New Target For Radiation Scaremongering: Thyroid Cancer Patients
March 23rd, 2010
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Irrational fear of radiation: first it was nuclear power plants, then it was medical reactors and then it was medical imaging. There’s an extra measure of jackassery when you go after life saving imaging procedures, but now it’s gone one worse. Thyroid cancer patients are the latest scary radioactive monster.
Now imagine the following situation: you’ve been diagnosed with thyroid cancer. Your doctor tells you that the odds are good that you’ll beat it, but your thyroid gland needs to be removed. After removal, you’re dosed with some iodine-131 to kill any remaining tissue from the cancerous organ. You’ll be taking synthetic hormones for the rest of your life to replace the function of the thyroid, but thankfully, the procedures are basically over.
Now what do you want to do? Probably go home and try to relax. That’s what most people would want to do after that kind of ordeal, and in general they are allowed to do so. But some now say that needs to change.
Report: Thyroid cancer radiation a public threat
A Nuclear Regulatory Commission rule allowing hospitals to discharge radioactive thyroid cancer patients to their homes and hotels poses a public health threat, a congressional report says today.The report (pdf), released by Rep. Edward Markey, D-Mass., chairman of the House Subcommittee on Energy and the Environment, which oversees the commission, also found that insurers routinely use the rule to deny hospital care even to patients whom doctors say may pose a radiation risk to others. Patients are often discharged to recover in self-imposed isolation.
“The United States simply cannot play radioactive roulette and gamble with public health and safety,” Markey says.
Radioactive iodine is a proven cancer fighter, with a five-year survival rate of 97%. The thyroid is the only body organ that uses iodine. Radioactive iodine kills any thyroid cancer cells that surgery might have missed. But radiation also poses a cancer risk, especially to children. Thyroid cancer patients give off radioactive iodine in urine, sweat and saliva for several days; traces may remain in the body for as long as two weeks.
In 1997, the NRC “weakened” its patient-release regulations from the global standard requiring hospitalization for patients whose bodies contain 30 millicuries or more of radioactive iodine to one that allows outpatient treatment, the report says. The report says the NRC repeatedly rebuffed efforts to get the agency to adopt stricter standards.
In August, the Ninth Circuit Court of Appeals rejected a petition by thyroid cancer survivor Peter Crane, a former NRC lawyer, to force a change. The court ruled that he “lacked standing to bring the case” because he is not undergoing treatment, the report says.
“I’m gratified that the committee is paying attention to this,” Crane said. “Patients are going home in this country with 200 millicuries of radiation in their system. In Germany, they would be hospitalized with 8 millicuries. This isn’t an academic matter, it’s about exposing children to cancer-causing radiation.”
Owen Hoffman, a radiation-risk expert at Senes Oak Ridge, says even though the risk is fairly low, about 1 in 1,000 for an infant boy and double that for an infant girl, “the right thing to do is to reduce unnecessary exposures.”
The report cites a 2007 USA TODAY survey, carried out with the Thyroid Cancer Survivors Association, showing that 4% of the patients treated with radioactive iodine checked into hotels or other accommodations, 2% took public transportation, and 14% failed to go directly home, which gave patients “plenty of opportunity” to “unwittingly” expose others to radiation.
NRC spokesman Eliot Brenner says the agency will examine the report, but he added in an e-mail, “I don’t want to set up false expectations about what we might do with the recommendations.”
Why am I not surprised that a former NRC lawyer got this all started? After all, NRC lawyers are specially selected and trained in order to make sure they do everything to get in the way of progress and make descent people’s lives hell, right?
And just what the hell do you expect to accomplish with this, rep Edward Markey? The proximity exposure from just being next to one of these individuals is generally nill, and the danger from somehow excreting some of the iodine-131 only to have someone else absorb it is nearly as small. Sure, some patients do check themselves into hotels or other isolation under the recommendation of doctors, but that’s a fairly extreme precaution. These are not people who need to be handled while wearing moon suits. Remember, radiation dose depends on time, and the clerk at the front desk who spends a few minutes checking in someone is not going to be in any danger from the gamma rays coming out of that person’s neck, nor is the person who sits next to them for a subway or bus ride.
Needless to say, we have “the children” thrown in here, just to make sure all rational thought is gone. A person who has iodine-131 in their system may be advised not to spend too much time cuddling with a child, but other than that, it’s not like they’re a walking, talking danger zone.
Patients are generally asked to take a few basic precautions to avoid contaminating others, although the risk is really not that huge. Patients are told not to have sex for up to a month after treatment. They may be told not to share a bed with another for at least a few days and to double-flush the toilet. But what could happen if they don’t adhere to this advice? probably nothing.
