Iridium Radiotherapy Treatment (moulds)

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1.What is Iridium ?

Iridium is a radioactive material, which is in the form of lengths of wire.  These will be placed into a perspex mould that is worn against the skin so that the radiation is concentrated where the treatment is most needed.

The treatment can take from two to seven days and you will be expected to wear the mould either continuously or for a specified number of hours per day (usually eight), depending on the dose prescribed by the doctor.

2.What does the Treatment involve ?

Before Treatment:
A couple of weeks before your treatment starts, you will be asked to attend an appointment in the mould room.  Here the staff will make plaster cast impression of the treatment area that they will subsequently turn into a perpsex 'shell' or mould that can be worn against the skin.  The doctor will decide which area needs to be treated and a separate attachment will be made for this area with the radioactive iridium wire impregnated inside it.

You will come back for another short appointment in the mould room once the perspex shell is made, to ensure that it fits properly and is comfortable for you.

The Room:
The room where you will be receiving your radiotherapy treatment is on ward A5.  It has been specially designed for the treatment that you are going to have.  The doors have been lead lined for the safety of you and others.

Your room will contain a television, call bell and personal bathroom.

We do recommend that you bring books and magazines to read as you may feel isolated when your treatment commences.

Admission:
You will be admitted on the day of the procedure.

When arriving on the ward, please report to the nurses station where you will be shown to your room.  A nurse will conduct an admission questionnaire to obtain information about you and your lifestyle and answer any questions you may want to ask.

Food and drinks are served throughout the day.  However; the nurses will be more than happy to make you additional drinks should you require.  Please use the call bell or internal telephone in your room.  Dial 2312 or 2312 to get through to the nurses station.

Commencement of Treatment:
On the first day you arrive, you will be given your shell to wear and the doctor will attach the radioactive part.  Once the radioactive attachment is in place, you will be kept in isolation in your own side room.  Visitors will be restricted and will have to follow some radiation safety guidelines whilst in the room (see section 3). 

Nursing staff will check on you and your treatment every four hours to make sure that the radioactive wires remain in the correct position and that you are comfortable.  If you yourself notice that the mould has altered in position or any of the wires come loose or fall out, inform the nurses as soon as possible.  DO NOT TOUCH OR PICK UP THE WIRES.  You may contact the nurses at any time using the call button and telephone.

The treatment is not painful and you will be able to read, watch TV and eat and drink normally during the treatment.

We do advise you to do deep breathing and foot and leg exercises to prevent the risk of complications whilst on bed rest.

Completion of Treatment:
When the treatment is complete, the radioactive attachment and shell will be removed.

You may go home once the treatment has finished.  You will NOT be radioactive and it is safe for you to be with family and friends.

Discharge:
Once treatment is complete a letter will be sent to your GP regarding the treatment you have received.  Any medication needed will be given to you and an outpatients appointment arranged and posted to your address at a later date.

3.Visitors

For this treatment there are two alternatives.  You may be asked to wear your shell continuously, or for a set number of hours per day.  The restrictions required for your visitors will depend on whether you are wearing the radioactive shell when they are present in the room.

If your treatment requires you to wear your radioactive shell continuously:
Because your treatment involves radioactive material, we request that a few simple radiation safety precautions should be taken during the time that the wires are in place.  If these simple rules are followed, the radiation does not pose a risk to visitors:

·        visitors must report to the nurse in charge of the ward prior to entering the room and when they leave

·        the time spent by each visitor with you should not normally exceed thirty minutes per day

·       visitors must sit behind the lead shields provided in the room

·        pregnant women and persons under 18 years of age must not enter the room

If there is any reason that your visitors will have difficulty complying with these rules, please ask to speak to the Radiation Protection Supervisor, who will be happy to discuss them with you.

If your treatment requires you to wear your radioactive shell for a fixed number of hours per day:
In this case, you can take the shell off for the remainder of the day and the radioactive part will then be locked away.

It is advised that you receive visitors during the times of the day that you are not wearing your shell and the radioactive segment is locked away.  Provided you are not wearing it, the time your visitors can spend with you is not restricted. 

Visitors must report to the nurse in charge of the ward prior to entering the room and when they leave.

4.Potential Side Effects

This is a localised form of radiotherapy and side effects therefore only related to the area that receives treatment. There are two types of side effects; those which come on during or immediately after treatment and resolve acute (early) effects and those which can be long term late (delayed) effects.  These can come on within weeks or even years after treatment  and are permanent. Your oncologists will have taken these into account when considering the benefits of treatment and will inform you of those you are likely to get.  Please discuss any concerns with your doctor, specialist nurse or radiographer at the time of consent or at any time during radiotherapy. The more common side effects will now be described but this does not mean you will definitely get them and it is also possible you may experience a side effect not mentioned.

4.a Early effects
You can expect a skin reaction in the area treated by the mould.  It may become red and sore (a little like sunburn).   This reaction will start 10 to 14 days after the treatment and will last for 21 to 28 days.  The skin should remain intact but you should not wet the area until the reaction has settled.

There is a very small risk of developing a blood clot in the legs when lying in bed in hospital (thrombosis).  You will be given stockings to minimise this risk.

4.b Late effects
The tissues underneath the skin in the treated area can become thickened and less mobile.  This is called fibrosis and is a relatively common side effect.

The skin around the area can develop prominent red blood vessels and become thinned.  This is call telangiectasia and indicates the skin is more fragile than elsewhere.

Very rarely the skin can break down and form an ulcer that doesn’t heal.

You can expect a skin reaction in the area treated.  It may become red and sore (a little like sunburn).   This reaction will start 10 to 14 days after treatment and will last for 21 to 28 days.  The skin should remain intact but you should not wet the area until the reaction has settled.

Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.