Steven Yorio

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DOS 516 - Fundamentals of Radiation Safety

Radiation Safety Paper

Practicing Safety in Radiation Oncology

When people think about the dangers of radiation they tend to imagine the most violent
of cases. The charred bodies and piles of rubble from the nuclear explosion at the Chernobyl
power plant, or the explosions of Fatman and Little Boy that vaporized citizens of Hiroshima and
Nagasaki and left nothing but their shadows imprinted on the pavement; these are the visions
imbedded in many peoples’ minds when they hear the word “radiation.” In order to make people
seeking radiation therapy treatment feel more at easy, certain steps need to be taken within the
radiation oncology department.
In the years between 1976 and 2007 one review identified more than seven thousand
incidents and near misses. Three thousand one hundred and twenty-five incidents reported
patient harm of variable intensity ranging from underdose increasing the risk of recurrence, to
overdose causing toxicity, and even death for 1%; 4616 events were near misses with no
recognizable patient harm.2 It is the responsibility of all roles in the Radiation Oncology
department to come together as a whole to combat this history of events and lay to rest any
qualm a patient and their family members may have about receiving a viable treatment that
would potentially save and prolong the patient’s life.
As most people are aware, radiation is inherently dangerous. It is because of this fact that
patients need to always be informed that there are a tremendous amount of precautions being
taken in order to minimize the potential for any malevolent outcome from their treatment.
Patients must be notified about potential side effects, and the steps that are being taken to avoid
those from happening during and after their treatment. If the patient has side effects that are
bothersome and affecting their daily activities or health, the doctor may stop their treatments for
a while, change the schedule, or change the type of treatment they are getting.1 One way to
reduce side effects is by using radioprotective drugs, but these are only used for certain types of
radiation given to certain parts of the body. These drugs are given before radiation treatment to
protect certain normal tissues in the treatment area.1 Above all else, patients and their loved ones
need to know that they are cared for and in good hands and that care providers want to see them
through to their goal.
Steven Yorio
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DOS 516 - Fundamentals of Radiation Safety

Radiation Safety Paper

Radiation has been used to successfully treat cancer for over 100 years. Throughout this
time treatments have been adjusted to make the process more safe and efficient. Prior to starting
a radiation treatment, the oncology team does a carefully planning of how the treatment will be
delivered including the source, dose, and the number of fractions that will be needed to deliver
said dose. Throughout the treatment, members of the team check and recheck progress by
performing additional imaging and ensuring that there is stability based on the patient’s charted
data. Weekly meetings help the team to note what is working properly during the treatment phase
as well as address any side effects that could be starting to present. Dosimetrists and Medical
Physicists provide the design and quality assurance for the Radiation Therapists to deliver the
dose, and the Radiation Oncologists orchestrates the umbrella under which every team member
is able to function in order to achieve the prescribed treatment for the patient in the safest way
possible.
It is necessary to have congruity, transparency and commitment amongst the entire cancer
team as well as strong connection with all the ancillary members of the system as well, i.e.
representatives of equipment manufacturers, vendors, and members of regulatory
agencies. Qualitative and dismissive responses are not satisfactory answers to a problem. Every
question raised by a user deserves an answer, and the answer should be useful, timely,
understandable, and comprehensive.2 The team members directly involved in the planning
process must be diligent in each step and maintain the strict system of checks and balances
needed in order to ensure proper calculations, physics checks, provision of treatment, along with
continuous care and follow up care. Implementation of an Event Learning Systems (ELS) in a
radiation oncology department has potential to enhance patient safety mindfulness and promote a
safety culture.1 There is growing interest in the anonymous reporting of mistakes and equipment
failures in radiation oncology. Through a reporting process, members of a treatment team could
be alerted to problems occurring elsewhere that may be relevant to their institution.1 An error-
reporting system should be a centralized, modality independent repository that is easy to use,
universal, anonymous, and nonpunitive.2 There is little benefit and potential for additional harm
unless a program encourages learning from past mistakes and catching those near misses. Issues
don’t resolve unless they are met head on and the course is corrected.
Steven Yorio
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DOS 516 - Fundamentals of Radiation Safety

Radiation Safety Paper

These are the types of steps radiation therapy departments need to take in order to make
patients and their loved ones feel truly comfortable with the whole process. Not only do these
steps need to be taken, but it could be advantageous to even inform the patient and their family
what these steps actually are and how they produce a desirable outcome. The therapy team
becomes morally remiss if they let their guard down in any of these manners. Treatments cannot
be designed and simply carried out with a blind eye. Patients need to be aware that they are
continuously evaluated as they go through the process. These are the only things that can calm
the mind of someone who is already having their life threatened by their own physiology. If the
radiation therapy department cannot express that the patient’s best interest has been in the hearts
of their teams members throughout their entire treatment, that is a true disparity.
Steven Yorio
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DOS 516 - Fundamentals of Radiation Safety

Radiation Safety Paper

Works Cited

1. Chang D, Alley ME, Adams RD, Williams AC, Church J, Comet E. Enhancing Patient
Safety Mindfulness and Promoting a Safety Culture in Radiation Oncology
Through the Use of an Event Learning System (ELS). International Journal of
Radiation Oncology*Biology*Physics. November 2015. doi:https://doi.org/
10.1016/j.ijrobp.2015.07.1811

2. Hendee W, Herman M. Improving Patient Safety in Radiation Oncology. Medical

Physics. December 2010. doi:https://doi-org.libweb.uwlax.edu/
10.1118/1.3522875

3. Shafiq J. An international review of patient safety measures in radiotherapy practice.

Radiotherapy and Oncology. 2009. doi:https://doi.org/10.1016/
j.radonc.2009.03.007

4. Wyant T. Radiation Therapy Side Effects. American Cancer Society.

https:www.cancer.org/treatment/treatments-and-side-effects/treatment-types/
radiation/effects-on-different-parts-of-body.html. Published December 27, 2019.
Accessed October 30, 2020.