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Chemotherapy Patients Set Off Subway Alarms

dave writes "Recently, cities such as New York and elsewhere have been installing radiation detectors in subways as an anti-terror precaution. However, as reported in New Scientist, patients who are undergoing radiation treatment are setting off the alarms. From the article, "a 34-year-old patient who had been treated with radioactive iodine for Graves disease, a thyroid disorder, returned to their clinic three weeks later complaining he had been strip-searched twice in Manhattan subway stations.""

28 of 525 comments (clear)

  1. huh? by gralem · · Score: 5, Informative

    Chemotherapy is not radiation therapy!

    1. Re:huh? by Idarubicin · · Score: 5, Informative
      Chemotherapy is not radiation therapy!

      In this case, it is.

      Graves disease is a form of hyperthyroidism, in which the thyroid secretes excessive amounts of certain hormones. The treatment of Graves disease involves removal of part or all of the thyroid, chemical supression of hormone production, or destruction of the thyroid using radiation.

      In the latter treatment, doctors take advantage of the fact that iodine is concentrated by the body in the thyroid gland. After dosing a patient with radioactive iodine-131 (in this case, 20 millicuries--a nontrivial amount) the iodine will accumulate rapidly in the thyroid. While it decays, it kills off most or all thyroid tissue without doing serious damage to the rest of the body. With a half-life of about eight days, the stuff remains detectable for quite a while.

      So--what we've done is use the chemical properties of a material (I-131) to deliver radiation therapy. Presto! Chemotherapy that is also radiotherapy. Actually, I'd probably lean towards describing it as brachytherapy, just to make everyone happy.

      --
      ~Idarubicin
    2. Re:huh? by Imabug · · Score: 5, Informative

      radioiodine therapy is not chemotherapy, nor is it brachytherapy. chemotherapy is the use of cytotoxic chemicals (none of which are radioactive) to kill cancer cells at a faster rate than normal cells. Brachytherapy is the implantation of radioactive sources into a tumour to kill them.

      Radioiodine therapy is a form of radioisotope therapy.

      there is also radioimmunotherapy, which uses monoclonal antibodies usually labelled with a beta emitter to deliver targeted radiation to a specific antigen expressing tumour.

      --
      "For I am a Bear of Very Little Brain, and Long Words Bother Me"
    3. Re:huh? by Idarubicin · · Score: 3, Informative
      chemotherapy is the use of cytotoxic chemicals...

      You're using the most popular--but also narrowest--definition of chemo. Pull out your Merriam-Webster (online at www.m-w.com) and the first definition is a literal interpretation of the term:

      chemotherapy: n. The use of chemical agents in the treatment or control of disease or mental illness

      Brachytherapy is the implantation of radioactive sources into a tumour to kill them.

      Brachytherapy is a blanket term is radiotherapy that covers a range of techniques to place radioactive sources in close proximity to a target volume within the body. It may include the use of sealed seeds (iodine-131 sealed in a casing is often used for prostate cancer) than can be permanently implanted. It also includes high dose rate therapies where wires within catheters or needles tipped with potent radioactive sources (ie iridium-192), are inserted into the body for a few minutes at a time, again to precisely deliver radiation to a controlled volume. The other broad branch of radiotherapy is teletherapy--external beam radiotherapy--which obviously doesn't apply in this case.

      --
      ~Idarubicin
    4. Re:huh? by Idarubicin · · Score: 3, Informative
      I fully concur on your last point. Total body irradiation in preparation for a bone marrow transplant is definitely one of the least pleasant treatments in oncology--and that's a field with a lot of competition in that regard.

      That said, not all radiation therapy has acutely painful side effects. Radiotherapy for localized skin lesions is often very quick and causes only mild discomfort.

      Prostate cancer can be treated using conventional external beam radiotherapy with all its attendant side effects. One alternative involves inserting anywhere up to about a hundred metal-encased 'seeds' of iodine-131 into the prostate to deliver radiation in situ. The patient can return home after the one inpatient procedure.

