[ RadSafe ] Trott review of Deetjen et al., on radon therapy

[Muckerheide, James]

Friends,

 

Our friend Klaus Becker has forwarded this review by Klaus Trott of the book
by our friends Deetjen and Falkenbach and associates (in German) summarizing
recent radon therapy medical research.  Note Trott’s explicit association of
the stimulatory effects found with the known benefits of low dose x-ray
therapy mechanisms for non-malignant diseases.  Note also that the direct
radiation doses are very small and that the mechanisms and physiological
responses are associated with the “bystander effect,” as indicated from 100+
years of known physiological responses to low doses.

 

Let me know if you want the PDF file version of this review.

 

Regards, Jim Muckerheide

===================

 

Radiat Environ Biophys (2005)

DOI 10.1007/s00411-005-0005-4

 

Book Review

 

Klaus-Rudiger Trott

 

Radon als Heilmittel. Therapeutische Wirksamkeit, biologischer
Wirkungsmechanismus und vergleichende Risikobewertung 

 

(Radon therapy. Therapeutic effects, biological mechanism, and relative risk

assessment)

 

P. Deetjen, A. Falkenbach, D. Harder, H. Jo¨ ckel, A. Kaul, H. v.
Philipsborn, Verlag

Dr. Kovacˇ , Hamburg, 2005, ISBN 3-8300-1768-5, 111 pp, € 19.50

 

_ Springer-Verlag 2005

Radon has been used successfully in the treatment of various painful joint
diseases for many years—it may even be traced back to Roman times.
Indications and prescriptions were purely empirical and very little research
on effectiveness and biological mechanisms of therapeutic effects was
performed until recently. Published concepts on those mechanisms were
extremely speculative. It comes as no surprise that most doctors looked at
radon therapy with great scepticism and regarded it as little more than
homoeopathy. 

 

All this has changed in the last 10 years: randomized trials have been
performed to prove its effectiveness, and radiobiological experiments suggest
well-founded mechanisms of action. This little book of some 70 pages text is
the first attempt to describe the results of recent research into
effectiveness and risks and in particular radiobiological mechanisms of radon
therapy. Chapter 1 describes six clinical studies on effectiveness, three of
which compared in a proper prospective randomized design thermal water
treatments with or without radon ( £ 3,000 Bq/l) in various degenerative
painful joint diseases, while two studies investigated the effects of radon
in the treatment of ankylosing spondylitis. In all studies, no effect of
radon on early clinical response was observed, whereas, consistently, there
was a significant benefit of radon after ‡6 months. This proof of
effectiveness compares well with that on other treatment options of those
medical conditions. Chapter 2 occupies about half the total text and is a
comprehensive review by D. Harder of recent research of molecular and
cellular mechanisms of the therapeutic action of radon therapy. It starts
with a careful analysis of a-particle exposure of the different potential
target tissues and arrives at the conclusion that the only tissue which
receives sufficient dose from the different radon treatments to account for
any observed biological effect is the skin: the mean dose to the epidermis is
in the order of a few mGy, i.e. approximately 100 alpha tracks per square
millimetre. This means that most cells in the epidermis are not hit at all
but those few cells, which are hit receive a dose high enough to induce
pronounced direct and indirect (‘‘bystander’’) cellular effects. The
therapeutic effectiveness is assumed to be mediated by the interaction of
apoptotic keratinocytes with immunocompetent (‘‘Langerhans’’) cells in the
epidermis which, via the cytokine network, modulate the inflammatory process,
which is the key pathogenetic mechanism underlying the clinical symptoms.
This hypothesis is clearly elaborated and supported with a large amount of
very recent radiobiological research. It sounds convincing and is fully in
line with current radiobiological concepts of therapeutic actions of X-ray
therapy of various nonmalignant diseases. In chapter 3, the risk estimates
for paramedical and medical personnel and patients are based on estimates of
effective doses which show wide variations between the different radon
applications. In some radon treatment facilities, doses to workers come close
to the official dose limits whereas for patients the total effective dose
from a complete treatment course rarely exceeds the total accumulated dose in
1 year from our natural environment. The final chapters compare the minute
hypothetical risks from therapeutic radon exposure with the well established
and potentially life threatening side effects of anti-inflammatory drugs.
Since after radon therapy, most patients require less anti-inflammatory drugs
the authors conclude that patients treated with radon are at a lower risk of
treatment related damage to their health than those treated with mainstream
alternative modalities. 

 

The book is well written, in clear and understandable language. Since its
circulation and impact are severely restricted by the fact that it is written
in German, a translation into English would be highly desirable. 

 

K.-R. Trott (&)

Gray Cancer Institute, Mount Vernon Hospital,

P.O. Box 100, Northwood, Middlesex,

HA6 2JR, United Kingdom

E-mail: trott at gci.ac.uk