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Abstract Purpose Twitter may reflect attitudes underrepresented in traditional surveys. This study aimed to understand professionals' and patients' thoughts regarding brachytherapy on Twitter. Methods and Materials Twitter was queried with "brachytherapy" to identify all tweets about patients' experiences from January 2012 to May 2017. A random sample of tweets by health care professionals containing "brachytherapy" was obtained using the first weekly tweet in the same interval. Consensus coding was used to categorize tweets as "patient" or "professional" based on content about receiving brachytherapy or self-identification as a health care professional. Tweets were analyzed for positive, neutral, or negative sentiment and recurrent themes using manual, iterative coding. Patient tweets were analyzed for whether they were shared before or after treatment and whether the patient, friends, or family had posted them. Professional tweets were analyzed to identify temporal theme changes. Results One hundred sixty-two patient tweets and 260 professional tweets were obtained from January 2012 to May 2017. On average, 2.5 patient tweets were shared monthly compared to 69 for providers. Among tweets by patients and professionals, 57% vs. 12% expressed positive sentiment, 21% vs. 3% negative sentiment, and 22% vs. 85% neutral sentiment, respectively. The most common patient and professional codes were "general sharing of experience/casual conversation" (32%) and "science" (21%), respectively. Conclusions Patients tweeted less about brachytherapy than professionals and generally expressed favorable and negative sentiments regarding their radiation treatment experiences. Professionals tended to express neutral sentiment and focus on research. Opportunities exist for greater radiation oncologist engagement in this medium. [ABSTRACT FROM AUTHOR]