      Although I appreciate the misery of what you went through, deciding whether or not something counts as radiotherapy, or chemotherapy, or both based on how bad its side effects are doesn't hold water.

      --
      ~Idarubicin
  2. Much more detailed article in the NYT by Cerlyn · · Score: 5, Informative
    The New York Times has a much more detailed article on this subject. Registration required, etc., etc., etc.

    Of particular note is that the NYT was *not* able to verify that anyone said they carrying a note from a doctor would be useful; rather, it said the police would not accept such a letter as "sole proof" that the person was not trying to pull a fast one on them, and would still conduct a full investigation.

  3. Radioactive iodine isotope by cyber_rigger · · Score: 4, Informative

    I know that some radioactive iodine isotopes are used for thyroid treatment as a marker or for destruction of cancerous thyroid tissue. Thyroid tissue absorbs iodine and certain iodine isotopes.

  4. Re:Radiation levels by Marijuana+al-Shehi · · Score: 2, Informative
    Remember, Taliban members would be more than willing to die

    Maybe you mean al Qaeda. The Taliban was just another batch of thuggish warriors in Afghanistan. Yet somehow you fear them attacking you here, halfway around the world.

    --
    "I think all foreigners should stop interfering in the internal affairs of Iraq"
    -- Paul Wolfowitz, 7/21/2003
  5. Re:chemotherapy != radiation by politovski · · Score: 2, Informative

    radiation and chemo work in different methods. radiation cleaves the strands of dna, making the cell unable to replicate. chemo works by many ways (alkylation of dna to inhibition of synthesis of the nucleiotides), but overall inhibits/kills dividing cells. same effect, different means.

  6. The White House, too by MacAndrew · · Score: 3, Informative

    I think it was the NYT that reported recently a guy who was entering the White House after a medical procedure and heart a faint electronic noise go off. He was instantly surrounded by the Secret Service which, given their limited sense of humor, is a pretty frightening thing. (I am proud that years ago I got one of them to smile. :)

    I don't think he was strip-searched (he didn't work there but was a VIP of some sort).

  7. Re: Radioactive iodine isotope by Desert+Raven · · Score: 2, Informative

    Yes, you are correct. However, that is not chemotherapy, it is radiation therapy.

    It's kind of like calling a capacitor a resistor. Yes, they're both small electronic parts, and they both go on circuit boards. But they are radically different items, and are not interchangeable.

    Judging by a post by the article submitter, it was the slashdot editors who decided to switch one word for the other. Apparently "chemotherapy" is a more l33t word.

  8. Re:My uncle... [I CALL BS!] by silvaran · · Score: 4, Informative

    There's a report on it in the New England Journal of Medicine (1998). It's not a capsule of plutonium or anything, it's a radioactive iodine. I didn't believe it myself until I saw the kind of treatment he was undergoing.

  9. Re:watches? by tocqueville · · Score: 2, Informative

    police with tritium on thier guns

    Why would police have tritium on their guns?

    Night sights have Tritium in them. It's how they glow in the dark.

  10. Depends on what they are using by The+Tyro · · Score: 5, Informative

    IANARO (Radiation Oncologist), but have some knowledge of this subject.

    Usually Iodine-131 is given as ablation therapy for hyperthyroidism... the thyroid gland takes up the radioactive iodine (just like it takes up regular iodine) and literally burns itself out. The damage is localized because I-131 is a beta emitter. You can get the gland surgically removed as an alternative, but most people go for the pill... it's just easier. There may be specific indications for surgical removal (discrete mass, need pathology input, etc), but I could not name them.

