the treatment of meningioma, a slow-growing tumor in the head that affects the brain. He co-authored many publications on the subject while at the University of California at San Francisco (UCSF).

Dr. McDermott’s team at the Institute (he is pictured aboveat left, with neurosurgeonVitaly Siomin, M.D.) and a team from Miami Cancer Institute,recently performed one of the first brachytherapy procedures in Florida using anew delivery device on a patient with a recurrent brain metastasis. The patientwas implanted with specially encased, radiation-emitting cesium-131 capsulesthat target residual tumor cells. Most of the radiation is emitted over thefirst 30 days after the surgery. 

“Brachytherapy provides us with another alternative fortreatment, once some of the other therapies have failed,” explains Dr.McDermott. “So, it’s an additional form of treatment that is new … toour practice here at Miami Neuroscience Institute. I have a lot of experience withbrachytherapy over the last 30 years at UCSF before I came to MiamiNeuroscience Institute.  And I’mdelighted that we’re doing it now.”

Miami Cancer Institute has been using other variations ofbrachytherapy, he emphasizes. “Miami Cancer Institute has a wide varietyof treatment options and treatment delivery systems,” says Dr McDermott.“It’s unlike any place in the world that I’ve seen — in terms of theradiation therapy facilities.”

Brachytherapy Expands Range of Radiation TreatmentOptions

RupeshKotecha, M.D., radiation oncologist at Miami Cancer Institute, saidbrachytherapy is often the best option for patients who have exhausted otherexternal radiation therapies. Those can include an array of prior treatments,such as GammaKnife, CyberKnife, or even proton therapy, which targets tumors precisely and spares healthy surroundingtissue. (Proton therapy was introduced at Miami Cancer Institute nearly threeyears ago.)

“The benefit of brachytherapy is that you’re actuallyputting the high dose of radiation therapy directly to the area of tumor ordisease, and you’re minimizing the dose of radiation to the remainder of thebrain,” explains Dr. Kotecha. “So, there’s radiation properties thatcan be exploited by doing brachytherapy, which is why for over 50 years brachytherapyhas been around as a form of radiation therapy.”

Brachytherapy implants emit most of their radiation after arelatively short period of time. When first put in place, the patient may needto limit his or her time around other people and take other safety measures.After surgery, a patient will likely need to wear a lead-lined cap to“absorb some of that additional energy when the radiation dose rate andactivity is at its highest,” adds Dr. McDermott.

“One of the things that patients need to be aware of isthat because the radioactive source is implanted into the tumor cavity, theyare safe,” said Dr. McDermott. “They are not excreting radioactivematerial in their urine or in their stool. And the skull is one of the bestabsorbers of radiation therapy.”

In a studypublished this year co-authored by Dr. McDermott, the findings indicatethat brachytherapy for recurrent and high-grade meningiomas is showing“good long-term survival” and that it may be a good option for“recurrent high-grade tumors.”

“I’m happy to be able to add brachytherapy to thearmamentarium of options for treating patients at Miami NeuroscienceInstitute,” says Dr. McDermott.Here are some of Dr.McDermott’s published works related to brachytherapy.