Download sent a letter - American Society for Radiation Oncology

March 6, 2017
Mr. Donald Trump
President of the United States of America
The White House
1600 Pennsylvania Ave., NW
Washington, DC 20500
Dear Mr. President,
The American Society for Radiation Oncology (ASTRO) applauds your appointment of Kristine Svinicki as
Chairman of the Nuclear Regulatory Commission (NRC) and is pleased to recommend James Welsh, MD,
MS for Commissioner of the NRC. Dr. Welsh, has an extensive medical, scientific, and NRC background,
all important given the NRC’s responsibility to oversee the medical use of radioactive isotopes. In fact,
Dr. Welsh served on the NRC’s Advisory Committee on the Medical Use of Isotopes (ACMUI) from 20072015. We have attached Dr. Welsh’s CV and biography and appreciate your consideration.
ASTRO is the largest radiation oncology society in the world, with more than 10,000 members who
specialize in treating patients with radiation therapies. As the leading organization in radiation oncology,
biology and physics, the Society is dedicated to improving patient care through education, clinical
practice, and the advancement of science and advocacy. ASTRO’s highest priority has always been
ensuring patients receive the safest, most effective treatments. As you may know, radiation therapy
uses various forms of radiation to safely and effectively treat cancer and other diseases, such as noncancerous tumors and thyroid problems. Doctors use radiation therapy to eradicate cancer, to control
the growth of the cancer or to relieve symptoms, such as pain. It can be used to treat cancer in almost
any part of the body, although breast, lung and prostate cancers typically make up more than half of all
patients receiving radiation therapy.
Patients receive radiation therapy in one of two ways: externally or internally. During external beam
radiation, a beam of radiation is directed to the tumor and immediate surrounding area in order to
destroy the tumor and any nearby cancer cells. Internal radiation, or brachytherapy, is the placement of
radioactive sources in or next to a tumor. Medical procedures generally require physicians to have a
state license to practice medicine; the NRC requires additional extensive training requirements for
physicians who use radioactive materials, such as those used in brachytherapy and other forms of
radiation therapy. A culture of safety and quality is woven into the fabric of radiation oncology, with
checks and balances at every level to ensure that the safest and most effective care is delivered to
patients. ASTRO strives to help the NRC issue regulations that strike the appropriate, often difficult,
balance between protecting the public’s safety and facilitating the practice of medicine.
For example, one of the important issues that the NRC has been working on involves the definition of a
“medical event” for permanent implant brachytherapy. ASTRO has been working closely with NRC staff,
including participating in several public workshops and testifying before the Commission, as well as with
the ACMUI on this issue. We support a change in the definition to accurately capture only cases that
might cause serious injury or harm to the patient. The Commission received a final rule containing a
revised definition in June 2016 for their consideration. ASTRO supports this revised definition, which we
believe strikes an important balance between ensuring safety and supporting continued use of costeffective brachytherapy. We hope the NRC will swiftly approve this final rule, without which many
medically acceptable implants will continue being inappropriately considered medical events, thereby
discouraging physicians from offering this essential treatment.
The Nuclear Regulatory Commission has a strong track record and is uniquely situated to maintain safety
and security for all domestic radioisotope users, including those used in radiation treatments. Further, it
is the only agency within the federal government required to measure both the risks and the benefits of
radioactive isotopes through the licensing process.
The NRC oversees approximately 100 licensed nuclear power plants, and approximately 7,000 medical
licensees between the NRC and Agreement States, and while NRC commissioners are well served by the
staff, experts on the ACMUI, and input provided by the medical community, we believe the NRC would
greatly benefit by having a medical expert on the Commission.
We appreciate your consideration of this request, and we look forward to continuing working with the
Administration and the NRC. If you would like to meet with us to discuss these issues, or if you have any
questions, please contact Cindy Tomlinson, ASTRO’s senior patient safety and regulatory affairs manager
at [email protected] or 703.839.7366.
Sincerely,
Laura I. Thevenot
Chief Executive Officer
CC:
Johnny DeStefano, Director of White House Personnel
Jeremy Katz, Deputy Assistant to the President and Deputy Director of the National Economic
Council
Senator John Barrasso, Chair, Senate Committee on Environment and Public Works
Senator Tom Carper, Ranking Member, Senate Committee on Environment and Public Works
Attachments:
James Welsh, MD, MS biography and CV