Radiation exposure question

[Creed_Bratton]

Hi all,
I have been discussing this question with a family member, so I decided to ask here as you folks are the experts on the matter.
A pregnant female healthcare worker is worried regarding coming in contact with patients undergoing radiation therapy.
What are the safety concerns for pregnant women working with patients undergoing external beam radiation vs brachytherapy vs IV radioactive materials vs any other common modalities?
When I say "working with these patients" I mean mostly just being within 3-6 feet from them with possible minor physical contact like auscultation (not being directly involved in the radiation treatment).
She is concerned because she recently was in in contact with some patients who are currently undergoing radiation therapy for prostate cancer (she doesn't know what kind but the patient mentioned it occurs daily) as well as some patients currently under treatment for testicular cancer and various lymphomas. The contact lasted for anywhere from 5 to 45 minutes, most often she was at an arms length ftom the patient except maybe being closer briefly while letting the patient through the door. Should she be worried?

---

Members don't see this ad.

 

[thecarbonionangle]

No.

 

[Ray D. Ayshun]

How many treatments is the prostate patient getting?

 

[Creed_Bratton]

How many treatments is the prostate patient getting?

She is not sure, she works at an outpatient clinic that has nothing to do with cancer, and she has no access to heme-onc records. The only thing the patient told them was that he's currently getting daily treatments

 

[Ray D. Ayshun]

She is not sure, she works at an outpatient clinic that has nothing to do with cancer, and she has no access to heme-onc records. The only thing the patient told them was that he's currently getting daily treatments

In all seriousness, she's in no danger. Patients getting external beam are the same as patients getting a ct: when the machines off the radiations off and they take none with them. The prostate seeds don't emit a type of radiation that leaves the body in any meaningful sense. If she's at risk for exposure to ionizing radiation, the clinic would give a radiation detector badge or risk getting in serious trouble. I think, nothing to worry about.

 

[RadRadRad]

She is not sure, she works at an outpatient clinic that has nothing to do with cancer, and she has no access to heme-onc records. The only thing the patient told them was that he's currently getting daily treatments

not enough details to answer with 109% certainty.

External beam radiation (majority of treatments) has no exposure risk after the delivery which is done in a shielded vault

Oral and IV radiation which are fairly uncommon but could be used for metastatic prostate cancer (pluvicto, xofigo, samarium etc), lymphoma (bexxar, zevalin… these are almost never used and may not be available), thyroid cancer (radioactive iodine pills), and a handful of other treatments do carry exposure risk

Brachytherapy has exposure risk if something permanent was left in patient (prostate seeds being most common)

It sounds like theses patients are getting external beam but can’t rule out seeds or something else base on info provided

 

[RadRadRad]

How many treatments is the prostate patient getting?

70 fractions in 1.2 bid with protons

Sorry couldn’t help it

 

[Creed_Bratton]

In all seriousness, she's in no danger. Patients getting external beam are the same as patients getting a ct: when the machines off the radiations off and they take none with them. The prostate seeds don't emit a type of radiation that leaves the body in any meaningful sense. If she's at risk for exposure to ionizing radiation, the clinic would give a radiation detector badge or risk getting in serious trouble. I think, nothing to worry about.

Thanks for the insight! She's been in a state of panic for the past 3 days. Seems like no one in the clinic cared or knew anything about it.

 

[Creed_Bratton]

not enough details to answer with 109% certainty.

External beam radiation (majority of treatments) has no exposure risk after the delivery which is done in a shielded vault

Oral and IV radiation which are fairly uncommon but could be used for metastatic prostate cancer (pluvicto, xofigo, samarium etc), lymphoma (bexxar, zevalin… these are almost never used and may not be available), thyroid cancer (radioactive iodine pills), and a handful of other treatments do carry exposure risk

Brachytherapy has exposure risk if something permanent was left in patient (prostate seeds being most common)

It sounds like theses patients are getting external beam but can’t rule out seeds or something else base on info provided

Hypothetically speaking, with brachytherapy or those IV oral treatments, would exposure likely cause fetal harm if she was no closer than about 3 feet to the patient?

 

[ramsesthenice]

Not realistically no. The oral agents have very short ranges and low specific activity. A high dose rate Brachy source could but she would have to force her way into a locked vault and past several authorized users to get there so no.

 

[FindMeOnTheLinks]

Occupational exposure to radiation is something that is very closely monitored and regulated. Unless her institution is grossly incompetent, there are processes in place to define and monitor the exposure of workers who may have exposure. They would make you sit through radiation safety modules and wear a badge that monitors the dose, so she would know if they deemed her at risk. Especially so for pregnant individuals. Further, radioactive sources and their processes are tightly secured, not really allowed to be floating about. All of that is to say, Not to worry!

 

[Creed_Bratton]

Occupational exposure to radiation is something that is very closely monitored and regulated. Unless her institution is grossly incompetent, there are processes in place to define and monitor the exposure of workers who may have exposure. They would make you sit through radiation safety modules and wear a badge that monitors the dose, so she would know if they deemed her at risk. Especially so for pregnant individuals. Further, radioactive sources and their processes are tightly secured, not really allowed to be floating about. All of that is to say, Not to worry!