    There are other radioactive treatments for cancers... radioactive "seed" implants in prostate cancer for instance. I have never seen anyone walking around in public with them, but scanning someone being treated in that fashion might be interesting (to say the least). If airline security goons are making new mothers drink their own breastmilk (yes, I said "goons," there's no other name for someone who would do something that stupid) I can see some overzealous security folks doing a body cavity search to find the source of that "rectal radiation." I shudder at the thought of the lawsuit amount after something like that.

    People undergoing chemotherapy will not set off any radiation alarms. However, from a theoretical standpoint, I can see the possibility of them setting off chemical warfare agent detectors. Please note the detectors would have to be outrageously sensitive (I don't know if it's even possible to make them that sensitive)... almost all of the chemotheraputic agents in common use are metabolic poisons of one type or another, including drugs like the nitrogen mustards (related to mustard gas). I could see someone getting some chemo solution spilled on their sleeve, and setting of somebody's chemical warfare sniffer. Someone with a little more chemical warfare experience want to comment?

    --
    Even if a man chops off your hand with a sword, you still have two nice, sharp bones to stick in his eyes.
  11. Just Wait for the Radon Fallout by NeuroManson · · Score: 5, Informative

    As I recall, nuclear power plants have often gone on alert for false positives resulting from radon exposure in the home.

    While the odds are slim, considering the entire length Adirondack and Appalachian mountains range from Georgia to Canada, porions of which contain significant uranium ore veins, there's going to be a considerable amount of radon gas emitted by these veins as they go through the natural process of decay. What does this mean? Inevitably, there will be false positives as well. More people will be detained, more public outcry.

    On a momentary tangent, I have difficulty putting too much weight in New Scientist's journalistic integrity. For example, why haven't pacemakers set off the alarms? While they may be shielded to a certain degree for safety, I doubt that they're 100% shielded against detection.

    And what of nuclear power plant employees, or students of radiological sciences in college, or radiotherapy doctors in hospitals? All of these pick up marginally higher levels of radiation in their fields, why aren't they setting off alarms either?

    To ensure against repeats of that article, the police need to (at least) inform the public of the minimum level of radiation that the sensors will trip on, so that at least innocent people won't be grabbed by police, just because they were picking up an old Radium book they won in an auction online.

    --
    Just because you can mod me down, doesn't mean you're right. Shoes for industry!
  12. Re:Al Queda's new weapon by stilwebm · · Score: 4, Informative

    Don't fire alarms use radiological material?

    Not fire alarms, but smoke detectors. They use a small amount of Americium in smoke detectors as well as some of those nifty advanced smoke/vapor detectors you might find in data centers. Still, I see the number of cases of people carrying smoke detectors through the subways in New York as rather small.

  13. Re:United Nations -- Iraq -- Weapons Inspections by Idarubicin · · Score: 3, Informative
    ...do they have the ability to sort out the different forms and identify only those that are not naturally occuring?

    The short answer is, yes!

    Depending on the size of the sample, you can look at its spectrum of gamma radiation. Different radioisotopes emit gammas at different frequencies when they decay, providing a distinctive fingerprint.

    High resolution mass spectrometry will also do it for you. I know a chemist who has tricks for detecting femtograms (1E-15) of an element (though his mass resolution isn't very good, you could see a very tiny amount of a transuranic element like plutonium.)

    Really, all you need is to be able to quickly identify areas that are worth further investigation. If you find something that seems suspicious--even if it isn't conclusive--that tells you where to bring in the analytical big guns. Actually, that usually means a lot more cotton swabs. ;)

    --
    ~Idarubicin
  14. The dose makes the poison by toxic666 · · Score: 5, Informative

    Depends upon the type of radiation source and the detector in use. Alpha, beta and gamma radiation are different animals and emitted by radioisotopes in different amounts.

