WASHINGTON (CN) - Lack of oversight and growing popularity of powerful radiation used to cure cancer has increased the nation's radiation exposure to six times what it was in the 1980s, witnesses told lawmakers Friday. They said treatments are applied so haphazardly that one patient can get 20 times the radiation of another even when undergoing the same procedure in the same facility.
"There is no regulation of computed tomography practice in the United States," University of California, San Francisco radiology professor Dr. Rebecca Smith-Bindman said in reference to the treatment that delivers between 1,500 to 5,000 times the radiation of a dental x-ray.
In many states, there is no licensing requirement to operate radiating machines, which emit powerful wavelengths capable of both fighting and causing cancer.
The hearing by the House Energy and Commerce Subcommittee on Health stems from an article by the New York Times, reporting that a veteran hospital in Philadelphia botched nearly 80 percent of its radiation procedures to treat prostate cancer.
New Jersey Democratic Chair Frank Pallone noted that many states don't require that health centers report errors and rarely impose penalties when they do. "We have no idea how often these errors occur and have no good data on where the weaknesses in the system truly are," he said.
In another case, a man treated for tongue cancer died from excess radiation exposure after a computer error went undetected. The man slowly decayed, going blind, then deaf and then losing his teeth, the man's father James Parks testified. Rotting tissue covered his scalp, and he vomited every day.
"Perhaps unfortunately, his brain was least affected during all but the last stages, and he was aware of all that was happening to his body," Parks said.
Parks said that his daughter-in-law, who was the man's caretaker, could not testify because of a gag order tied to the financial settlement. "It is the hospital's way of making serious accidents a guarded secret," he said.
"Hospitals in general cannot be relied upon to report or make public, serious medical accidents without strong external sanctions," he said, relying on his experience as a psychiatric social worker, and on his wife's job as a nurse. He called for the development of a database and for laws requiring medical centers to report all serious accidents.
And in a Los Angeles case, 200 hospital patients were administered up to eight times the normal dose of radiation while undergoing brain scans.
"These are not isolated cases," California Democratic Rep. Henry Waxman said, and blamed outdated federal oversight authority, as well as non-existent or meager state regulations.
Cancer survivors, who owe their lives to the radiation technology, were also present to testify. Suzanne Lindley from Texas thought she had three months to live before signing up for a clinical trial where radioactive beads were placed into her tumors. She has since been able to carry on with her life. "The last thing we need is to add yet another barrier by invoking unwarranted fear about the radiation used in these miraculous procedures," she said.
It is generally thought that patients getting computed tomography scans are so sick, that the benefits outweigh the risk, but the use of such scans is on the rise.
Dr. Smith-Bindman from UCSF - who painted CT as one of the most important advanced in medicine - said, "The increase in the number of CT tests that are done each year, and the higher dose per CT test, has resulted in a very large increase in the population's exposure to radiation from medical imaging."
She said that radiation exposure is estimated to be six times what it was in the 1980s.
Smith-Bindman called CT oversight "very fragmented." The Food and Drug Administration regulates the equipment, but not how it is used. She said that even within the same facility, radiation doses vary dramatically between patients treated for the same problem and that in a study she conducted, one patient received 20 times the radiation dose of another.
And for some patients, one CT scan increases cancer risk by one percent. 'This is an extremely high risk for a test that is supposed to find cancer, not cause it," Smith-Bindman said.
She recommended that standards be set to lower the traditional dose of CT scans and to ensure that they are used only when necessary, and to track how much exposure a patient has over time.
"Exposure to radiation increases a person's risk of getting cancer," Smith-Bindman said. "We need very clear standards for what are acceptable levels of radiation exposure."
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