February 1999

Radium was first used as a medical therapy in 1904. It was used internally and externally to treat a variety of diseases and conditions -- from cancer to goiters to scalp ringworm. During the 1920s, a new technique was developed using radium to treat hearing loss in children caused by repeated ear infections (otitis media). This technique was called nasophayrngeal radium therapy.

What was nasopharyngeal radium therapy, who received it and what was its goal?

A radium-tipped rod was inserted in the nose and left for several minutes. Often, several treatments were provided in a series, each two to three weeks apart. The therapy also was used to treat sinusitis, tonsilitis, asthma, bronchitis, and repeated viral and bacterial infections. Because it was effective in treating otitis media, military physicians used it to treat aerotitis media in submariners, aviators and divers. Aerotitis media is hearing loss caused by swollen tissue in the throat combined with rapid pressure changes in the middle ear. The treatment was used to shrink tissue in the throat and prevent ear damage from pressure changes. An estimated 500,000 to two million civilians, mostly children, received these treatments. It is estimated that between 8,000 and 20,000 military personnel received them during World War II and until about 1960.

What were the advantages of the treatment?

It was used on tissues unsuitable for surgery, only local anesthesia was required, and it could be performed in a physician's office. The treatment also was believed to be safer than conventional X-ray treatment.

Why was it discontinued?

Pressurized aircraft cabins and new treatments, such as better antibiotics, as well as concerns about radiation safety resulted in its discontinuation.

Nasopharyngeal Radium Therapy -- Page 2

Have nasopharyngeal radium treatments been shown to have harmful effects?

Several studies of the possible harmful effects of the treatment have been published. One study found an increased risk of head and neck cancer in people who were treated when they were children. Another study, also mostly of individuals treated as children, did not find any statistically significant increase in head and neck cancers. It is well known that children are more sensitive to the effects of radiation than adults. It is uncertain whether there are any health risks when adults are treated with nasopharyngeal radium. More research is being done, but it will take several years for answers from that research.

Are there any recommended actions?

A workshop of experts was held at Yale University in 1995 to help figure out what needed to be done for people who had received these treatments. The experts concluded that no special action should be recommended. They agreed that there are no screening tests for people who did not have symptoms of head or neck problems. However, physicians may want to consider conducting thorough head and neck examinations of patients with a history of these treatments. In addition, physicians who treat patients born before 1960 who have head and neck complaints should ask them if they have ever had these treatments or other head and neck radiation.

What should veterans do?

Veterans who remember being treated or think they were treated with nasopharyngeal radium should tell their physicians about it. Veterans who have health problems they think may be related to nasopharyngeal radium also are encouraged to contact the nearest VA medical center.

Public Law 105-368 enacted in November 1998 authorizes examinations and treatment of head and neck cancers for veterans who received nasopharyngeal radium treatments during active military, naval, or air service. For veterans not otherwise enrolled in VA health care, documentation of nasopharyngeal radium treatment in service records may be required to be eligible for these services. Veterans who are enrolled in VA health care receive medically indicated diagnostic and treatment services without any need to document exposures.

Information on filing a claim for disability compensation may be obtained by calling the nearest VA regional office at 1-800-827-1000. For questions on nasopharyngeal radium therapy, veterans may call VA's Public Health and Environmental Hazards Office at 1-202-273-8578. Questions on enrolling for VA health care may be directed to VA toll-free at 1-877-222-8387.

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