To CT or Not to CT: The Potential Relationship Between CT Scans and Cancer
We’ve all been conditioned to believe that advanced imaging technologies such as Computer Axial Tomography (CAT Scan — aka CT Scan, X-ray CT, PET SCAN, etc) which have been around since the 1970’s, are safe. But is this true? And if not, where is the tipping point — the point where the doctor / patient relationship moves from using a necessary and even vital tool to diagnose, to something merely geared toward protecting a doctor against liability? Or worse yet, simply another profit center (HERE and HERE)?
We’ve known for decades that ionizing radiation such as that used in X-rays can damage cellular DNA. Furthermore, DNA MUTATIONS lead not to new species as many biologists would tell us, they lead to CANCER. The problem with all of this is that few of us are aware of the extent to which cancer is directly related to CT scans and the mega-dosing of radiation which is inherent with the technology. And although it;s just starting to make its way into the mainstream media, none of this is new information.
The June 27, 2008 issue of Time Magazine said this about the situation, “A CT scan packs a mega-dose of radiation — as much as 500 times that of a conventional X-ray“. Worse yet, the June 18, 2013 issue of Scientific American upped that by saying a single CT can blast an individual with as much as, “1,100 times the radiation of a conventional x-ray“. Just check out some of the ‘fun-facts’ that that these authors pulled from the peer-reviewed research and governmental agencies.
“The use of medical imaging with high-dose radiation — CT scans in particular — has soared in the last 20 years. Our resulting exposure to medical radiation has increased more than sixfold between the 1980s and 2006, according to the National Council on Radiation Protection & Measurements. The radiation doses of CT scans (a series of X-ray images from multiple angles) are 100 to 1,000 times higher than conventional X-rays.” From the January 30, 2014 edition of the New York Times (We Are Giving Ourselves Cancer) by Dr. Rita F. Redberg (cardiologist) and Dr. Rebecca Smith-Bindman (radiologist) of the University of California, San Francisco Medical Center.
A comment from a reader who described himself as a ‘physicist’ agreed by writing that…
“The article is spot-on. I’m a physicist, not an MD, but nobody I know on either end of the process considers the arithmetic: One CT equals 500 chest x-rays. Repeat this number until people understand it. Certainly, high resolution imaging, for diagnosis, or use during surgical procedures, is a significant advance, but malpractice-dictated overuse, or need to amortize equipment, or convenience, or simple ignorance, combined with virtually no responsibility for long-term injury, adds up to large-scale risk.”
Here are a couple of unrelated quotes….
“I, like many doctors, do not discuss the radiation risks of CT scans with my patients often enough, if at all.” Dr. Anna Reisman from the August 2012 issue of Slate (Is your physician increasing your risk for cancer?).
“We routinely run the “Super Seven” on trauma patients, whether they really need it or not.” From a conversation with a friend who is a rad tech in the ER department of a large hospital. In other words, if you’ve been in a car wreck or other accident you will automatically get seven different CT Scans.
According to a Johns Hopkins study funded by the Veterans Administration and the National Cancer Institute, and published in a 2009 issue of Archives, four thousand people will contract cancer from the CT head scans performed between January 1 and December 31 of 2007. The same study said that head CT’s dosed the rest of the body with up to 400% more radiation than previously believed. Gulp!
A 2009 collaboration between the University of California, Kyung Hee University, Johns Hopkins University, the National Cancer Institute, and the University of Washington, showed that for every 4,300 head scans done on 20 year old females, there would be one additional case of cancer. How many head scans are done in the US each year?
Although exact numbers are sketchy, approximately 10% of the U.S. population has a CT scan done each year, with a total of around 75 million (many people have more than one per year). The August 2010 issue of The Medical Post said that, “In Calgary, Canada 12.1% of people who present to the emergency with an urgent complaint received a CT scan, most commonly either of the head or of the abdomen“. As near as I can tell, the numbers in America are similar.
A study funded by the National Cancer Institute and UK Department of Health and published in the August 2012 issue of the medical journal Lancet, stated that, “Use of CT scans in children… might almost triple the risk of leukemia and… might triple the risk of brain cancer. Radiation doses from CT scans ought to be kept as low as possible and alternative procedures, which do not involve ionising radiation, should be considered if appropriate.” But it gets worse.
