"I don't think the risk from inadvertently cremating a body that might contain small levels of radiation is large. I think the risk is small," said Nelson, adding, "but what we're trying to do is reduce even those small levels of exposure as much as we possibly can. I think we have an onus in the community to try to do that."

The case involved a 69-year-old man who had been given intravenous lutetium Lu 177 dotatate for a pancreatic neuroendocrine tumor and then was admitted the next day to a different hospital for hypotension. He died from the pancreatic disease two days later and was cremated five days after his radiation treatment.

When Nelson and the patient's treating doctors found out – almost a month later – they alerted the crematorium and the Arizona Bureau of Radiation Control. A subsequent investigation of the facility's oven, vacuum filter, and bone crusher found “very low” levels of Lu 177. But the crematorium operator's urine was found to have levels of technetium Tc 99m, which Nelson thinks may have come from another cremated body.

"The question that this raises is, how frequently is this occurring?." Nelson noted to the Arizona paper, advising that, "when we look at exposure to members of the general public who don't know they are being exposed, that's another level of concern."

In some states, he said, procedures are different. In Florida, for example, the remains of patients who have had radiation treatments must either have the organs removed or the bodies stored until radioactive decay has cut the risks to acceptable levels.

"Just this morning I was in contact with the funeral home director where this occurred and in his industry this is getting a lot of notoriety," Nelson told the paper. "We want that discussion to happen. That was partially the reason we published this."

While present guidelines provide for safe handling of radioactive materials, in October, 2018, the EPA raised some alarm bells when it suggested questioning these current, decades-old guides that hold that any exposure to radiation places individuals at greater risk of developing cancer in their lifetime.

“The American Society of Radiologic Technologists is committed to optimal patient care that includes a focus on protection from unnecessary medical radiation,” Greg Morrison, ASRT associate executive director, told HCB News at the time. “We strongly oppose any measure that would weaken radiation protection measures for patients, radiologic technologists and all other healthcare workers.”

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