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Veterans Receive Wrong Prostate Cancer Treatment In VA Hospital


The VA Medical System has been in the news during the past year due to veterans being exposed to HIV and hepatitis during routine colonoscopy. Several veterans became infected due to the improper sterilization of the instruments used. The hospitals involved were located in Miami, Fla., Murfreesboro, Tenn. (where the problem was first detected), and Augusta, Ga. Now the Philadelphia VA Medical Center is the focus of a failure of oversight and problems in prostate cancer care. As many as 92 veterans received incorrect doses of radiation for their prostate cancer treatment.

The veterans were to receive implanted radioactive seeds (brachytherapy) as treatment for their prostate cancer. The use of these radioactive seeds when implanted correctly focus the radiation in the prostate and limit the damage to nearby tissues.

Several of the veterans received incorrect doses (often too small for adequate treatment) of radiation while others had improper placement of the seeds. Some were improperly placed into the bladder and/or rectum rather than the prostate. In at least one case, the improperly placed seeds may have contributed to rectal bleeding.

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It is reported that all of the affected veterans have since gotten follow-up care. Eight patients received additional seed implants for their prostate cancer treatment at the VA Medical Center in Seattle.

Brachytherapy is usually done as an outpatient procedure under spinal anesthesia. An ultrasound probe is inserted into the rectum and used to guide the placement of the radioactive seeds. The seeds are then implanted into the prostate through very thin needles. Depending on different variables, between 50 and 100 seeds are used. The needles are inserted into the skin between the scrotum and rectum. The US probe is used to guide the needles into the right place to most effectively treat the cancer.

The seeds used in prostate brachytherapy may include Iodine-125, Palladium-103, and echnogenic Iodine-125 seeds. They emit a low level of radiation which doesn’t usually travel beyond the prostate. Because there is such a small amount of radiation involved, it is not considered a risk to others. Ask your doctor questions about what the precautions should be, or any other questions that you have about the safety of the radiation used in brachytherapy treatments.

Related article
Veterans Get Tested for HIV and Hepatitis After Colonoscopy

New York Times
American Brachytherapy Society
Philadelphia VA Healthcare System