Therapy with radionuclides: Clirucal acceptance is overdue

In this issue, Drs. Bererhi and Constable’ have published an important paper on the radiation doses received by relatives of patients after radioiodine therapy for thyroid cancer or for hyperthyroid Graves’ disease. Basically, they have shown that the radiation doses to the relatives are too small to be an important consideration in radioiodine therapy. The authors are, thus, suggesting much less restrictive precautions, and justifiably so. They have rightly pointed out that in other countries-at least in the United States and in Britain- the regulations are much less demanding as a result of similar earlier studies done in those countries. The US. Nuclear Regulatory Commission (NRC) no longer dic- tates the exact load of radioactive drug within the patient as the limiting factor prior to being discharged from the hospital. Instead, the exposure to the relatives and members of the public is the limiting factor. A patient may be released as long as ’the effective dose equivalent to any other individual from exposure to the released individual is not likely to exceed 5 millisieverts (0.5 rem).2 It is up to the treating physician to decide whether the risk of exposure to other people is low enough, (under 0.5 rem) before releasing the treated individual from his/ her control.2 In fact, in the United States, it is now possible to treat patients with thyroid cancer using 3700-7400 MBq (100-200 mCi) of radioiodine-131 (1311) without admission to hospital. Dr. Bererhi’s article’ will go a long way towards alleviating the anxieties of the public and physicians in Oman and elsewhere.