Gynaecological, breast, urological, rectal, oesophageal, skin and soft tissue indications — delivered by the Clinical Lead for Brachytherapy at Mount Vernon Cancer Centre.
Brachytherapy places a radiation source directly within or immediately adjacent to a tumour, allowing a very high dose to be delivered to the target while sparing surrounding healthy tissue in a way that external beam radiotherapy cannot match. Complex brachytherapy takes this further: rather than relying on standard applicators alone, it involves the image-guided placement of interstitial needles and catheters into the tumour itself, with the implant designed around each patient's individual anatomy and disease.
Dr Abdul-latif undertakes complex delivery for gynaecological, urological, oesophageal and rectal cancers, including contact radiotherapy, and performs interstitial implants for rarer presentations involving the skin, breast and soft tissues. Techniques of this kind remain available in only a small number of UK centres, and they are frequently what makes curative treatment possible where surgery would otherwise be the only option, or where no option remained at all.
With external beam radiotherapy the dose has to travel through healthy tissue to reach the tumour. Brachytherapy starts inside it. Because radiation dose falls away steeply with distance from the source, placing the source within the tumour delivers a dose to the target that external beam cannot safely match, while the surrounding organs receive comparatively little.
Standard brachytherapy uses pre-formed applicators that sit in a body cavity. Complex brachytherapy is a different undertaking: needles and catheters are placed through the tumour itself under image guidance, their positions chosen for that patient's anatomy, and the dose distribution is then sculpted around the disease. It is technically demanding, requires theatre time and an experienced multidisciplinary team, and is offered at only a small number of UK centres.
The clinical consequence matters most to patients: it is frequently what makes curative treatment possible where surgery would otherwise be the only option, or where no option remained at all.
A radiation source placed within or immediately adjacent to the tumour delivers a very high dose to the target while sparing surrounding healthy tissue.
Image-guided interstitial needles and catheters are placed into the tumour, with the implant designed around each patient's individual anatomy and disease rather than a standard applicator.
Steep dose fall-off makes re-treatment of previously irradiated tissue possible, and organ preservation achievable where surgery would otherwise be required.
Dr Abdul-latif established a dedicated breast brachytherapy programme at Mount Vernon Cancer Centre. Its most valuable application is in women whose breast cancer has recurred after previous radiotherapy.
Where breast cancer returns in a breast that has already been irradiated, standard practice has long been mastectomy — because the breast cannot usually be treated a second time with external beam radiotherapy without unacceptable damage to the skin, lung and heart. For many women that has meant losing the breast, not because the tumour demanded it, but because the radiotherapy options had run out.
Multicatheter interstitial brachytherapy changes that calculation. Flexible catheters are implanted through the breast around the tumour bed and used to deliver a second course of radiotherapy to that region alone. The steep dose fall-off means the previously irradiated skin, lung and heart are protected, while the tissue at genuine risk receives a full therapeutic dose. For carefully selected patients this makes breast conservation a possible alternative to mastectomy in the salvage setting.
The programme also supports accelerated partial breast irradiation (APBI) for suitable early breast cancers, and palliative indications where local control is the priority. Dr Abdul-latif has published on interstitial breast brachytherapy dosimetry and its relationship to late side effects, and undertook further training in breast brachytherapy in France and Italy under the Royal College of Radiologists' Kay-Durrant Fellowship.
“For carefully selected patients, multicatheter interstitial brachytherapy can make breast conservation possible where mastectomy would otherwise be the only option.”
Referrals are welcome from breast surgeons, oncologists and GPs, and patients may also self-refer for a second opinion. Suitability depends on the site and size of the recurrence, the previous radiotherapy received, and imaging — assessment is individual.
Discuss a caseComplex delivery for gynaecological, urological, oesophageal and rectal cancers, including contact radiotherapy, alongside interstitial implants for rarer presentations involving the skin, breast and soft tissues.
Image-guided adaptive brachytherapy is a defining component of curative treatment for cervical cancer, and Dr Abdul-latif delivers the full range — from intracavitary applicator-based treatment through to hybrid intracavitary/interstitial and fully interstitial implants for bulky or asymmetric disease.
High-dose-rate (HDR) prostate brachytherapy as monotherapy or as a boost alongside external beam radiotherapy, and permanent seed (LDR) implants. Hydrogel spacer (SpaceOAR) implantation forms a routine part of his prostate cancer treatment protocols, increasing the distance between prostate and rectum to reduce rectal dose.
Contact radiotherapy (Papillon) and interstitial brachytherapy for rectal cancer, used to intensify dose to the primary tumour with the aim of organ preservation — avoiding major surgery and a permanent stoma in suitable patients. Intraluminal brachytherapy for oesophageal cancer offers effective relief of dysphagia as well as a role in radical treatment.
Interstitial and surface-mould brachytherapy for skin cancers and soft tissue tumours, including rarer presentations and anatomically awkward sites — where surgery would be disfiguring, where function needs to be preserved, or where previous radiotherapy limits further external beam treatment.
Salvage and re-irradiation brachytherapy — including breast-conserving approaches to avoid mastectomy, rectal-preserving approaches to avoid a stoma, and focal prostate salvage after previous radiotherapy — requires highly specialised training and experience. It is often the option that remains when a recurrence appears in previously treated tissue and further external beam radiotherapy is not safe.
Because brachytherapy dose falls away so steeply outside the implanted volume, tissue that has already received a full course of radiotherapy can, in selected cases, be treated again. Assessment is individual and depends on the site and extent of recurrence, the previous dose delivered, the interval since treatment, and current imaging. Second opinions are welcome, including for patients who have been told that no further radiotherapy is possible.
Every implant is planned individually. The outline below describes the usual shape of a complex brachytherapy pathway; specifics vary by tumour site and are discussed in full at consultation.
Review of your diagnosis, previous treatment and imaging, in person or remotely. Discussion of whether brachytherapy is appropriate, what it would involve, and the realistic alternatives.
MRI, CT or ultrasound as required to define the target and the surrounding organs, and to plan where needles or catheters should sit.
Needles or catheters are placed under anaesthetic with image guidance. Imaging is repeated with the implant in place, and the dose distribution is then designed around your anatomy.
The radiation source is delivered through the implant, which is then removed. Follow-up covers recovery, response assessment and management of any late effects.
Brachytherapy, Volume 23, Issue 2 — Abdul-Latif M et al. PMID 38383205
BMJ Open — Abdul-Latif M, Choudhury A, Tharmalingam H et al.
Clinical Oncology — Abdul-Latif M et al. PMID 37246040
Dr Abdul-latif accepts referrals from GPs, surgeons and oncologists, and patients are welcome to self-refer for a second opinion — including where previous advice has been that no further radiotherapy is possible. Consultations are available at Mount Vernon Cancer Centre, at The Clementine Churchill Hospital in Harrow, and by video or telephone.
Secretary: 020 3826 2182 · amy.bignell1@nhs.net
New patient consultation £250 · Follow-up £150 · Self-pay and all major insurers accepted