TO CT OR NOT TO CT?
IT ALL DEPENDS ON HOW BADLY YOU WANT CANCER
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 I pulled from the peer-reviewed research and governmental agencies on this subject.
"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?).
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.
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 (SHAWN ENO OF XTREME FOOTWERKS) several years ago. 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 Stormont Vail in Topeka, Kansas. 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.
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 (if I am correctly remembering exactly what he said) 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?
Anyway, it still p_ _ _es 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.