Nasopharyngeal Radium Irradiation
Li Liu, MD
Last Modified: November 1, 2001
Could you please provide me with any information about a now discredited form of medical "treatment" called nasopharyngeal radium irradiation?
Li Liu, MD, OncoLink editorial assistant, responds:
Thank you for your interest and question.
The nasopharyngeal (NP) radium applicator was developed in the 1940s (Otolaryngology - Head & Neck Surgery. 115(5):388-90, 1996 Nov) to treat hearing loss, chronic otitis, and other conditions in children as well as aerotitis media in submariners and aviators in the military (Otolaryngology - Head & Neck Surgery. 115(5):391-4, 1996 Nov). The goal of this approach was to reduce swelling of enlarged lymphoid tissue, which was believed to be a cause of both hearing loss and aerotitis media. Treatment usually included insertion of an applicator with a capsule of radium through each nostril and placement of the radium near the eustachian tube opening for 8-12 minutes. From 1940 through the mid-1960s, it is estimated that between 500, 000 and 2 million persons may have received NP radium treatments.
Based on a cohort study in Maryland of 904 exposed and 2021 unexposed persons during 1943-1960, there was no increased overall cancer risk detected (Journal of the National Cancer Institute. 68(1):3-8, 1982 Jan).
A workshop entitled "Public Health Response to Nasopharyngeal Radium Irradiation" was convened in New Haven, Connecticut in September of 1995 to address issues regarding possible adverse health effects of this former medical treatment (Otolaryngology - Head & Neck Surgery. 115(5):387, 1996 Nov). They encouraged Center of Disease Control and Prevention (CDC) and the U.S. Department of Veterans Affairs (VA) to collaborate on the following public health activities:
- Continue the follow-up studies of existing cohorts.
- Veterans who received NP radium treatments should be provided access to the Ionizing Radiation Registry maintained by the VA and to priority medical care at VA medical facilities.
- Rather than screening asymptomatic persons, physicians should be educated about how to obtain more complete and accurate histories from patients who received NP radium treatments. Subspecialists should be provided specific information about NP radium exposure.
The CDC encourages physicians to perform thorough head and neck examinations of patients with a history of NP radium treatments. In addition, physicians who provide care for patients aged > or = 35 years with head and neck complaints should ask the patient whether they have a history of NP radium treatments or other head and neck radiation. Persons who recall being treated or believe they were treated with NP radium should inform their physicians of the exposure.