In the event that the tiny traces of iodine-131 in their sweat and skin secretions do contaminate anything, the half-life of I-131 assures it’s not going to be a big concern. With a half-life of about eight days, the iodine-131 dissipates fairly quickly. If they did manage to leave a detectable level of I-131 behind on a phone receiver or remote control, in about a week, half of it will be gone; in a month the vast majority will be gone and in about another month, there will be hardly anything left.
Most of the iodine is eliminated from the body within a couple of days. The remainder, though detectable, is quite low and will be gone in a month or so.
In conclusion, if I ever were to have a friend who had thyroid cancer and was left isolated while they let the iodine run its course, I’d have no problem keeping them company, because it seems exceptionally cruel to lock away someone in that condition over a small or non-existent risk. I might be a bit apprehensive about much close contact, at least for the first couple of days, but the idea that they are playing “radiation roulette” is insulting.
This entry was posted on Tuesday, March 23rd, 2010 at 1:29 am and is filed under Bad Science, Nuclear, Politics, Quackery, inverse square. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
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March 23rd, 2010 at 2:18 am
Oh for Pete’s sake! This is sickening! “Radiation Roulette”???
If they don’t need continued medical monitoring and treatment, let the poor damn cancer patient go home or somewhere and have some relaxation. Christ. What’s next? “What if terrorists get their hands on a thyroid cancer patient” You know, it’s not like we don’t have enough hospital beds taken up as is. I mean if someone does not need to be in the hospital and are perfectly fine to take care of themselves, should we really be expending our medical system housing them over irrational radiation fears??
This is enough to make me sick.
Their justification is that they can name another country which has unnecessarily tight standards?
What do they think? These people go home and spend the next two weeks rubbing their neck against children?
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March 23rd, 2010 at 6:21 am
“But radiation also poses a cancer risk, especially to children. Thyroid cancer patients give off radioactive iodine in urine, sweat and saliva for several days; traces may remain in the body for as long as two weeks.”
Hah! No ****. When Amy (my fianceé) was ablated, she was told very clearly of the exile she’d go into. It’s part of the treatment: you don’t want to kill your friends, family or pets, and they (the doctors) let you know that’s exactly what you’d do if you hang around anyone too much during your “cool down”.
Hell, the doctor wouldn’t even shake her hand when she took the pill.
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March 23rd, 2010 at 8:35 am
So, the saliva, urine and sweat may contain traces of I-131. Well, getting some on your skin will not be dangerous, especially as it will wear off or be washed off pretty soon, and the amounts are minute anyway.
In other words, just about the only activity which may transfer significant amounts of these traces into the body, where it could conceivably be dangerous, is sex. Now, wouldn’t it be good if there was a device which prevented transfer of body fluids during sex? Since there obviously isn’t one, I’ll invent one. I think I’ll call it a “condom”. If you take that basic precaution and avoid deep kisses, you should be safe (unless you are into golden showers, in that case, you’ll take a tiny risk which is probably less than other risks associated with that practice).
Well, I can at least see some reason in that. For a family member or friend, having someone close to you going through this treatment is not something that usually happens more than once or twice in a life time. The doctor, on the other hand, meets such patients all day.
I see it much like how the dentist steps behind a wall to take X-rays. They are harmless to the patient, but the dentist takes maybe 50 X-rays a day, so some prudence is probably not a bad idea.
On the other hand, a doctor can’t be afraid of sick people and still do their job, so they shouldn’t overdo it either.
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March 23rd, 2010 at 10:13 am
Troberg said:
Umm, do you have sex without touching the other person? And/or do you rush through it? I would have thought the advice to not have sex is more sound than any of the other advice/demands: no clothes, close proximity, sweat-inducing exertion, extended periods of time.
However if I ever get turned into a glowing green radiation monster, I fully intend to run around rubbing children against my neck willy-nilly.
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March 23rd, 2010 at 10:20 am
Iodine 131 is a beta source, that means that it is only radioactively toxic when already inside your body, otherwise your skin (or clothes, or the droplet of contaminated urine) is good enough to efficiently stop those radiations.
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March 23rd, 2010 at 12:56 pm
Franck said:
Actually it does produce some gamma emissions at about 34 KeV directly and via the daughter of Xe-131m which produces some reasonably strong gammas (163 KeV)
Of course most of the energy is in the form of beta particles and really, it’s not a whole lot of exposure from someone near a person. However, if they have many millicuries, I would still consider it enough to make it worth while to keep reasonable distance for at least a couple of days.
