Brachytherapy in Singapore

Brachytherapy, or internal radiation, is available at selected hospitals in Singapore. This is a form of radiation treatment in which a small pellet, which is a radioactive source, is placed near the site of the tumor. It allows high doses of radiation to be delivered to the tumor site without damaging the nearby tissues.

The pellets are placed permanently or removed after some time. It may be placed inside a body cavity or inserted with the help of a hollow needle.

Factors Affecting the Cost of Brachytherapy in Singapore

The following factors affect brachytherapy cost in Singapore:

  • Type of Hospital and its location
  • Type and location of the cancer
  • Stage and grade of cancer
  • Clinical status of the patient
  • The recommended dosage for radiation
  • Experience of the specialist
  • Doctor’s fee
  • Hospital charges
  • Additional taxes as applicable
  • Unforeseen expenses
  • Complications management
  • Any additional treatment required

Candidates for Brachytherapy in Singapore

Brachytherapy in Singapore is available for the treatment of a variety of cancers. Patients suffering from the following types of cancers can discuss with the specialists on whether they can receive brachytherapy in Singapore:

  • Prostate cancer
  • Cervical cancer
  • Uterine cancer
  • Head and neck cancer
  • Eye cancer
  • Rectal cancer
  • Bile duct cancer
  • Soft tissue cancer
  • Breast cancer
  • Esophageal cancer

Patients in which tumor regrowth is suspected can also receive brachytherapy in Singapore.

Treatment and Cost

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20 Days Outside Hospital

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About the Brachytherapy

Brachytherapy is an advanced form of radiation therapy. It is also known as internal radiation therapy. Radiation therapy is a type of cancer treatment in which ionizing radiation is used to destroy cancer cells and shrink the size of the tumors. The conventional form of radiation therapy is external beam radiation that projects radiation from a machine outside of the body. In case of internal radiation or brachytherapy, radioactive particles or sources that are internally placed in or next to the tumour site, are used to destroy cancer cells. Brachytherapy helps deliver a high radiation dose to the tumor, with minimal exposure to the surrounding healthy tissues.It thus allows delivering high doses of radiation to more-specific areas of the body.

Brachytherapy can be used for effective treatment of cervical, prostate, breast, skin, lung, head and neck, and gum cancer, in addition to tumors located in other parts of the body. Brachytherapy for prostate cancer is a commonly performed procedure. It is also used for the treatment of gum cancer as well. Brachytherapy is an alternative treatment for gum cancer and is conducted who are unfit to undergo a surgery or do not need one.

Brachytherapy can be completed in less time than other conventional radiotherapy techniques. Brachytherapy for prostate cancer and other cancers is often performed on an outpatient basis and patients typically have to take fewer brachytherapy sessions, as compared to external radiotherapy treatment for cancer. This makes brachytherapy more accessible and convenient to many patients. Most of the patients are able to tolerate brachytherapy very well with fewer side effects.

Types of Brachytherapy

There are two types of brachytherapy treatment:

  • Temporary brachytherapy:

    In this method, highly radioactive particles are placed in a catheter or slender tube for a specific amount of time and then withdrawn. Temporary brachytherapy can be administered at either low-dose rate (LDR) or high-dose-rate (HDR).

  • Permanent brachytherapy:

    In this method, a radioactive seed or pellet is implanted in or near the tumor and left there permanently. After a period of several months, the radioactivity level of the implanted seed eventually diminishes to nothing.

How is Brachytherapy performed?

Brachytherapy treatment plan is created and governed by a radiation oncologist, who is a highly trained physician specializing in treating cancer with radiotherapy. The radiation oncologist will require a team, including a medical physicist, dosimetrist, radiation therapist, radiation therapy nurse and in some cases, a surgeon to conduct the procedure. However, the radiation oncologist is the one who evaluates the patient and determines the appropriate therapy, including how much radiation to deliver.

In permanent brachytherapy, needles that are pre-filled with the radioactive brachytherapy seeds are inserted into the tumor. Then the needle or device is removed, leaving the radioactive seeds behind. Sometimes these seeds may be implanted in sessions using a device that inserts them individually at regular intervals. An appropriate imaging means such as an ultrasound, X-ray, MRI or CT scan may be used to assist the physician in positioning brachytherapy seeds at the right place. After implantation, some additional imaging can be done to verify seed placement.

Temporary brachytherapy starts with placing a delivery device, such as a catheter, needle, or applicator, into the tumor. Methods of imaging such as an ultrasound, MRI, or CT scan will help position the radiation sources correctly. The delivery device can either be inserted into a body cavity such as vagina (intracavitary brachytherapy) or applicators such as needles or catheters can be inserted into body tissues (interstitial brachytherapy). Device implantation will depend on the location of cancer.

Radiation using brachytherapy procedure can be delivered at three different levels:

  • High-dose-rate (HDR):

    HDR brachytherapy is given for over 10 to 20 minutes per session, but it can take several hours worth of preparation, which includes device placement. HDR brachytherapy is mostly conducted as an outpatient procedure, although sometimes patients are admitted for one to two days to have several HDR brachytherapy sessions using the same applicator.

    HDR brachytherapy delivers a specified dose of radiation to the tumor in a short burst using a remote-afterloading machine. This will help protect the patient from unnecessary exposure to radiation. This procedure can be repeated a couple of times on the same day.
  • Low-dose rate (LDR):

    LDR is delivered at a continuous rate of radiation for over 20 to 50 minutes. The patient needs overnight hospitalization so the delivery device can remain in place throughout the treatment. The radiation oncologist may insert the radioactive particle manually through the delivery device and remove the material and delivery device after the treatment.

