AP National Wire Story, April 17, 1999

WASHINGTON (AP) Steve Culpepper had already endured blinding headaches, double vision, brain surgery and the violent nausea of chemotherapy before a doctor connected his cancer to the nasal radium treatments he received as a boy.

Culpepper, who'd been plagued by childhood ear infections, remembered the radium small amounts of the radioactive material had been inserted through the nose and used to shrink surrounding tissues.

But it never worried the successful businessman, who rarely got so much as a cold. He hadn't had a physical in years, much less a consultation about an obscure Cold War-era medical procedure.

''If someone had said, 'Anyone having these treatments in the '50s or '60s ought to immediately go see an ENT (ear, nose and throat) doctor,' he would have gone,'' said Culpepper's widow, Patti, of Newport Beach, Calif. ''I know he would have gone.''

Mrs. Culpepper, like others, now believes the federal government should warn people who had nasal radium treatments many for childhood colds, ear infections and adenoid and sinus problems that they could be at risk for nasopharyngeal cancer or other diseases.

Many submariners working out of the docks at New London, Conn., also received the treatments.

Notification, advocates say, could save lives by prompting people to get a check-up or at least discuss the matter with a doctor.

But the federal government maintains there's no need for screening or notification.

''Current studies do not indicate substantial increases in risks ... among those who received NP (nasopharyngeal) radium treatments,'' the U.S. Centers for Disease Control and Prevention said in the March 29, 1996, edition of its weekly morbidity and mortality report.

The agency said diagnostic tests are unnecessary for anyone who doesn't show symptoms of a problem.

That stance has angered activists such as Stewart Farber, a Rhode Island public health scientist who has spent years researching the radium issue. He maintains that CDC is ignoring important evidence of radium's health risks.

''It's severely impeachable science,'' said Farber. ''They're doing a great disservice to the population at risk and not meeting any of their responsibilities.''

By the CDC's own estimate, as many as 2 million people mostly children and members of the military were treated with nasal radium in the 1940s, 1950s and 1960s.

Typically, about 50 milligrams of radium was placed against the opening of the eustachian tubes for six to 12 minutes to shrink tissues. The eustachian tubes help the ear to drain and balance pressure on the inner and outer ear.

Decades later, radium patients have complained of tumors, thyroid and immune disorders, brittle teeth and reproductive problems.

The government has taken some steps to help veterans. Last year, Congress required the U.S. Department of Veterans Affairs to provide health care to veterans with head or neck cancer who had radium.

But little has been done for civilians, who were treated in clinics, doctor's offices and on military bases.

In Connecticut, for example, children and submariners were treated by the late Dr. Henry Haines in New London. One old log kept by Haines recorded the names of 1,000 men.

CDC has cited various studies in support of its stance, two of which deal specifically with nasal radium. One 1982 study of hundreds of Maryland children who had nasal radium from 1943-60 found four cancers three of the brain and one of the soft palate in the treated group, compared with no cancers in untreated children.

Dr. Anne Mellinger-Birdsong of CDC's National Center for Environmental Health said those findings were too small to draw broad conclusions. Also, a 1989 Dutch study found no significant increase in cancer deaths from nasal radium. She said CDC would review the results of two follow-up studies, one of which is completed.

''If necessary, we're going to revise our recommendations,'' she said.

Farber points out that the Maryland study also found that children who had nasal radium were more than 8 times more likely than untreated children to get thyroid disease. He also says the National Academy of Sciences calculated that treated children were more than five times as likely to die of brain cancer.

Also, a 1996 follow-up of the Dutch study showed that children who had radium at lower doses than in the United States had twice as many cancer incidents as unexposed children. And one of the follow-ups pending CDC review found that children who had radium were 31 times as likely to develop a brain tumor than untreated children, Farber said.

Dr. Mellinger-Birdsong said the thyroid findings were suggestive but not conclusive. The 1996 Dutch findings were disregarded because they covered a wide range of cancers that could have had other causes.

CDC's approach hasn't been completely hands-off.

In an advisory reprinted in the Journal of the American Medical Association, it suggested that doctors consider head and neck examinations for patients with a history of nasal radium. It also recommended that doctors ask patients over 35 with head and neck complaints about past irradiation.

CDC urged patients who had nasal radium to tell their doctors, and posted information about the treatment on the Internet.

But what of those who don't remember?

Dr. Mellinger-Birdsong said most people will probably recall such an uncomforable treatment and are free to get a physical if they're concerned.

If they don't remember, ''we don't feel it would be that harmful,'' she said.

Steve Culpepper would disagree.

After 16 months of harrowing cancer treatments, Culpepper died in January. Before he died, he told his family that he was glad that his mother wasn't around to see him suffer.

''He said, 'Thank God my mother died,''' Mrs. Culpepper said, ''so she wouldn't have felt the guilt for taking him for those radium treatments.''

Farber's Radium Experiment Assessment Project, a project of the nonprofit Center for Atomic Radiation Studies Inc., can be reached at radproject ''at'' aol.com.

AP-ES-04-17-99 1253