On January 24, 2010, The New York Times published an article titled: “Radiation Offers New Cures, and Ways to Do Harm” by Walt Bogdanich. The story depicts several “mistakes” made in New York where overdoses of radiation had serious, and fatal, consequences. However, the numbers reported are exceptionally misleading. The story cites 621 radiation mistakes. During that time, The American Society of Radiation Oncology, ASTRO, estimated that half a million New Yorkers received 13.6 million daily radiation therapy treatments, meaning radiation errors occurred only .0046 percent of the time.
No medical error is acceptable, radiation therapy is a tool and it should be used only by those with appropriate training and board certification.
There are guidelines that should be followed and patients should make themselves aware of them, which includes an annual physician audit: -Each facility is recommended to follow ACR guidelines:
Patients should also be prepared with a list of questions they should ask:
1. Has your machine been upgraded to utilize standard techniques and comply with current safety measures?
2. Is your physician board certified/up to date with re-certification? Your physician should be re-certified every 10 years a requirement of the American Board of Radiology.
3. Are the therapists certified? NY state requires therapist to be certified but not all states do.
4. Ask the level of physics and QA that are performed on an on-going basis…. the physics staff should perform QA checks on every single dosimetry plan for every single patient (this QA check is considered “optional” by state law, and was not performed in the fatal case that was described in the Times article).
5. The facility should hold weekly chart rounds. This is a review of new patients starting treatment, any patients with changes to treatment, and any patients with issues while on treatment.
National organizations that represent the radiation oncology community have already responded as well. The president of The American Society for Therapeutic Radiation Oncology (“ASTRO”) has issued a response to the NY Times article, and as well, they have issued a series of important facts about the overall safety of radiation therapy in this country. Some of these points are shown here (click here to see the ASTRO response the NY Times and their full “fact sheet” ):
—->The New York Times story identified 621 errors over eight years, many of which were minor. We estimate that half a million New Yorkers received radiation therapy over this time period, receiving 13.6 million radiation therapy treatments, meaning errors occurred only .0046 percent of the time. In other words, radiation therapy is safe and effective 99.99 percent of the time.
—->Even one error is too many. However, for every one medical error in New York as reported by the New York Times, we estimate radiation oncologists delivered nearly 22,000 treatments safely and accurately. The vast majority of patients received excellent care and benefit from cure or reduced pain through radiation.
—->We are concerned some patients may avoid lifesaving treatments like radiation therapy due to fear and concerns raised in this article. However, it’s important to note that more than three out of four patients survive their cancer. This means your odds of beating cancer with the help of treatments like radiation therapy are significantly greater than being harmed by a mistake.
—->Radiation oncologists are the only physicians with the expertise and training to prescribe and deliver radiation therapy treatments. In addition to college and medical school, five years of additional training are required for radiation oncologists. Radiation oncologists receive extensive training in cancer medicine, in the safe and effective use of radiation to treat disease, and in managing any side effects caused by radiation.
—->This training includes 500 hours of work experience handling live radiation sources and 200 hours of training in radiation physics, radiation protection, radiation biology and mathematics pertaining to the use and measurement of radioactivity. Once the radiation oncologist passes an examination by the American Board of Radiology, he or she is board certified
There are people processes and machine or computer processes with most treatments in most specialties today. Each one comes with the possibility of error. It is important that there be checks in place to minimize the potential for error.
Not only is it ok for a patient to ask about checks in place, we feel it is important for them to do so, to understand as much as possible about the treatment they are about to begin.
