Answer to Question #4287 Submitted to "Ask the Experts"

My husband had radiation seeds implanted in his left groin as part of a treatment for cancer. We have a two-year-old child and are concerned about her safety. His doctors have told us that it would be safe for him to hold her as long as he held her by his right shoulder. But they have said that time on his lap (or the immediate area of the seeds) should be limited to four mintues a day for the next 60 days. Does this make sense?

Also one of the doctors said that it would be possible to have a sort of protective shield to cover his groin so that we wouldn't need to limit the time. But when we asked about the shield they looked at us like we are crazy. Does any of this make sense? What can we do to protect our daughter and the rest of our loved ones?

Also they are saying that this is the best they can do for recommendations because they have never had this situation before. We are concerned that they are being under or over cautious.

Your question did not include the radionuclide contained in the seeds; however, we will assume the radionuclide to be either ¹²⁵I or possibly ¹⁰³Pd, the two most common radionuclides used. Because the instructions provided mentioned 60 days, it is most probable that the radionuclide is ¹²⁵I. Both of these radionuclides emit relatively low-energy radiation; however, not all of the radiation is "trapped" within the patient's body and some radiation exposure will be measurable at the surface and at short distances from the surface. For this reason, it is usually recommended that the person not hold young children or babies on top of the area where the seeds are located for long periods of time. 

Because of the low energy of the radiation emission, it is possible to use a shield to limit or remove the presence of radiation. In the case of ¹²⁵I, a shield containing the amount of lead used to shield for diagnostic x rays should be sufficient. You can find these shields in x-ray supply catalogues. There are shields available that shield only the abdomen, sometimes called "half-aprons" and these should be sufficient to remove the radiation emitted. You can, of course, search on the Internet. To get you started, you might want to check out the following URLs:

Penn-Jersey X-Ray website
American X-Ray Corp website

You will find many more vendors on an Internet search. 

Finally, we suggest that you may wish to look at the following reference where we looked at instructions given to patients implanted with radioactive seeds and assessed their value. You should be able to find this journal in a medical library.

Dauer L, Zelefsky M, Horan CL, Yamada Y, St. Germain J. Assessment of radiation safety instructions to patients based on measured dose rates following prostate brachytherapy. American Brachytherapy Society, 8-10 May 2003, New York, NY; Brachytherapy 3(1):1-6; 2004.

Jean St. Germain, CHP