SOURCE: RoboticOncology.com

prostate cancer - www.RoboticOncology.com

February 17, 2010 14:12 ET

Robotic Surgery Expert Dr. David Samadi, MD Discusses New York Times Article on the Dangers of Radiation Therapy for Prostate Cancer Treatment

NEW YORK, NY--(Marketwire - February 17, 2010) - In a recent New York Times article, it was reported that radiation therapy, to treat various forms of cancer, including prostate cancer, is on the rise, and so are the risks. Flaws in software or programming coupled with insufficient safety procedures and training are resulting in devastating, and sometimes, fatal mistakes. Unfortunately, many patients are often unaware of these hazardous risks, according to the Times analysis.

Robotic prostatectomy expert, Dr. David Samadi, Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center in New York City, has longed believed that technology can only do so much. "We need a better system of checks and balances, and certainly more training and experience when it comes to radiation treatments," said Samadi.

The NY Times article (January 27, 2010, The Radiation Boom: As Technology Surges, Radiation Safeguards Lag, by Walt Bogdanich) brought to light many sobering realities behind radiation treatments:

-- There is no single governing body to manage radiation treatment errors.
   Radiotherapy accidents are under-reported, if they are reported at all,
   with little or no follow-up on problematic cases. New technology has
   created more chances for error in software and operation, which are
   difficult to detect.
-- Medical regulations cannot keep up with technological advancements.
   Manufacturers often sell the technology with a brief governmental review
   before all of the kinks have been caught and eliminated.
-- There is a significant lack of financial support to operate these
   machines properly.
-- Lack of training and oversight of medical physicists and radiation
   therapists result in over-radiations that are not detected by device
   operators.
-- Errors integrated into a radiation treatment plan can be repeated in
   multiple sessions.
-- Sixteen states, including the District of Columbia, do not require
   licensing or registration of these machines. Eight states allow
   operators to run these machines without credentials or educational
   requirements of any kind.
-- In some hospitals, there were no formal follow-up procedures for
   patients to ascertain the success, failure or complications associated
   with radiation cancer treatments.
-- There are also no internals checks such as quality assurance meetings,
   peer reviews, mortality and morbidity outcome studies, where doctors
   review cases.

Dr. Samadi feels that hospitals are too quick to trust new technology, overlooking the human factor behind the technology. In his practice as a robotic surgery and prostatectomy expert, Samadi utilizes the da Vinci robot to remove cancerous prostate glands. However, Samadi has long acknowledged that "it is not the robot that performs the surgery, it's the surgeon." He believes volume in practice and experience of the surgeon, or, in this case, the technician, is paramount to the machine. Radiation therapists have to ensure optimal radiation dosages; correct administration of prescribed treatments; proper machine set-up; daily warm-up checks and comprehensive monthly and annual evaluations.

"Hospitals will often forego quality assurance because in some states it is voluntary," said Dr. Samadi. In his practice at Mount Sinai, a renowned center of excellence, patient follow-up is mandatory. Samadi routinely conducts extensive pre-operative and post-operative interviews to ensure satisfactory treatment did what it was supposed to do. "Education, experience and technology are not things that you can skimp on," said Samadi. "As medical practitioners, we are obligated to deliver a cure and a quality of life, and we usually only get one chance to deliver on that. The machines only do what we tell them to do, so we need to go whatever distance that we must to ensure quality care."

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