The best preparation for a brachytherapy appointment is a short written list of questions. Appointments move fast, the vocabulary is new and it is easy to leave without asking what mattered most. This page gives you that list, grouped the way decisions are usually made, plus a printable one-page checklist at the end.
The questions fall into five groups: whether brachytherapy fits your case, how the procedure will work, side effects and follow-up, the centre's experience, and cost and coverage. The first three draw on the question lists published by the National Cancer Institute (NCI) and the American Brachytherapy Society (ABS). The centre-experience questions are the ones patient leaflets rarely suggest, so we explain why each one matters and what a reassuring answer sounds like.
We also cover how to find a brachytherapy centre, how to ask for a second opinion, and what to check about insurance or Medicare. Nothing here is individual medical advice: the aim is to help you have a better conversation with your own team.
How to use this list
- Pick your top five. You will rarely get through 30 questions in one visit. Tick the ones that matter most to you and ask those first.
- Bring someone. A relative or friend can take notes while you listen. The NCI also suggests that you may wish to bring a family member for support when you seek a second opinion.
- Ask for it in writing. Most centres have written information on your specific type of brachytherapy, including the instructions you will follow after going home.
- Ask who to call. Get a name and number for questions after the visit — many questions only occur to people later.
Questions about whether brachytherapy fits your case
These questions are about the decision itself. The NCI's patient booklet Radiation Therapy and You starts its own list with "Why do I need radiation therapy?" and "What kind of radiation therapy will I receive?" — good openers for any radiation conversation.
- Why are you recommending brachytherapy for me? What is the goal — cure, control or symptom relief?
- Will brachytherapy be used alone, or combined with external beam radiotherapy, surgery, hormone therapy or chemotherapy?
- What are the alternatives, and how do they compare for my situation? (Our guide to brachytherapy vs external beam radiation explains the main differences.)
- Am I a good candidate based on my overall health and anatomy? (The ABS lists this as a key question.)
- What happens if I choose not to have it, or to wait?
If brachytherapy has not been mentioned
It is fair to ask why. The ABS explains that there can be several legitimate reasons: brachytherapy "may not be appropriate for all types or stages of cancer", certain medical conditions may make it unsuitable, or another treatment may be more effective or convenient for you.
There is one situation where the question is especially worth asking. For locally advanced cervical cancer, brachytherapy is a standard part of treatment, and a 2024 US study of 8,500 patients found that those who received brachytherapy with external beam radiotherapy had a lower 4-year cumulative incidence of cancer death than those treated with external beam alone (32.1% vs 43.4%, after propensity-score matching). This was an observational study, so it cannot prove cause and effect on its own, but it is why specialists stress access to brachytherapy for this cancer. Read more in our step-by-step guide to cervical cancer brachytherapy.
Questions about the procedure
The answers here vary most between tumour sites and centres, so do not assume what you read online applies to you.
- Will I have HDR (temporary, short sessions) or LDR (for example, permanent seeds)? Why that type? (See HDR vs LDR brachytherapy.)
- How many treatments, over how many days or weeks, and how long does each visit take?
- Will I need a general anaesthetic, a spinal anaesthetic, sedation or nothing? Will I need to fast beforehand?
- Will I stay overnight in hospital, or go home the same day?
- How will pain or discomfort be managed during and after the procedure?
- How much time off work, driving or caring duties should I plan for?
- Will I be radioactive afterwards? Are there precautions for my partner, children, pets or travel? (Our guide to radiation precautions for family and visitors explains the difference between temporary and permanent sources.)
Questions about side effects and follow-up
- What side effects are common in the first days and weeks, and how long do they usually last?
- What late side effects are possible months or years later? (The NCI booklet lists "What kinds of late side effects should I expect…?" as a core question.)
- What will you do to help me manage side effects?
- Which symptoms mean I should call you straight away, and who do I call at night or at weekends?
- What follow-up visits, scans or blood tests (for example PSA for prostate cancer) will I have, and for how long?
To give a sense of what a specific answer looks like: for permanent seed (LDR) prostate brachytherapy alone, the 2021 ABS consensus statement reports that urinary symptoms peak within the first 3 months and take a median of about 1 year to resolve with iodine-125 seeds and about 6 months with palladium-103. Your team should be able to give you comparable figures for your own treatment. Our prostate brachytherapy guide covers the full recovery timeline.