Troberg said:
IS it that big a deal to abstain from sex for a few days? Rolling around with someone, sharing the same bed and so on are all things I think I’d try to avoid. Like I said the result would be “probably nothing” but it’s one of those circumstances where there’s probably enough potential for signifficantly increased exposure to warent a few days of caution.
100 milicuries of I-131 is a pretty significant amount. Remember: they are giving this person enough radioactive material to thoroughly kill the tissue its absorbed by.
Would I be willing to be in the same room with the person? Yes. Would I touch them? Yes.
Would I want to spend eight hours or more laying a few inches from them and then do that for several nights in a row? Er… just to be on the safe side, I think I would avoid that.
Anyway, I’m not really qualified in this area to give so if you want real information Ask the Experts
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March 23rd, 2010 at 6:51 pm
Troberg said:
I think you misunderstand me. My point was that the doctors are overzealously careful (and, frankly, that’s fine; Type-II errors are much better than Type-I in this case), that that can seriously screw with people’s perspectives.
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March 23rd, 2010 at 7:01 pm
I think we have two issues really here: First, is it appropriate to take some reasonable precautions with radioiodone therapy, like reducing close contact for a few days or so. I think the answer to that is universally agreed to be yes, if only to be on the safe side.
The second issue is do these people actually present any kind of general risk to the public and therefore do they need to have some kind of increased regulation. On that one, I’d say no and it sounds to me like congress is sticking their stupid head into a non-issue because it has that big bad ‘radiation’ monster attached to it.
Really though this is starting to get out of hand.
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March 23rd, 2010 at 7:34 pm
An Actual Scientist said:
What he said
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March 23rd, 2010 at 9:34 pm
I am currently 13 days out from 110 milicuries and staying away from my children and infant (6 months) for 2 more days. Everyone I know is terrified of me and doesn’t want me to be around my children for at least another week thanks to this article. My doctor says I am fine to go home, but now I am terrified!!! I recently ate dinner out with friends and they leaned away from me all 30 minutes of the super quick dinner. Seriously, I am starting to wonder if I am going to be called a “dirty bomb” forever (their words…..not mine!)
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March 23rd, 2010 at 11:38 pm
Currently in Isolation said:
Geez, man. That’s really rough. The biological halflife of iodine in a person who has had most of the thyroid removed is pretty short. Most of that 110 millicuries probably came out of you in the first two or three days. At 13 days, you’ve already been through about 1.5 half-lives of the material anyway. There’s no way you have more than a few millicuries in you, if even that.
Your doctor is right. You probably could have gone home even earlier.
There’s something called “factor of safety” which basically means, take a little extra to be on the safe side. IE “We think he can go home in two days, we’re pretty sure he can go home in five days, so lets wait ten days just to be extra sure”
Generally they go WAY over on these kind of things, they tend to be conservative. Your doctor would not tell you you’re fine if you were not.
People tend to be really afraid of radiation – more so than most other things. If a person were infected with a virus that was contagious and the doctor told them they were fine, they had been cured, the virus was no longer a threat, most people would believe them and be okay with it. But radiation? It seems to inspire a much greater fear.
15 days is quite a while. By that time close to 75% of the iodine will have decayed away whether or not it’s in your body, and most of it will be excreted anyway.
Yes, people are protective of their children and everything. Perhaps two more days is good “just to be on the safe side” but you really don’t have that much to worry about.
If your family and friends are really making a big deal about this and you can’t seem to get them to lay off of you being a “dirty bomb” or them not wanting you to get near the children, then you can send me an E-mail with your mailing address (my contact information is on the page “contact” on the front page of this blog) I can overnight you a small Geiger counter. It’s not a super precise instrument, but you can run it up and down your body to demonstrate that you’re no more radioactive than anyone else.
Of course, it’s way too late now, so if I drop it at FedEx tomorrow, it won’t get to you until Thursday.
You don’t need to pay for it or anything. It’s no big deal. You’re a guy getting cancer treatment who is being freaked out by scaremongering around him. That’s good enough reason for me to send one.
Best of luck with your treatment and health. As I’m sure you know, modern treatment of thyroid cancer is extremely successful in general.
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March 24th, 2010 at 12:11 am
As long as the sweat doesn’t enter the body in large quantities, the risk should be neglible.
Well, given how long I’ve been single, no. I used that example to put the risk in perspective, nothing else.
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March 24th, 2010 at 4:54 am
[...] Depleted Cranium » Blog Archive » New Target For Radiation Scaremongering: Thyroid Cance… [...]
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March 24th, 2010 at 12:47 pm
Edward Malarkey is at it again.