    Alpha particles are helium nucleii without electrons; beta particles are electrons; gamma radiation is electromagnetic radiation similar to X-Rays. Alpha and beta radiation are mostly stopped by inches to feet of air; gamma is more or less unaffected. Harmful doses are more complicated to assess, but basically, alpha and beta emitters are typically harmful when they get into your body and emit particles right next to cells, where they cause ionizing damage. Inserting alpha and beta emitters within a tumor is, essentially, what one form of radiotherapy does; put deadly ionizing radiation into a tumor to kill it. Radium has been an effective treatment for breast cancer (one of the first reasonably successful ones) since the 1920's.

    Gamma radiation, although it passes through many feet of air and well into tissue, is not as damaging because it is not ionizing. However, high exposures have significant impacts. Gamma will pass through metals more or less unaffected.

    The detectors are likely designed to pick up gamma radiation characteristic of enriched fissionable materials, because gamma passes through several feet of air. However, certain types of radiotheraputic isotopes (e.g. radium) also emit a heck of a lot of gamma.

    Thus, the dilema of false positives for radiotherapy patients. If you want to pick up enriched radioisotopes, you will pick up gamma from legitimate theraputic uses. We should provide radiotherapy patients with a hospital-issued ID so they do not have to suffer through security checks. It would not be much more difficult than issuing a driver's license.

  15. Hold on there turbo by Sycraft-fu · · Score: 3, Informative

    I'm guessing you probably don't know a lot about the radation treatment of the thyroid so allow me to explain:

    They give you radioactive iodine (I believe it's I-131, but I could be wrong) in a non-tribial dose. This will then accumulate in your thyroid. Now It has a pretty short half life, around 8 days, so it doesn't stay in you in a significant quantity for all that long. Also, since it accumulates in the thyroid, damage to teh rest of the body is limited.

    However, notice that I said non-trivial dose. It's enough that you are warned to limit contact with family members for a week, and enough that you can tell if someone has had it done just by pointing a Giger counter at them.

    Along the same lines, my grandma has two metal hips, and is gaurenteed to set off any metal decetor. Well she isn't stupid about it, if she knows she's going through one, she notifies the people that she has metal hips, and they can take the appropriate setps to verify her story.

  16. Re:No, it won't. by Guppy06 · · Score: 2, Informative

    "In the case of 12/7/41, there is evidence that the government knew that the attack on Pearl Harbor was coming, and did nothing to stop it because it would involve the USA in the war."

    What would have been the point in doing nothing with the information? All that could have been done with it was to improve Pearl Harbor's defenses in preparation for the attack, thus involving the US in a war. The attack would have happened regardless. And even if it didn't, there was always the issue of the actual war declaration coming in from Tokyo to deal with (the one that was supposed to be delivered to Washington minutes before attack but got delayed on the Pacific telegraph lines).

    Or are you talking about the war in Europe? Hitler himself solved that problem by also declaring war on the US.

    Hell, the new radar facilities on Oahu would have made a big difference in what happened during the attack if the operators knew how to interpret the information, which brings me back to my main point...

    At any rate, if you're going to troll with statements like that, make sure they stand up to Occam's Razor.

  17. Re:My uncle... [doing the math] by wirelessbuzzers · · Score: 3, Informative

    You do that math, that's some senstive equipment they have in the White House.

    It can't be that sensitive. Suppose they put about 20 millimoles in him (that's a lot, especially just for imaging). About 10^22 atoms (Avogadro, remember him?). After 3*7*3=63 halflives there about 2^63 /=/ 10^19 times fewer, about say a thousand (this is rounded to the nearest power of 10). If he's near the detector for about say 1 minute, that's about a 500th of a halflife so we can expect, what, one of the atoms to decay? Even if the gamma hits the detector (probably another 10,000 to 1 against), it's below the noise threshold, and they certainly can't pick him out of the crowd. Maybe if it were two weeks, or there were a less common isotope with a longer half-life mixed in, I could believe it.

    --
    I hereby place the above post in the public domain.
  18. Re:Al Queda's new weapon by tuxlove · · Score: 3, Informative

    I guess we haven't heard any stories about timex setting off the nuke detectors...so it can't be all that bad can it?

