Radiation Therapy Saves Lives, but Not Without Risk

Medical radiation, used to diagnose and treat patients, has saved countless lives in this country. But some doctors now warn that more needs to be done to ensure that the technology is used more safely.

The U.S. Food and Drug Administration (FDA) said earlier this month that it wants to issue new safety requirements for manufacturers of CT scan machines and fluoroscopic devices to help reduce unnecessary radiation exposure.

The FDA proposal focuses on CT, nuclear medicine studies and fluoroscopy, which have especially high radiation doses. Together, they are the greatest contributor to total radiation exposure within the United States. Conversely, lower-dosage radiation procedures include mammograms and standard X-rays.

Today, families affected by radiation accidents, medical professionals and members of Congress gathered on Capitol Hill for a hearing to discuss new regulations for radiation therapy.

"My hope," Tim Williams of the American Society for Radiation Oncology said at the hearing, "is that patients across the country will recognize these incidents for what they are -- isolated acts -- and that these reports will not dissuade patients who need radiation therapy from receiving needed treatments."

But, according to Sandra Hayden of the American Society of Radiologic Technologists, "In some states, hairdressers are better regulated than people who perform medical radiation procedures."

A Lack of Standards

The radiation from CT scans produces precise images, which is why Americans undergo 72 million scans a year to help diagnose their illnesses.

But there's a problem.

Dr. Rebecca Smith-Bindman, of UCSF Medical Center, reviewed the CT images of 1,000 patients at four of San Francisco's largest hospitals and found that the radiation doses varied wildly. In fact, some patients received 20 times more radiation than others, even for the same type of test within the same hospital.

"We don't have standards that say this is not allowable," said Smith-Bindman. "This is an area that really lacks close oversight."

Radiologists, eager to get the clearest picture possible, can order higher doses of radiation, and few hospitals bother to check.

Then there's the CT machine itself, with its sophisticated software, tracking dozens of different measurements. But the most important, the actual radiation level, is not clearly displayed.

In Los Angeles and in Huntsville, Ala., more than 300 patients getting CT scans last year were accidentally given up to eight times more radiation than they were prescribed. It was only when some started losing their hair that anyone knew there was a problem.

Fatal Consequences

Radiation therapy can have similar problems.

Patricia Quirk was given radiation to kill her cancer cells. Instead, it killed her, perforating her bowel. Hospital records showed she was given 50 percent more radiation than the doctor ordered over 17 days of treatment, and no one noticed.

"They've got to have rules and standards and follow them," said Quirk's husband, Tom Quirk. "Double check. This should never have happened."

Scott Jerome-Parks died at 43 after a linear accelerator delivered radiation treatments that were seven times the strength he was prescribed to receive. As a result, he spent two years losing his sight, hearing and ability to swallow, and endured the pain of internal burns caused by the extra radiation. Jerome-Parks's parents, James and Donna Parks, went to Capitol Hill today to tell their son's story.

"It is a horrible way to die," said James Parks. "What was a minimally invasive procedure turned out to be a two-year nightmare for the whole family. ... I think what ultimately killed Scott, it's human errors."

Such accidents are considered rare, but experts say patients should ask their doctors whether tests or treatments using radiation are really needed. If they are, they should be done using the lowest radiation levels possible and a doctor should check the dose actually given through a patient's therapy.