Are We Giving Ourselves Cancer?

Here's a horrifying fact.  We're giving ourselves cancer.  Or so says a New York Times op-ed.

Rita F. Redberg and Rebecca Smith-Bindman write that all the CT scans and MRI's and PET scans and full-body imaging we get for just about anything medical are assaulting our bodies with radiation, which, as we all know, can cause cancer.  (I had 6 1/2 weeks of radiation for breast cancer and I think about that all the time.)

"The use of medical imaging with high-dose radiation — CT scans in particular — has soared in the last 20 years," according to the writers. "Our resulting exposure to medical radiation has increased more than sixfold between the 1980s and 2006. . . The radiation doses of CT 
scans. . . are 100 to 1,000 times higher than conventional X-rays."

They give credit to the technologies for early diagnosis (which, I suppose, I certainly should be grateful for), but note "there is distressingly little evidence of better health outcomes associated with the current high rate of scans."

There is, however, evidence of its harms.

They quote tests done on children, explaining that a single CT scan "exposes a patient to the amount of radiation that epidemiologic evidence shows can be cancer-causing."  In the study, children exposed to multiple CT scans were found to be three times more likely to develop leukemia and brain cancer.

In a 2011 report sponsored by Susan G. Komen, Redberg and Smith-Bindman report, "The Institute of Medicine concluded that radiation from medical imaging, and hormone therapy, the use of which has substantially declined in the last decade, were the leading environmental causes of breast cancer, and advised that women reduce their exposure to unnecessary CT scans. "

With my recent broken wrist, I've had over 20 x-rays.  The technician at one point said to get my head out of the field of radiation.  I laughed, and told him I'd had almost two months of radiation so my brain was probably fried anyway.  He didn't laugh. Neither did I. 

Why are we having so many CT scans and MRIs now?  Liability, I guess, is the main reason. What doctor, or dentist, for that matter (my husband obsesses over malpractice all the time), doesn't worry about being sued?  My former oncologist lost a suit where he misdiagnosed a woman's cancer, she died, and he wound up coughing up over $2 million.  (He also missed my second cancer.)

The writers put it down to multiple factors, "including a desire for early diagnoses, higher quality imaging technology, direct-to-consumer advertising and the financial interests of doctors and imaging centers. CT scanners cost millions of dollars; having made that investment, purchasers are strongly incentivized to use them."

Redberg and Smith-Bindman have a scary prognosis for the future. "The National Cancer Institute estimates that CT scans conducted in 2007 will cause a projected 29,000 excess cancer cases and 14,500 excess deaths over the lifetime of those exposed. Given the many scans performed over the last several years, a reasonable estimate of excess lifetime cancers would be in the hundreds of thousands. According to our calculations, unless we change our current practices, 3 percent to 5 percent of all future cancers may result from exposure to medical imaging."

Even worse, many patients are given far more radiation from these scans than warranted,

The answer?  Better monitoring and guidelines would help, say the writers, along with avoiding unnecessary scans and minimizing the radiation from appropriate ones. 

They add, "Patients have a part to play as well. Consumers can go to the Choosing Wisely website to learn about the most commonly overused tests. Before agreeing to a CT scan, they should ask: Will it lead to a better treatment and outcome? Would they get that therapy without the test? Are there alternatives that don’t involve radiation, like ultrasound or M.R.I.? When a CT scan is necessary, how can radiation exposure be minimized?"

No one wants cancer.  And no one especially wants to develop it from treatment or diagnosis of the disease.  But if we make sure we follow some of these suggestions, maybe we can avoid some of these potentially deadly side effects.


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