Over Radiating Patients
On December 21, 2010, Ricardo McKenzie, popular bar co-owner of Smokey and Bunty in St James died at Jackson Memorial Hospital in Florida, USA, following treatment for a brain tumour. His widow Lisa McKenzie claimed he was diagnosed by his doctors at Jackson Memorial with “radiation necrosis” in the head, which is “the death of tissue due to possible over-radiation” and confirmed that Mckenzie was treated at the Brian Lara Cancer Treatment Centre in Trinidad during the period the centre’s radiation machine was reportedly over-radiating patients. On July 6, 2011, Health Minister Dr Fuad Khan announced the findings of an investigation launched by the Pan American Health Organisation (Paho) which revealed that 223 patients treated for cancer at the Brian Lara Cancer Treatment Centre (BLCTC) were exposed to overdoses of radiation, between four and 20 per cent, over a one-year period due to a miscalibrated radiation treatment machine.
At the time, Dr Khan urged patients exposed to the machine between 2009 to 2010 to contact the centre to “get whatever checks needed to determine whether or not there was any over-exposure or any mal-affects from that radiation.” The Chief Medical Officer Dr Anton Cumberbatch warned that when patients “get exposed to radiation, the monitoring extends from a period of three to five years” since it is “possible that for the immediate first six months or year, there may not be any symptoms at all.” A senior official at the BLCTC, however, maintains that “over-radiation only went up to 11 per cent at most, was never at a dangerous point and not even close to “misadministration” which is defined as 20 per cent “over-radiation” adding that the BLCTC is “open,” and has “no problem” with the upcoming Ministry of Health investigation.”
The centre’s clinical director, radiation oncologist Dr Peter Bovell, has insisted that “no patient at the Brian Lara Cancer Treatment Centre has shown effects of over radiation.”
I spoke to an independent oncologist who agreed with BLCTC officials saying between ten to 20 per cent over-radiation fell under “a grey area” and did not technically qualify as misadministration. However, he cautioned that as radiation levels rose so did the risk of side effects: “For every bit more, even though we may say there is acceptability the patients risk increases.” Even as the Minister of Health prepares to launch an investigation into BLCTC to determine whether disputed over-radiation was at 11, 14, or up to 20 per cent as Paho reports—which will either establish culpability or clear the BLCTC (and hopefully, out of it, establish an authority or legislation to govern the use and administration of radiation devices)—patients themselves are beginning to feel left out of the equation.
A patient’s story
This is the story of one patient who was treated for cancer during the time BLCTC’s radiation machine was reportedly over-radiating patients:
“I am a very active middle-aged woman. In ’09 my annual mammogram showed signs of a small tumour which was removed. In November, 2010, after being diagnosed with DCIS, the beginnings of cancer which only mammograms can detect, I was advised by the doctor to get radiation. I made an appointment with the BLCTC before the treatment. The leaflet they gave me on the long-term possible side effects was frightening, including inflammation of heart and oesophagus, difficulty when swallowing, lymphedema—which damages the lymph nodes (located in clusters in the neck, armpits and groin) and causes swelling of an arm or leg, and secondary cancer. I was terrified, especially of the damage to my heart as I would be radiated on my left breast. I told the doctor: ‘I don’t want to do this. It could kill me.’
“The BLCTC gave me a good sales pitch, assuring me it’s absolutely safe, with state-of-the-art equipment that was equal or better to anything abroad. I was reassured. I had to pay $120,000—half before they would start treatment and the other half during it. During the treatment I did not have serious side effects apart from extreme fatigue. “At the centre I made a friend, Susan (not her real name) a beautiful, courageous 31-year-old woman with breast cancer. The radiated area on her chest where her breast was removed was red and the skin peeling, but she was always smiling. She was sure she was going to beat it. She was always saying, ‘I feel so grateful for being alive, I feel blessed.’ We kept in touch. “Then suddenly last year, I got no response from her cellphone. So I called the BLCTC and said: ‘I just wanted to know how Susan is.’
“They said she was ‘fine.’ I thought, I’m fine, she’s fine. We made it. “Finally, her sister answered her cell and Susan was dead. She had been treated for breast cancer and developed a spot on her lung which her sister says ‘puzzled’ doctors... and died of lung cancer. She spent her life’s savings in the Brian Lara Cancer Centre and died in a public facility. “After Dr Fuad Khan alerted the public I called Susan’s sister again. No one from the centre called Susan’s family to say she had been over-radiated. She suffered and died penniless and no one reached out to her or her parents who want answers but are too broke, old, tired and still grieving for their daughter, to ask questions. “The first I heard of the over-radiation was when the Minister of Health came on TV and said 223 cancer patients had been exposed to over-radiation and that anyone treated between December 2008 to June 2010 should get in contact with the centre. Mine was in February, 2010, so I fell within that time frame.
“What made me really angry was in November, 2010, when I went in for my annual check-up the centre definitely knew of radiation overdose according to Dr Anesa Ahamad, who first blew the whistle on the BLCTC, but no one told me that I was a victim of that. “No one from the BLCTC called me. I rang the BLCTC on the advice of the Minister, wanting to know what mechanisms were put in place for over-radiated patients. They gave me an appointment. When I got there I met several other patients looking for answers. We had to wait up ’till three hours since we were informed that doctors were in a meeting. We were clearly not their priority. “I asked the doctor: ‘How much was I over-radiated?’ He said: ‘Not a lot’ and that I had no ‘visible signs of over-radiation.’ He didn’t tell me my radiation prescription or the extent of my overdose. I asked him what was happening with my lungs, my heart, and who would pay for my further investigations for five years.
“While I was waiting, I had spoken to two people who had developed lung cancer following the radiation, one who suffered a stroke and another woman whose father died of cardiac arrest. I knew of five people who had died while I was there. I was worried about future complications especially as I was radiated in my left breast near the heart. The doctor said only this visit was free. He said I would have had to do follow-ups anyway, and for that I would have to pay as usual. “I am left wondering, worried and confused, suffering from fatigue, weakness in my arm where I was radiated... and hair loss. Who do I I am a pensioner and I already trust? Who do I turn to? Where do I go from here? spent $120,000. Most of us spent our life’s savings on trying to fight cancer. UK Prof Karol Sikora, the world renowned UK-based oncologist clearly said that a 14 per cent overdose could result in significant long-term side effects which may take several years to manifest. Did I get more, or less than that? Am I going to drop dead of cardiac arrest three years hence? I don’t know and no one can tell me. I need a mammogram, chest xray, and am worried about my heart. I have to see a specialist. Who will pay for this?
“I don’t know if anything can be done, if they’ve damaged my heart. Nobody knows. We, the patients are broke, and worn out. All 223 of us (or less as some have died) have this cloud hanging over us for the next five years I want to believe that we will in addition to dealing with a cancer diagnosis. have no side effects from the over-radiation, but the Brian Lara Cancer Treatment Centre should take responsibility for all over-radiated patients and give us free monitoring for the next five years because they over-radiated us, or monetary compensation for those who don’t wish to go back there so we don’t die penniless and forgotten like Susan. ”