Radiation treatments have helped save the lives of countless cancer patients, but when medical personnel get sloppy and manufacturers fail to provide technical safeguards the results can be devastating. Two tragic cases at hospitals in New York City illustrate the dangers, and a look at cases elsewhere reinforces the feeling that much more needs to be done to protect patients.
The dark side of radiation therapy in an age when the technology is getting more powerful, complex and medically useful was laid bare in two investigative articles in The Times this week by Walt Bogdanich.
The first, published Sunday, described the plight of two patients who died in New York City after receiving extremely high doses of radiation from linear accelerators. In the first case, a man being treated for tongue cancer at St. Vincent's Hospital in Manhattan was subjected to high-energy radiation that was supposed to be directed precisely at the tumor but blasted his brain stem and neck for three days because of a computer problem. Technicians did not notice the warnings on their computer screens.
In the second case, a woman being treated for breast cancer at the state's Downstate Medical Center in Brooklyn got three times the prescribed radiation for 27 days because a therapist programmed a computer improperly, a vital filter was not activated and therapists again failed to notice indicators on their screens.
Wednesday's article described cases in several other states where patients were overradiated because medical teams made mistakes or failed to detect errors.
Radiation oncologists typically respond that such accidents, while heartrending, occur in only a tiny fraction of the radiation treatments delivered annually. But no one really knows how often radiotherapy accidents occur because there is no central clearinghouse of cases. Accidents are thought to be hugely underreported.
Manufacturers need to develop software that will shut down the linear accelerators before they can deliver extreme amounts of radiation. Medical teams that deliver the radiation must be far better trained than many now are. Surely it should be standard procedure to run a test before the first treatment to be sure the computer is programmed correctly. Once the damage is done to a patient, there is little that can be done to correct it.
