Answer to Question #11311 Submitted to "Ask the Experts"

Category: Medical and Dental Patient Issues — Therapy - Radiation Oncology

The following question was answered by an expert in the appropriate field:

Q

In 1952, 11 radon seeds were implanted in my lower lip to remove a birthmark. I was six weeks old. Now I am facing esophageal cancer and wonder if any links have been found between the two.

A

I am very sorry to learn of your esophageal cancer and hope your treatment is progressing successfully. Although radiation at sufficiently high doses is a cause of esophageal cancer, the major players are tobacco use, alcohol use, and having Barrett's esophagus (gastric reflux disease). Increasing age is also a risk factor.

Gold seeds filled with radon were used to treat birthmarks (hemangiomas) such as yours from about the 1930s through about 1958. The gold seed prevented particles from the decay of radon to escape so that it was the gamma radiation that provided the dose to the tissues, including your lip and tissues close by.

With radiation "the poison is in the dose" but even at high doses radiation is not very effective in producing cancer. One reason is because it is such a good killer of cells (and this is why it is used to treat various malignant and nonmalignant conditions). Because the amount of radiation delivered to tissue decreases rapidly with distance from the source (radon seeds), the dose to the esophagus would accordingly be much lower than the dose to your lip. So while it is conceivable that radiation treatments might have played a role, it seems only a remote possibility, especially if you have any of the other known risk factors for esophageal cancer.  

Best of luck with your treatments.

John Boice, Jr., ScD
Professor of Medicine (Epidemiology)

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