How To Protect Yourself Before Undergoing Brachytherapy

A truly horrifying story appeared in Sunday's New York Times about a cancer unit in a veteran's hospital in Philadelphia. According to the story, one of the unit's doctors, Gary D. Kao, M.D., on numerous occasions improperly implanted radioactive seeds in patients with prostate cancer causing serious complications. Usually, during this relatively common procedure known as brachytherapy, a surgeon places radioactive seeds close to a cancerous tumor. The procedure is often done in place of or in conjunction with external beam radiation. According to an investigation by the Times and federal authorities, during brachytherapy Dr. Kao was often placing the seeds in the wrong organ then attempting to cover up his errors.

My reading of the story offered two clues for how patients seeking to undergo this procedure can protect themselves from surgeons like Dr. Kao. The story noted that there was no peer review at the V.A. hospital. All good hospitals have some kind of peer review procedure wherein physicians at the same institution look over each others' shoulders, reviewing one others' work. Bad outcomes are discussed openly and frankly with the goal of avoiding them in the future. Ask your surgeon if the hospital where your surgery is to take place has peer review procedures in place.

The other way you can protect yourself is to ask your surgeon about his or her experience performing that particular procedure. The Times article pointed out that Dr. Kao had a medical degree from an outstanding institution and was board certified in radiation oncology. However, he had "limited experience in brachytherapy."

VA patients test positive for HIV after treated with contaminated equipment

Here's a follow up to the story about Veteran's Administration patients who received treatment with contaminated endoscopic equipment. Some have tested positive for HIV.

VA patient tests positive for HIV after mistakes

Apparently, a Veterans Affairs patient undergoing a colonoscopy may have contracted HIV after unsterilized equipment was used during the procedure. I didn't think I could be surprised by medical errors, but this is shocking if it turns out to be true. How do you protect yourself against such reckless disregard for patient safety? Should you ask the physician, "Listen, before you stick that thing up my guswhatzits is it clean?" Maybe.

To read the full story click here.