Thanks! She works at a physical rehab clinic that has nothing to do with cancer, but by the luck of the draw they recently had some patients who happen to have cancer come in for completely unrelated reasons.
Her worry is that her supervisors don't even have it on their radar since their practice is unrelated to cancer. But what if the patient she interacts with for their physical therapy also underwent brachytherapy the day before?

 

[Palex80]

70 fractions in 1.2 bid with protons

Sorry couldn’t help it

Protons can actually activate titanium implants! That could actually present a theoretical (yet negligible) risk for people around the patient!

She is concerned because she recently was in in contact with some patients who are currently undergoing radiation therapy for prostate cancer (she doesn't know what kind but the patient mentioned it occurs daily) as well as some patients currently under treatment for testicular cancer and various lymphomas. The contact lasted for anywhere from 5 to 45 minutes, most often she was at an arms length ftom the patient except maybe being closer briefly while letting the patient through the door. Should she be worried?

Testicular cancer? Various lymphomas? Treated with radiotherapy? I am intrigued!

 

[Mandelin Rain]

Testicular cancer? Various lymphomas? Treated with radiotherapy? I am intrigued!

Let's party like it's 1985!!!

 

[Creed_Bratton]

Protons can actually activate titanium implants! That could actually present a theoretical (yet negligible) risk for people around the patient!


Testicular cancer? Various lymphomas? Treated with radiotherapy? I am intrigued!

Lol, I freely admit I have little knowledge of rad onc, so don't try to catch me out haha. But in my defense, I said that she encountered a patient getting radiation for prostate cancer as well as a couple of patients undergoing treatments (didn't say radiation here) for testicular cancer and lymphomas (so I'm not a complete dummy). Sorry if "various" was not an appropriate word, but the point is that they were both Hodgkins and non Hodgkins. And as I said, it's a rehab clinic where they do things like PT and OT, so there is no details available regarding the subtype of cancer nor about the exact treatment modality

 

[thecarbonionangle]

Lol testicular cancer is in our boards but i dont know anyone my age who has treated one recently

 

[Creed_Bratton]

Lol testicular cancer is in our boards but i dont know anyone my age who has treated one recently

Gotcha.
The main question distilled down is whether brachytherapy or IV radiation could cause fetal harm with exposure at an arm's length for up to an hour.

 

[Wildcat321]

Gotcha.
The main question distilled down is whether brachytherapy or IV radiation could cause fetal harm with exposure at an arm's length for up to an hour.

While I'm not aware of any studies looking at physical therapy and brachy, here are some exposure numbers for very close contact.

Radiation safety of receptive anal intercourse with prostate cancer patients treated with low-dose-rate brachytherapy - PubMed

During the immediate weeks after prostate seed implant, the estimated intrarectal dose rates are higher in (103)Pd compared to (125)I. As (103)Pd decays faster than (125)I, 2 months after the implant, radiation exposure from (103)Pd becomes lower than (125)I. Receptive anal intercourse time...

pubmed.ncbi.nlm.nih.gov

 

[DoctwoB]

Lol testicular cancer is in our boards but i dont know anyone my age who has treated one recently

I referred one to rad onc!

Stage 2a seminoma.

 

[deleted1116990]

I think the toxic chemicals in our water and food supply are flying on long airplane trips (ionizing radiation exposure) are probably more of a threat, which is still near zero.

Seriously, I would not worry about this.

 

[Creed_Bratton]

While I'm not aware of any studies looking at physical therapy and brachy, here are some exposure numbers for very close contact.

Radiation safety of receptive anal intercourse with prostate cancer patients treated with low-dose-rate brachytherapy - PubMed

During the immediate weeks after prostate seed implant, the estimated intrarectal dose rates are higher in (103)Pd compared to (125)I. As (103)Pd decays faster than (125)I, 2 months after the implant, radiation exposure from (103)Pd becomes lower than (125)I. Receptive anal intercourse time...

pubmed.ncbi.nlm.nih.gov

That's a very helpful article. Very nice schematics as well

 

[evilbooyaa]

Hi all,
I have been discussing this question with a family member, so I decided to ask here as you folks are the experts on the matter.
A pregnant female healthcare worker is worried regarding coming in contact with patients undergoing radiation therapy.
What are the safety concerns for pregnant women working with patients undergoing external beam radiation vs brachytherapy vs IV radioactive materials vs any other common modalities?
When I say "working with these patients" I mean mostly just being within 3-6 feet from them with possible minor physical contact like auscultation (not being directly involved in the radiation treatment).
She is concerned because she recently was in in contact with some patients who are currently undergoing radiation therapy for prostate cancer (she doesn't know what kind but the patient mentioned it occurs daily) as well as some patients currently under treatment for testicular cancer and various lymphomas. The contact lasted for anywhere from 5 to 45 minutes, most often she was at an arms length ftom the patient except maybe being closer briefly while letting the patient through the door. Should she be worried?

EBRT patients are almost never 'radioactive'

Patients undergoing LDR brachytherapy (where permanent radiation is left in them) are recommended to avoid being in too close of proximity to young children, pregnant women (meaning not having them on their lap) but even that is mostly dogmatic.

IV radioactive material administration rooms do have some shielding so I'd probably recommend a pregnant woman to be hanging out in the room with the patient while the infusion is administered and running but otherwise shouldn't be an issue.

Oral thyroid shouldn't be an issue for bystanders either but maybe don't stand super close to them.