National Cancer Institute NCI Cancer Bulletin: A Trusted Source for Cancer Research News
March 9, 2010 • Volume 7 / Number 5

Legislative Update

Congressional Hearing Focuses on the Prevention of Medical Radiation Overdoses

In Case You Missed It

In the last issue of the NCI Cancer Bulletin, experts from NCI’s Radiation Research Program authored an article on maximizing the benefits and minimizing the harms of radiation oncology. You’ll find that Guest Director’s Update by Drs. Bhadrasain Vikram, James Deye, and C. Norman Coleman in the February 23 issue. You may also be interested in reading two other NCI Cancer Bulletin articles on radiation exposure—one on CT angiography and the other on diagnostic imaging.

Prompted by recent news reports describing medical radiation overdoses, in some cases resulting in tragic consequences, the House Energy and Commerce Committee, Subcommittee on Health, held a hearing on February 26 to learn more about the risks and benefits of both diagnostic and therapeutic radiation. Chairman Frank Pallone, Jr. (D-NJ), opened the hearing with an acknowledgement of the lives saved due to advances in radiation-based imaging and treatment, an opinion that resonated with the members who were present. But the subcommittee was concerned about the potential harms associated with these technologies.

The subcommittee heard testimony from James Parks, whose son died after receiving a massive radiation overdose during treatment for tongue cancer. Another witness, Suzanne Lindley, credited diagnostic imaging and radiation therapy for her cancer survival. A group of expert witnesses representing academic medical institutions and professional organizations described how radiation is used in clinical practice.

The witnesses reported that, although accidents are rare and the vast majority of imaging studies and radiation treatments are performed safely and as prescribed, the current patchwork approach to regulation, oversight, and data management does little to reduce the potential for harm. There is extreme variability from state to state in education and certification requirements for the technical personnel who administer and supervise medical radiation procedures, and some states have no requirements, they reported. There was general consensus that action must be taken to minimize the cumulative doses of diagnostic radiation received by individual patients, establish minimum competence and training standards for radiology professionals at all levels, urge accreditation of facilities using medical radiation, mandate error reporting, and consider applying these measures nationally.

Several witnesses and subcommittee members expressed their support for legislation introduced by Rep. John Barrow (D-GA). The bill, the Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act (CARE Act, HR 3652), if enacted, would require the Secretary of Health and Human Services to establish certification and licensing standards and procedures for medical radiation technology practitioners, and restrict Medicare payment for imaging and radiation therapy services to those performed in accordance with the CARE Act’s requirements.

Adjourning the hearing, Chairman Pallone commented that the discussion had uncovered troubling issues requiring further scrutiny. He intends to hold additional hearings on the subject.

More information about the hearing, including a full list of expert witnesses, is available on the subcommittee’s Web site.

House Committee Convenes Hearing on Prostate Cancer

The House of Representatives Committee on Oversight and Government Reform held a hearing on March 4 to examine questions surrounding prostate cancer screening, diagnosis, and treatment. The panel of witnesses included researchers, clinicians, and advocates, as well as actor and prostate cancer patient Louis Gossett, Jr.

Members of the committee and panelists recognized the health disparity surrounding prostate cancer incidence and mortality, as African American men currently have a 60 percent higher incidence of prostate cancer than white men and are twice as likely to die from their disease. Panel member Dr. William Dahut of NCI’s Center for Cancer Research emphasized improvements in areas such as imaging, nanotechnology, and the identification of biomarkers as critical to developing more accurate screening methods. He also stressed that being able to differentiate between lethal and non-lethal prostate cancer is the single largest challenge in effectively treating the disease and avoiding unnecessary treatment. A number of panelists echoed these points, and many called for increased federal funding dedicated to research in these areas.

Committee member Rep. Elijah Cummings (D-MD) has introduced the Prostate Research, Imaging, and Men's Education Act of 2010 (PRIME Act, HR 4756), which has been referred to the House Committee on Energy and Commerce. The legislation calls for increased funding for research on prostate cancer imaging and screening methods, among other initiatives. Although the legislation was not the subject of the hearing, panelists referenced the bill and called for many of its provisions.

Prior to the hearing, on March 3 the American Cancer Society (ACS) released updated guidelines on prostate cancer screening. The guidelines focus on the limitations of current screening tools, including the prostate-specific antigen (PSA) test, and encourage men “to have meaningful discussions with their doctors to allow for informed, shared decision making.” Dr. Otis Brawley, chief medical officer of the ACS, was also a panelist at the hearing.

More information on the hearing, including a full list of witnesses and their statements, can be found on the committee Web site.

For more information about this and other NCI congressional activity, visit the NCI Office of Government and Congressional Relations Web site.