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March 24th, 2010 at 1:46 pm
This is the same stupidity that spelled the end for Pu power pacemakers. As a consequence batteries in these things must be replaced at regular intervals. This becomes problematic in the case of an aging patient, when the risk of surgery becomes too high and perforce, the cell is not replaced thus almost guaranteeing that the underling heart condition that was being controlled by the pacemaker will reemerge, just as the patient is in decline.
In practical terms, radiophobia leads to increasing cost and complications with no measurable benefit for the public. Meanwhile, the benefits of nuclear technology are being ignored to the determent of the sick, some of whom will in fact perish because of being denied access to treatments.
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March 27th, 2010 at 11:50 am
Hi. Thanks for the blog. I had a couple of good reads and a chuckle or two in the process, which is rare.
You’re basically right about this whole issue. Radioactive iodine therapy is extremely safe and very effective. It’s been around for many years and has saved many lives. The danger from radioactivity to those around someone are small, and isolation is a precaution that keeps it to a minimum, but to characterize a person who has received radioiodine as a walking dirty bomb or a hazard to public health is a huge exaggeration.
There is almost always a lot of anxiety about this kind of treatment. It’s not necessary, because the cancer is what to worry about and the treatment is really a blessing. However, radiation is one thing that always elicits a lot of fear.
Congress should worry about more important things.
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April 2nd, 2010 at 1:15 pm
A couple good counter points to the very conflicting verging on hysterical tones of the articles I have read. The nuclear tech that administered my 150 mc dose yesterday actually pulled out the geiger counter & showed me the distance to which I was emitting radiation. Also he suggested that on the third day I take some laxatives to eliminate the unused portions which would otherwise sit in the bowels. He also offered to reassess my radiation emissions a few days later to ease my mind. Basically his opinion was much like what you are saying don’t go around swapping spit & such with anyone you will be fine. Limit the time & maintain a safe distance away from others for a few days but you can feasibly live in the same environment without infecting the general population. Thank you so much for a bit of humor during what otherwise would be a long boring couple of days!
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August 6th, 2010 at 9:33 am
Do you think I’ll give you a choice of how far you’ll be sitting to me in the bus/train on my way home from the hospital where I ingested 150mCi of radioactive iodine? No, I’ll just come in and sit next to you or your pregnant wife. I’ll try to stay away from children or obviously pregnant ladies, but hey, it’s a rush hour, I’m tired and nauseous, and there is no room in the bus/train, so I’ll jsut stand with everybody. For the whole 1.5hr ride home. So you say that’s OK… Now I’ll worry less about that! Stupid me, was worring how not to expose other people to the thing that gave me cancer, but now I can see nobody cares. So now mith my mind at ease I’ll be taking public transportation and checking into a hotel. Cause I’m not going home to radiate my family. And that’s really really stupid that hospital personell that works with those that get this treatment inpatient stays the heck away from the patients’ rooms. They probably have no clue. Nobody told them that it’s not dangerous at all, may be you’ll explain that to them?
Why is it so hard to set up special “hotels” for treatments like this? It doesn’t have to be a hospital. Nobody needs a team of doctors and nurses to be available 24 hours. It doesn’t have to cost 2k a day.
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August 6th, 2010 at 10:18 am
It’s a lot of radiation. Even 2 weeks post treatment, the guy triggered radiation alert on a ferry in UK. So don’t take it so easy;
“Cancer patient sparks radiation alert on cross-Channel ferry after setting off terrorism detectors”
Read more: http://www.dailymail.co.uk/news/article-1294561/Cancer-patient-recovering-radiation-therapy-sparks-bomb-alert.html#ixzz0vq6JG1O7
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August 6th, 2010 at 10:49 am
News lady said:
The sensitivity of the survey equipment is no indication of the magnitude of the risk. This is the problem with all of these stories. Radiation, by its very nature, lends itself to detection very, very easily. However the mere presence of radioactivity is meaningless. With any Geiger-counter, one can find nominally radioactive material anywhere. You would be surprised just how active track ballast (the stones they make the bed that railroad tracks sit on) or any number of items you pass by every day are.
Hell, most of the buildings in any big city made, or covered in granite are radioactive. In fact radiation from the granite used in Grand Central Station exceeds the NRC limits for nuclear-plant operation. Grand Central Station wouldn’t get a license as a nuclear plant.
In 2000, according to a study, radioactive discharges from non-nuclear industries were estimated to contribute more than 90% of the European population’s total exposure. The fact is it is everywhere.
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August 6th, 2010 at 4:53 pm
News lady said:
A cheap radiation detector that could be had for under one hundred dollars can easily detect a microscopic quantity of I-131. A professional grade detector with a large surface area can detect a smoke detector from across the room. These radiation detectors which are supposed to detect “dirty bombs” are routinely set off by shipments of things like masonry and kitty litter.
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