    Tritium gives off beta particles, I believe (either that or it's alpha particles). They cannot penetrate the glass or plastic face of the watch, nor the bezel. They stay within the watch, and so pose no risk. But that's somewhat irrelevant given the rarified particle count and the nature of beta particles.

    As for your gunsight, the tiny dot of tritium gives off next to no radiation, but in any case the particles only travel a few inches at most. You'd have to practically touch it to the radiation detector to set it off, if even that would do it.

    I have a Vaseline glass bead I use to test my Geiger counters with, and it has to be taken out of its paper sleeve and placed next to the detector tube to be measurable. Within a centimeter or two it puts off 20 times the normal background radiation, but 10 centimeters away you can barely tell the difference. It's the uranium in the green tint that exudes radioactive particles, but the quantity of radiation and the nature of beta particles make it effectively undetectible at any range. My guess is that your tritium sight is even less radioactive.

  19. Re:It happened to a friend of mine by Anonymous Coward · · Score: 1, Informative

    http://www.bradford.ac.uk/acad/envsci/radon_hotlin e/radonstory.htm

  20. Re:Breastmilk? by The+Tyro · · Score: 4, Informative

    yep... it's almost an urban legend, though there have evidently been two such instances... Here's a link

    Snopes.com

    --
    Even if a man chops off your hand with a sword, you still have two nice, sharp bones to stick in his eyes.
  21. Re:Al Queda's new weapon by Anonymous Coward · · Score: 3, Informative

    Camping lantern mantles contain either thorium or yttrium for a metal that aids in lighting performance and does well in heat.

    Most new mantles are yttrium and are non-radioactive, but from all accounts the older thorium mantles were superior.

    Thorium emits alpha, beta, and gamma radiation. It does this regardless of whether it is heated or not.

    On a sidenote, tritium can't be detected by a geiger counter even when bare because the radioactivity in it is that weak (you have to use a scintillation counter over time), and smoke detectors exclusively emit alpha radiation and can't be detected by a geiger counter beyond about 1 cm from the GM tube.

    I have a geiger counter I made and it's a lot of fun to play around with. A family member recieved a thyroid test using iodine-131 and I could detect the radioactivity from over two feet away.

  22. Nuclear Medicine Therapy by radon222 · · Score: 3, Informative

    Sorry folks , but this isnt Chemotherapy or Bracytherapy ... brachytherapy is irradiation with sealed sources which are inside the body . Best name for this is Nuclear Medicine Therapy. ... by the way , I am a Radiation Therapist and a Nuclear Medicine Technologist

  23. Answers to general questions... by garcia · · Score: 3, Informative

    no.

    All round trip. All booked well in advance. Beard is neatly trimmed, hair is short and combed, prescription medicine is in my name, car stereo should have been questioned at the security entrance after going through the X-ray (not at the gate), I wear clean clothes, and nothing to suggest that I am a member of any small minority faction...

    These trips were from SMALL airports to SMALL airports. Connecting flights were at large airports but generally at the large airports is where the 20% of skipping came in.

    Toledo -> Pittsburgh -> Scranton
    Minneapolis -> Philadelphia -> Scranton
    Dayton -> Charolette -> Savannah

  24. Re:It's hard to check for dirty bombs by Anonymous Coward · · Score: 1, Informative

    Actually, Alpha Radiation can be blocked by the dead layers of skin that cover your body, Beta Particles (Essentially Electrons) are stopped by a couple of sheets of paper. (i.e. you could hold an Alpha emitter in your hand and get no radiation dose from it by means of Alpha radiation.)

    If the material is in a suitcase there is no radiation outside.
    Actually all Alpha emmissions that I'm familiar with also emit Gamma's which would pass right through that briefcase of yours.

    It is correct however that Alpha emitters would be the worst if it was exploded and people inhaled it because of the highly ionizing nature of the Alpha particle.