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The Douglass Report February 2010

February 2010 PDF

Avoid the common medical test that can send your cancer risk skyrocketing

If something had the potential to cause cancer in one in every 80 people who were exposed to it, you’d think doctors would warn their patients to stay away. Instead, doctors themselves routinely expose their patients to this carcinogen—ironically, often in an attempt to diagnose cancer.

According to a recent study published in the Archives of Internal Medicine…

14,500 people could die every year as a direct result of following doctor’s orders

The danger comes from the massive amounts of radiation caused by computed tomographic scans, or CT scans. (You’ve probably also heard them called CAT scans.)

A few years ago, the New England Journal of Medicine published a study showing that CT scans cause cancer in one out of every 1,000 patients, leading most docs to believe that the benefits outweighed the risk. But this latest study shows that as many as one in 80 patients who get CT scans could develop cancer as a direct result.

The study found that the dose of radiation used in a test of the heart and blood vessels (called a coronary angiography) will cause 1 in 270 women and 1 in 600 men to develop cancer. The dose of radiation used in a head scan will cause 1 in 8,100 women and 1 in 11,080 men to develop cancer.

Women and young people are especially vulnerable to the radiation. The study showed that 20-year-olds who receive a CT scan have double the risk of developing cancer.

To make matters worse, doctors order somewhere in the neighborhood of 62 million CT scans per year. They don’t even bother keeping track of how many scans a patient has had—which means they have no idea how much radiation someone has been exposed to.

Well, let me clue them in. A study from Harvard University’s Brigham and Women’s Hospital found that 4 percent of patients have been exposed to 2,500 X-ray’s worth of radiation. And with CT scans, that’s not tough to do, since every CT scan delivers the amount of radiation equal to 50 to 250 X-rays.

Of course, that’s from just ONE scan. Many patients get multiple scans. The researchers found that…

– 1 in 3 patients had five or more scans,

– 1 in 20 patients had 22 or more scans, and

– 1 percent of patients had more than 38 scans!

Doctors shouldn’t order these tests unless there’s no other option. Instead, practically everyone who enters an emergency room complaining of a stomachache or a headache gets one of these tests. Doctors use them for everything from lung cancer tests, to virtual colonoscopies, to whole body scans—and in most cases, there are other testing options that don’t involve exposing patients to massive doses of radiation.

According to David J. Brenner, director of the Columbia University Radiological Research Accelerator Facility, at least one third of all CT scans are completely unnecessary. That’s 20 million unnecessary tests per year.

“There are several experiences in the past where radiation was used and we thought it was fine at the time, and then down the road the legacy of these treatments becomes apparent,” said Eric J. Hall, director of the Center for Radiological Research at Columbia University College of Physicians and Surgeons. “So we are very concerned about the built-up public health risk over a long period of time.”

And they should be. Since the cancer can take between 20 and 50 years to develop, most people who develop cancer as a result of this radiation exposure will never know the true cause.

I’m not suggesting the medical community should do away with CT scans, but ordering one should not be a knee-jerk reaction. Other tests, like MRIs or sonograms, can often get the job done. If you have no other choice than to get a CT scan, at the very least, make sure the technician uses the minimum radiation needed.

Or—and here’s a novel idea—maybe doctors could rely less on high-tech tests and more on hands-on bedside skills. I know the idea sounds simplistic and archaic. Why would you rely on a human when a machine can do all the work for you?

Here’s why. A study published in the Journal of Neurosurgery found that…

A simple bedside exam could be far superior to a CT scan

It’s routine for doctors to order CT scans after brain surgery to determine if there are any complications. But after reviewing the records of 251 patients, the researchers found that zero percent of the tests predicted which patients needed further surgery and which ones didn’t.

However, when the doctors took the time to conduct a simple bedside exam, 30 percent of the patients who the doctors determined had serious problems ended up needing more surgery.

Imagine that. Taking the time to examine the patient, ask questions, and perform hands-on bedside exams could reduce the need for a costly, cancer-causing test that might not even work to begin with.

The hardest thing about this scenario is getting the doctor to find time in his busy schedule to give the patients the one-on-one attention they need and deserve.

The senior author, Dr. Thomas Origitano, said, “Scanning technology is really good, but applying it without a physician’s input is not necessarily helpful.”

You’ve got that right. No matter how advanced technology becomes, nothing can ever replace a skilled physician who takes to time to listen, examine, and evaluate.

Here’s what to do:

If you’re faced with getting a CT scan, there are a few things you should consider before willingly exposing yourself to the radiation:

1). Ask your doctor if the scan is absolutely necessary. Find out what information he hopes to discover from the test—or if he could make a diagnosis without it. And always get a second opinion.

2). Find out if there is a better alternative. If your doctor determines that you do need some form of testing, ask if less-harmful tests—such as an MRI or an ultrasound—could get the job done.

3). If your doctor insists you need to get a CT scan, talk to him about the dose of radiation being used. In one hospital alone, the researchers found that there was a 13-fold difference in the dose of radiation given by different machines. Since there are no standard procedures, you really never know what you’re going to get—and many people are exposed to far more than necessary.

4). Don’t ever get a CT scan as part of a routine checkup “just in case.” The risks do not outweigh the benefits.

5). Keep a record of how many scans you’ve received. Regardless of these studies, doctors continue to prescribe CT scans willy-nilly, and you’re the only one who is going to be concerned about over-exposure to radiation.

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