Questions about the centre's experience
Brachytherapy is a hands-on skill: placing applicators, needles or seeds accurately and planning the dose around them takes practice and an organised team. These questions help you understand how a service works. They are not a test, and there is no single "right" number — but clear, confident answers are a good sign.
| Question to ask | Why it matters | What a good answer includes |
|---|---|---|
| How many of this procedure (my tumour site and technique) does your team do each year? | Experience is specific: a centre that does many prostate implants may do few gynaecological interstitial implants. | A straightforward figure or range for your procedure, and who performs it. |
| Who will perform my implant, and who else will be in the room? | Brachytherapy is delivered by a team of doctors, physicists, planners, radiographers and nurses. | Named roles; for HDR in the US, a qualified physician and physicist present when treatment starts (a federal requirement). See who performs brachytherapy. |
| What imaging do you use to plan each treatment (CT, MRI, ultrasound)? | Modern brachytherapy is planned on images of your anatomy with the applicator in place. | An explanation of the imaging used for your site; for cervical cancer, many centres use MRI- or CT-based planning. |
| For seed implants: do you check where the seeds ended up afterwards? | The ABS 2012 prostate guideline calls CT-based post-implant dosimetry within 60 days "essential" for quality assurance. | Yes — a post-implant scan and dose check, and what happens if it shows a problem. |
| Who checks my plan before it is delivered? | Independent checking catches errors before treatment. | A medical physicist checks every plan, using a documented process. |
| Is the centre or its radiation oncology service accredited? | Accreditation means an outside body has reviewed staffing, equipment and quality processes. | Named accreditation, for example from the American College of Radiology (ACR), the ACoS Commission on Cancer or The Joint Commission in the US. |
| Do you offer the treatment here, or would I be referred? | Not every radiotherapy department offers every type of brachytherapy. | A clear plan, including travel and who coordinates care between sites. |
The NCI suggests similar questions when choosing any cancer centre, including "Does it have experience and success in treating my condition?" and whether it has "been approved by a nationally recognized accrediting body".
How to find a brachytherapy centre
There is no single official "brachytherapy near me" directory. These are the most reliable starting points:
- Ask your current team. Your oncologist or cancer nurse specialist usually knows which regional centres offer your specific type of brachytherapy, and a referral keeps your records moving with you.
- NCI-Designated Cancer Centers (US). The NCI lists 74 designated centres in 37 states and the District of Columbia, with a "Find a Cancer Center" search. Most are linked to university medical centres. Designation reflects research and cancer-care leadership; it does not by itself guarantee that every brachytherapy technique is offered, so ask.
- Accredited cancer programmes (US). The NCI points patients to the American College of Surgeons Commission on Cancer, which has a searchable database of accredited programmes, and to The Joint Commission's Quality Check service. The ACR Radiation Oncology Practice Accreditation programme is specific to radiation oncology.
- NHS (UK). Brachytherapy is organised through cancer multidisciplinary teams and regional radiotherapy centres. Your team will refer you to the nearest centre that provides your treatment; ask which centre it is and whether there is a choice.
- Check the doctor. Once you have a name, confirm their board certification or registration using the official lookups in our guide to who performs brachytherapy.
Second opinions
Asking for a second opinion is common and usually welcomed. The NCI says "Most doctors welcome a second opinion" and that many US health insurers pay for one or even require one. It recommends involving your current doctor, because your records, scans and pathology need to be sent to the second specialist. If your question is specifically about brachytherapy, ask for the second opinion from a radiation oncologist who performs it.
Cost and insurance: what to ask
We do not publish prices: costs depend on the country, the centre, the technique, the number of treatments and your coverage, and any figure without that context would mislead. These are the questions that get you a real number.
Medicare (US)
Medicare states that it covers radiation therapy: Part A for hospital inpatients, and Part B for outpatients or patients in freestanding clinics. As an outpatient, you pay 20% of the Medicare-approved amount after meeting the Part B deductible. Medicare adds that what you owe depends on other insurance you have, whether your doctor accepts assignment and the type of facility.
Private insurance (US and elsewhere)
- Is brachytherapy covered under my plan for my diagnosis? Is prior authorization required, and who requests it?
- Are the centre, the doctors and the anaesthetist all in-network?
- What will my deductible, co-pays and co-insurance be for the whole course, not just one session?
- If coverage is denied, how do I appeal? (The ABS recommends knowing your appeal rights and suggests a patient advocate or a social worker experienced with insurance.)