Dr. David Brenner ( Higgins Professor of Radiation Biophysics Director of the Center for Radiological Research, Director of the Radiological Research Accelerator Facility, Professor of Environmental Health Sciences, head of the Department of Radiation Oncology) of the Center for Radiological Research at Columbia University Medical Center published a review of the scientific literature in the November 2007 issue of the New England Journal of Medicine called Computed Tomography — An Increasing Source of Radiation Exposure. Cherry picking Brenner’s conclusions reveals that…..
“CT involves much higher doses of radiation, resulting in a marked increase in radiation exposure in the population. There is a strong case to be made that too many CT studies are being performed in the United States. There is a considerable literature questioning the use of CT, or the use of multiple CT scans, in a variety of contexts, including management of blunt trauma, seizures, and chronic headaches, and particularly questioning its use as a primary diagnostic tool for acute appendicitis in children…..
Part of the issue is that physicians often view CT studies in the same light as other radiologic procedures, even though radiation doses are typically much higher with CT than with other radiologic procedures. In a recent survey of radiologists and emergency-room physicians, about 75% of the entire group significantly underestimated the radiation dose from a CT scan, and 53% of radiologists and 91% of emergency-room physicians did not believe that CT scans increased the lifetime risk of cancer….
However, if it is true that about one third of all CT scans are not justified by medical need, and it appears to be likely, perhaps 20 million adults and, crucially, more than 1 million children per year in the United States are being irradiated unnecessarily.“
Here’s the bottom line. I could have found enough studies on this issue of OVERUSING ADVANCED IMAGING — particularly CT, and the dangers it poses to one’s health — particularly the health of your children; to turn this section into a book . The research is all there online for you to dig into. You can go look it up and do it yourself if you are interested. However, before I sign off, I am going to leave you a story that is all too common here in the U.S. Like the majority of you reading this post, I do whatever I can to make sure MY KIDS are healthy.
We exercise. My wife is a fabulous cook who knows how to knock it out of the ball park in the kitchen, and has been doing a good job with the whole GLUTEN FREE thing for myself and one of my daughters. We try to avoid HORMONE EXPOSURE. My kids have not ever been on ANTIBIOTICS, nor have they been exposed to the wide array of toxic junk that happens from buying in to our government’s VACCINATION POLICIES. In other words, we are serious about our kids health.
Three years ago this week, MY THEN 12 YEAR OLD SON and I were looking forward to heading out to Idaho Springs, Colorado to spend a few days with the guy who cured my decade-long foot problem several years ago (SHAWN ENO OF XTREME FOOTWERKS). I was going to have some work done, and we were all going to hit the slopes for a couple of days (my son had taught himself to snowboard here in the Ozark Mountains with Shawn’s old board, and was ready to move on to the real mountains).
Wouldn’t you know it; he started complaining of a ‘belly ache’ the Saturday before we were to leave. Telling myself that there was no way he could come down with acute appendicitis right before our trip, I ran several simple check on him and then called my BROTHER — an E.R. doctor at a large Midwestern hospital. In my heart, I already knew what I did not want to hear him say. Kevin confirmed the worst and told me we needed pack up and head to the the hospital. We drove to the nearest facility that could remove an appendix — about half an hour from us, and began the 18 hour process.
After it was all over, my brother had told us that since Malachi had almost no body fat, a CT scan was a total waste of time and money. The reason for this is because a CT done for appendicitis looks for displacement of a local fat pad more than it looks at the appendix itself. I verified the gist of what he told me by looking up a March 2003 study of the results of a five years study that was published in the Journal of Pediatric Surgery (The Diagnosis of Acute Appendicitis in a Pediatric Population).
The study’s conclusions stated that, “CT imaging was not significantly more accurate in predicting appendicitis than examination alone. Preoperative FACT-CC [focused appendiceal computed tomography with colon contrast (dye)] did not increase the accuracy in diagnosing appendicitis when compared with patients diagnosed by history, physical examination and laboratory studies [simple blood work].”
But here’s the kicker — the thing that shows you what a waste this test really is.”If there was a strong suspicion of appendicitis, a negative CT scan did not exclude the diagnosis of appendicitis.” In light of all this, why in the world would you order this as a ‘standard’ test for appendicitis, particularly in a kid?
Anyway, it still pisses me off that we were essentially held hostage as far as removing my son’s appendix, until we agreed to the CT by signing on the dotted line. I regret the fact that I did not know this particular information, and did not fight harder. They, however, knew better. So much for EVIDENCE-BASED MEDICINE. The takeaway here is that imaging is rarely as good as it’s been touted to be (HERE or HERE) and should be avoided if at all possible.