[ RadSafe ] CT vs. X-Ray for reduction of Cancer Death

[Ed Hiserodt]

Hello Gary, 

 

Thanks for that interesting response.  As a layman I  have a problem with
radiation scientists ignoring two of the largest epidemiological studies
done on low level radiation effects, the first of which is the "Shipyard
Study" by Johns-Hopkins that was kept under wraps for years as it pointed
STRONGLY to a  hormetic effect from LLR - not the desired conclusion.
Starting with a pool of 700,000 some 39,000 nuclear workers were paired with
33,000 peers from the same hiring line.  Yet the nuclear workers had
Standard Mortality Ration of 0.76 compared to their unexposed fellow
workers.  No "healthy worker effect" here.  

 

And how can radiation protection folks summarily dismiss Bernie Cohen's
monumental study of effects of residential radon where he continues to ask
about "our discrepancy".  The discrepancy?  Only that the University of
Pittsburgh study of 1,729 COUNTIES showed an unmistakable decrease in lung
cancer when the mean radiation level increased up to 6 pC/l.  No one yet has
come forth yet with an explanation other than hormesis.  

 

Not being part of your club, but having 50 years experience in other
engineering disciplines, I just can't understand why there is such a
reluctance to look this subject in the eye when the statistics are
overwhelming.  In deference to Sandy's statement "The notion that everyone
would benefit from a higher dose of radiation in my opinion is not
acceptable, nor is there evidence that there is any positive benefit", I
would point out that in my amateurish book "Underexposed",  there were 162
examples of a positive benefit.  I would be happy to send a copy to anyone
interested in this evidence collected over a two year study on my part.

 

Ed Hiserodt

Controls & Power, Inc.

Maumelle, AR

501 258 2571 

 

-----Original Message-----
From: radsafe-bounces at health.phys.iit.edu
[mailto:radsafe-bounces at health.phys.iit.edu] On Behalf Of
garyi at trinityphysics.com
Sent: Sunday, November 07, 2010 4:41 PM
To: The International Radiation Protection (Health Physics) Mailing List
Subject: Re: [ RadSafe ] CT vs. X-Ray for reduction of Cancer Death

 

Hi Sandy,

 

I will be devil's advocate.

 

RE CT as a cost effective Ca preventative, here is a back of the envelope,
per person 

estimate.  Assume at least 100 patients per week (200 is doable), 50 wks per
yr, 4 yr scanner 

lifetime (a conservative estimate).  That's 20,000 scans for every scanner.
Assume the 

scanner costs $1e6.  That would be $50 per person for each scan.  Throw in
another $50 per 

person to make the venture profitable.  Voila!  For $100/yr, reduce your
risk of lung Ca 

mortality by 20% and your overall mortality risk by 7%.  If (its a big if, I
know) it turns out that 

annual CT scans do significantly reduce cancer mortality, and if I'm
approximately right about 

the economics, then new CT clinics would spring up like mushrooms to meet
demand.  

Haha, maybe the study authors are quietly buying up CT stocks now.  :)

 

But it does seem economical, and I haven't even considered the savings due
to cancer 

treatments that are no longer needed, or the savings due to prolonged
productivity of those 

who dodge the Ca bullet.  There's also the advantage of dying from something
that is often 

quick, like stroke or heart attack, instead of lingering painfully on your
way to death.

 

One test that should be applied to the existing NLST cohort is Ca incidence
instead of just 

mortality: did the CT screened group have significantly lower incidence of
lung cancer than 

the chest x-ray group?  If so, it would certainly support the idea of CT
scans as a Ca 

prophylactic.

 

It seems almost that people are afraid to ask some questions.

 

> The notion that everyone would benefit from a higher dose of r

>  adiation in my opinion is not acceptable, nor is there evidence that
there is any positive benefit. The risks are

>  well-known and to ignore the known facts cannot be ignored.

 

I think you mean "not proven" instead of "not acceptable".  Yes, if the data
show that the 20% 

is due only to early detection, then I agree with you.  I merely think we
should find out what 

the data show.  Simply assuming that hormesis can not play a role in the
study results would 

be a lamentable case of jumping to conclusions.  Historically, lung cancer
has been difficult 

to treat, and I would be surprised if the huge difference in mortality can
be wholly due to early 

detection.

 

-Gary Isenhower

 

 

On 7 Nov 2010 at 12:22, Perle, Sandy wrote:

 

A reduction of any illness/disease through the use of technology does not
imply that every 

individual in the entire population should undergo that
application/procedure with the stated 

goal of reducing the long-term probability of said individual to detect and
minimize the effects 

of that illness/disease from occurring. There are many preventative exams
that can be 

conducted today for age specific, genetically prone individuals, to be
tested, at an economical 

cost. Just considering the cost of CT scans and the economic effect if
everyone was to 

receive this exam, would be not cost effective. Another point is the
assumption that somehow 

this dose may be a positive outcome is simply not acceptable. Personally I
still am of the 

opinion that exams involving either radiological or nuclear medicine should
only be utilized 

where there is a distinct requirement for the exam to diagnose an illness or
confirm the 

diagnosis. The notion that everyone would benefit from a higher dose of r

 adiation in my opinion is not acceptable, nor is there evidence that there
is any positive 

benefit. The risks are well-known and to ignore the known facts cannot be
ignored.

 

Regards,

 

Sandy

____________________

Sander C. Perle

President

Mirion Technologies

Dosimetry Services Division

2652 McGaw Avenue

Irvine, CA 92614

 

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