In the UK, NHS treatment is free at the point of use. If you are using private medical insurance, ask your insurer to confirm pre-authorisation for the specific procedure and centre before you book.
Printable checklist
Questions to ask before brachytherapy — brachytherapist.com
My case
- Why brachytherapy for me, and what is the goal?
- Alone or combined with other treatment?
- What are my alternatives, and how do they compare?
- Am I a good candidate given my health?
The procedure
- HDR or LDR (seeds)? Why?
- How many treatments, over how long?
- Anaesthetic, sedation or none? Fasting?
- Overnight stay or same-day?
- Time off work, driving, caring?
- Any radiation precautions at home or when travelling?
Side effects and follow-up
- Common short-term side effects and how long they last
- Possible late side effects
- Symptoms that mean I should call — and the number to call out of hours
- Follow-up visits, scans, blood tests
The centre
- How many of my procedure do you do per year?
- Who performs it and who will be present?
- What imaging is used for planning? Who checks my plan?
- Seeds: is there a post-implant scan and dose check?
- Is the service accredited, and by whom?
Cost and coverage
- Is it covered? Prior authorization needed?
- Are all providers in-network?
- Total expected out-of-pocket cost for the whole course
- How do I appeal a denial? Is there a financial counsellor?
General information, not medical advice. Your treatment team is the right source for decisions about your care.
FAQ
What questions should I ask before brachytherapy?
Ask why it is recommended and what the goal is, whether it is HDR or LDR, how many treatments and what anaesthesia are involved, what side effects to expect and for how long, whether there are radiation precautions at home, how experienced the centre is with your procedure, and what it will cost you.
How do I find a brachytherapy centre near me?
Start with your current oncologist, who knows which regional centres offer your type of brachytherapy. In the US you can also search NCI-Designated Cancer Centers and the Commission on Cancer's accredited programmes, then confirm the centre performs your specific procedure. In the UK, referral is made through your NHS cancer team.
Is brachytherapy covered by Medicare?
Medicare covers radiation therapy, including brachytherapy: Part A for hospital inpatients and Part B for outpatients. As an outpatient you pay 20% of the Medicare-approved amount after the Part B deductible. What you owe also depends on other insurance and the type of facility.
Should I get a second opinion before brachytherapy?
It is your choice and is common. The NCI says most doctors welcome a second opinion and many US insurers pay for one. For brachytherapy questions, ask for the opinion of a radiation oncologist who performs the procedure, and have your records and scans sent ahead.
Why didn't my doctor mention brachytherapy?
According to the American Brachytherapy Society, it may not be suitable for your cancer type or stage, your general health, or your preferences, or another treatment may be more effective or convenient. It is reasonable to ask your doctor directly whether brachytherapy was considered and why it was or was not recommended.
Sources
- National Cancer Institute — Radiation Therapy and You (patient booklet, including "Questions to Ask Your Doctor or Nurse") (accessed 9 October 2026)
- National Cancer Institute — Finding Cancer Care (choosing a doctor and a centre; second opinions) (accessed 9 October 2026)
- National Cancer Institute — NCI-Designated Cancer Centers (accessed 9 October 2026)
- American Brachytherapy Society — Frequently Asked Questions (patients) (accessed 9 October 2026)
- Han K, Colson-Fearon D, Liu ZA, Viswanathan AN. Updated Trends in the Utilization of Brachytherapy in Cervical Cancer in the United States: A SEER Study. Int J Radiat Oncol Biol Phys. 2024;119(1):143-153 (accessed 9 October 2026)
- Davis BJ, et al. American Brachytherapy Society consensus guidelines for transrectal ultrasound-guided permanent prostate brachytherapy. Brachytherapy. 2012;11(1):6-19 (accessed 9 October 2026)
- King MT, et al. Low dose rate brachytherapy for primary treatment of localized prostate cancer: a systemic review and executive summary of an evidence-based consensus statement. Brachytherapy. 2021;20(6):1114-1129 (accessed 9 October 2026)
- eCFR — 10 CFR 35.615 Safety precautions for remote afterloader units (accessed 9 October 2026)
- Medicare.gov — Radiation therapy coverage (accessed 9 October 2026)
- American College of Surgeons — Commission on Cancer (accessed 9 October 2026)
- American College of Radiology — Radiation Oncology Practice Accreditation (accessed 9 October 2026)
Educational content. It does not replace advice from qualified healthcare professionals. Your own treatment team is the right source for decisions about your care. Written by the brachytherapist.com editorial team from the sources listed above.