By PRADIP

M. PATHARE

I am a radiation oncologist who has worked in the academic and private practice settings over the past 30 years. I read recent articles published in The New York Times on Sunday, Jan. 24, entitled "Radiation offers new cures, and ways to do harm" and also the article on radiation safeguards on Jan. 27 with special interest and concern. Although the headline appeared to be balanced, the entire report has not unexpectedly caused many of its readers significant anxiety and trepidation towards undergoing life-saving radiation treatments. As a nonprofit community hospital, we take our responsibility of delivering accurate and safe radiation very seriously. We have in place multiple quality assurance checks designed to avoid the kind of rare errors described in these articles.

There is no question that all of us empathize with the suffering of the patient described in the article. To insinuate that surgery would have been better and not associated with morbidity is false and will dissuade future patients reading the article from choosing radiation treatment for their various malignancies like prostate, breast, and head and neck cancers and to choose to unnecessarily undergo radical surgery fraught with other potential problems.

Radiation therapy today in the right hands is one of the safest, most effective ways to treat cancer. We have in place multiple safeguards designed to avoid errors in the planning of treatment and transmission of computerized instructions into the treatment machine and have an independent record and verification process that will prevent transmission of radiation if all parameters do not match precisely.

Our radiation therapists have been trained at leading academic centers and are all certified and continue to receive annual continuing education credits. They have years of experience and monitor every moment of the treatment on the monitors. The team in radiation therapy includes the radiation oncologist, medical physicists, radiation therapists and nurses all dedicated to working cooperatively to provide optimum care of the patient. Our medical physicists are responsible for quality assurance and technical aspects of the complex technology used to treat patients with radiation. They have undergone a rigorous multi-year process that requires considerable clinical experience and passage of written and oral examinations. Our medical physicists are board certified. Patients' ongoing treatments are continuously monitored for side effects, both anticipated and those out of the ordinary, by all team members and by their radiation oncologist so that prompt intervention can prevent irreparable harm.

No treatment -- be it surgery, chemotherapy or radiotherapy -- can be 100 percent safe. In radiation, we take pride in our quality assurance procedures, which include weekly chart checks by physics, weekly chart rounds with mandatory attendance by the radiation oncologists, physicists, therapists, and nurses, the mortality and morbidity conferences and outcome measures.

Radiation therapy remains one of the safest and most effective ways to treat cancer. There were an estimated 35 million radiation treatments on Varian machines last year. Errors do occur but they are rare; fewer than 0.0001 percent of treatments involve an incident that puts a patient at risk of harm. Very rare events with tragic consequences serve as a sad reminder that a mishap can and will occur in the future and is no more likely than a terrorist getting onto a flight in spite of all our efforts. One's risk of potential injury in a car crash driving to and from the airport on busy stretches of highways is far greater than the risk from radiation treatment needed to save lives. In untrained hands even a car can be a dangerous instrument that can injure or kill.

The operation of complex radiation treatment machines requires proper training of staff, direction, and leadership. Norwalk Hospital and other not-for-profit institutions have made a commitment to their patients that they can expect safe and effective radiation treatment for every patient in the fight against cancer.

For those of you who may be considering forgoing radiation treatments and choosing to go back to more radical surgeries, I would urge you to discuss your concerns with your radiation oncologist who is uniquely trained to take care of your cancer and to satisfy your valid concerns.

Pradip M. Pathare is medical director of Whittingham Cancer Center and chief of radiation oncology at Norwalk Hospital, and an associate clinical professor at Yale University's School of Medicine.