Re: Strontium Therapy on In

[Kent Lambert <lambert@allegheny.edu>]

Mike,

I agree with you that this is a grey area in the regulations and in
guidance.  But, is there really any difference between the
administration of a sub 35.75 therapeutic quantity and the
administration of a diagnostic imaging agent?  Do you subscribe to
monitoring NM in-patients in a similar manner?  For example, do you
follow patients receiving Tl-201 for tumor imaging and subsequently
undergoing surgery to remove the tumor?  At my former employer we were
going crazy trying to figure out how I-125 seed(s) (in dissolvable
suture material) was ALL OVER the operating room after a permanent brain
implant.  Of course, it was thallium that had been administered earlier
in the day.  

We also modify our I-131 inpatient requirements but more so than you
do.  For example, we do not paper the room or survey upon discharge,
(although, we will reconsider it) but we do give the nurses instructions
to follow universal precautions and contact isolation procedures.  Have
you seen contamination from simple patient contact?  They are also
instructed to contact Radiation Safety if there is a "spill" (e.g.,
patient is incontinent).

I have noticed more inpatients undergoing Sr-89 therapy recently, which
makes sense to me.  A patient with terminal CA and bone pain is likely
to have other medical problems requiring hospitalization.  Have you seen
this trend, too?

Hopefully, the RSO section of HPS will be a forum for discussions of
this sort through presentation of papers in special sessions at HPS
meetings.  

Regards, 
--
Kent N. Lambert, CHP
lambert@allegheny.edu