  • Pulsed dose-rate (PDR):

    PDR brachytherapy is delivered in a similar way of LDR, but the treatment takes place in periodic pulses instead of continuous radiation. 

Recovery from Brachytherapy

For patients who have received brachytherapy for prostate cancer or any other types of cancer, limiting physical activity for at least three to five days is important. You can experience some level of grogginess after the procedure, however, it will last for only a few hours. You will be prescribed a few emergency medicines that you can take in case you experience pain or any other type of discomfort.

There are some side effects associated with all kinds of radiation therapy. However, the acute, sub-acute, or long-term side effects of brachytherapy depend on the location of the tumor being treated and the type of brachytherapy being used.

Some acute side effects of brachytherapy are

  • Localized bruising,
  • Bleeding, swelling,
  • Fatigue and discomfort within the implanted region.

But these are temporary side effects and usually resolve within a few days following completion of treatment.

Usually, brachytherapy does not cause any long-term side effects, but in a few cases, it may cause urinary and digestive problems. But in that case as well, long-term side effects are usually mild or moderate in nature and there are many palliative medicines that are available to cope with the symptoms.

Patient Stories

Frequently Asked Questions

What is the health care infrastructure of Singapore / Why should opt for Singapore as a destination for your medical treatment?
Singapore is generally known for its well-managed health care infrastructure and has an efficient and widespread system of healthcare. Singapore was ranked 6th in the World Health Organization's ranking of the world's health systems in the year 2000. Bloomberg ranked Singapore's healthcare system the most efficient in the world in 2014. Three main healthcare groups exist in Singapore:
  • National Healthcare Group
  • National University Health System
  • SingHealth
The 10 public hospitals in Singapore comprise 8 general hospitals (AH, SGH, NUH, CGH, TTSH, KTPH, NTFGH & SKH), and 2 specialized hospitals (KKH & IMH). In addition, there are 9 national specialty centres for cancer (NCCS & NCIS), cardiac (NHCS & NUHCS), eye (SNEC), skin (NSC), neuroscience (NNI) and dental care (NDCS & NUCOHS). The private healthcare infrastructure in Singapore is also well established. The payment methods include private payment gateways or private insurance companies. You can expect better technology to be used in private hospitals in Singapore. Various procedures like stem cell therapy and cancer research are conducted in Singapore.
What are the conditions of the hospitals in Singapore? Are they JCI certified? What is the quality of the support staff in the hospitals?
The Joint Commission International (JCI) is a global leader in health care accreditation. JCI accreditation is considered a gold standard in worldwide health care. It provides the most skilled and experienced healthcare professionals in the medical industry, as evaluators of the rigorous international standards in healthcare quality and patient safety. Here are some of the JCI certified hospitals in Singapore :
  • Mount Elizabeth Hospital
  • Singapore National Eye Centre
  • National Dental Centre
  • Raffles Hospital
  • National University Hospital
  • Gleneagles Hospital
  • Singapore General Hospital
  • National Heart Centre Singapore
  • Changi General Hospital
  • National Cancer Centre
  • National Skin Centre
  • Johns Hopkins Singapore International Medical Centre
  • Tan Tock Seng Hospital
Are the doctors/surgeons in Singapore of the best quality?
Since Singapore is known all over the world for some of the best medical treatments all across the globe, you can surely expect the best quality of doctors and surgeons here. This country has a very high quality of life and hence the health of people is of high priority.
What is the process for obtaining a medical visa in India?
People who wish to go to Singapore as a tourist for social purposes or seeking medical treatment, and require a longer period of stay beyond the Visit Pass granted on entry into Singapore, may submit an application for extension of stay (not more than 89 days from date of entry) online using the e-Service of ICA. All extension applications must be submitted online using the e-service at least seven days prior to the expiry of the visit pass to avoid overstaying. Extension of visit will not be accepted over the counter. Every visit pass issued to any person as a tourist or for the purpose of a social visit or medical treatment shall be subjected to the condition that the holder shall not engage in any form of employment (paid or unpaid) or in any business, profession or occupation in Singapore during the validity of that pass unless he is a holder of a valid work pass issued under the Employment of Foreign Manpower Act. Do visit the ICA website for further information.
What support services does MediGence provide in the United Arab Emirates?
MediGence enables you to plan and manage your medical decisions better. These are some of our services offered:
  • Expert Opinion
    We help you seek an Expert Opinion on your diagnosis and treatment from an experienced team of doctors at MediGence and specialists from a reputable hospital.
  • Hospital Recommendation
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  • 360-degree Hospital Review
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  • Doctor Validation and Communication
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  • Options to Choose From
    Based on your choice of destination and other preferences, we provide you multiple options with respect to hospitals and doctors to choose from.
  • 24X7 Patient Care Support
    A dedicated patient case manager stays in constant touch with you to help you at every step of the decision-making process and resolve queries that you may have.
  • Transparent Treatment Cost and Other Expenses
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  • Visa Assistance
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  • Accommodation Arrangements
    We propose to you a choice of accommodation based on your preference such as long stay, short stay, or luxury properties.
Which are the best cities in Singapore for medical treatment?
Singapore is a sovereign island city in itself. So you can find many options for treatment in Singapore itself, without having to travel too much.

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