Having internal radiotherapy for eye cancer

Internal radiotherapy is also called brachytherapy. It can treat some types of eye cancer by using a small radioactive disc called a plaque. This is called plaque radiotherapy.

When you might have it

You can have plaque radiotherapy for different types of eye cancer. For example, a small or medium size melanoma inside the eye, such as choroidal or ciliary body melanomas.

You can’t have this treatment if your melanoma is too thick. This is because the radiation would not reach all the cancer. In this case, you would have external beam radiotherapy instead.

Plaque radiotherapy

Plaque radiotherapy delivers high dose radiation to a small area. You have a small radioactive metal disc placed over the cancer on the affected eye. The disc comes in different sizes but is small enough to place over the cancer on the eye. The plaque continually gives off radiation while it is in place, and it treats a small area.

It treats the part of the eye it covers. Side effects can vary slightly depending on the type of radioactive material used. It doesn’t affect any other part of your body.

You have an operation to attach the plaque to your eye, usually with a general anaesthetic. You will stay in hospital for a few days while the plaque stays in place. This is because there is a small risk of radiation exposure to others.

The plaque is removed before you go home, so there will not be any radioactivity in your eye when you leave the hospital.

Your eye specialist will explain your treatment, how long you will stay in hospital and how it will feel.

Having an operation to insert the plaque

To have plaque radiotherapy, you need an operation. You usually have a general anaesthetic, so you are unconscious. In some eye centres, you might have a local anaesthetic. So you are awake, but your eye area is numbed.

You have the plaque sewn in place over the eye cancer. The inner lining placed directly on the eye cancer contains the radioactive treatment. The outer lining has a protective shield. It can stay in place for up to a week, depending on how thick your cancer is. The thicker the cancer is, the longer the treatment lasts.

The surgery takes about 90 minutes. Afterwards, you may have some discomfort or pain. You will have painkillers to relieve this. Although you might have some pain after surgery, you do not feel the radiation from the plaque.

Usually, you have a gauze pad or a protective shield or both over the eye being treated. These stay over your eye while the plaque is in place. Your nurse will check your eye regularly for signs of inflammation or infection. You might have eye drops to help reduce the risk of an infection.

Will I be radioactive?

While you have the plaque in place, you stay in a single room in the hospital. This is because the plaque gives off a small amount of radiation, which means other people in the room are exposed to it. Your nurses will check the amount of time your visitors spend in your room. Although the radiation level is very low, pregnant women and children should not visit at all.

Staying in hospital during plaque radiotherapy treatment

The plaque can be in place from 2 to 7 days. During this time there are precautions you need to take including:

• always let your nurse know before you leave and when you return to your room

• do not flush the toilet or empty the bath, your nurse will do this

• do not have a shower

It can be quite difficult and boring to stay in one room, even if it is only for a few days. Make sure you take something to keep you occupied. It is safe to watch TV as it needs very little eye movement. The ward usually provides a radio or TV, but you can also use your phone to watch streaming services.

When the treatment time has finished, you have another operation to remove the radioactive plaques. After this, all the radiation is gone. You do not give off any radiation to yourself or anyone you are with. All your personal belongings that were in the room with you during the treatment are safe to take home. They won’t be radioactive.

Going Home

You usually go home the same day or the day after the plaque is removed. You will need someone to accompany you home because of the anaesthetic. Your vision might also be blurry.

You may have eye drops to use at home. These help to reduce the risk of infection and inflammation.

Side effects of treatment

You shouldn’t feel unwell, but it is common for your eye to look red for a few weeks. You may also have blurred vision in the treated eye. How long this lasts does vary, but it can be a few weeks. Do speak with your eye specialist if you have any concerns.