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Re: Hormesis - medical benefits?
Hi Bill, Mark,
Sorry I have little time at the moment, but just a note that your 'med
benefits' and example aren't applicable to the issue.
In relevant data, many studies, low-dose radiation (LDR) stimulates
immune competence, and other factors. Tumors, pre-cancerous cells,
etc., are prevented or eliminated, or at least growth substantially
constrained. Your note below is about high-doses, radiation to kill
cancer cells. LDR is also used in conjunction with HDR (as low as
200-300 rad to 1000s rad local exposures) with the 'adaptive response'
enhancing the effectiveness of the high-dose, and eliminating metastases.
We have a few examples in our "Data Document":
See, eg, the 1st, 2nd, and 4th medical effects papers at:
http://cnts.wpi.edu/rsh/Data_Docs/1-2/3/3/1233list.html
most of the research papers at:
http://cnts.wpi.edu/rsh/Data_Docs/1-4/14list.html
with some fundamental biology data at:
http://cnts.wpi.edu/rsh/Data_Docs/1-5/15list.html
There's some of our 1999 updates not yet on the site ([Rev 2] in the contents):
http://cnts.wpi.edu/rsh/Data_Docs/
and we have more data for a 2000 update, from which I've sent a few
recent abstracts that show that net LDR effects on immune, enzymatic,
and other responses reduces mutations and cancer cells/tumors, and
increases in anti-cancer cellular and molecular phenomena (and that in
vitro 'linear' responses are NOT relevant to in vivo responses in
immunologically 'whole' organisms).
Note also, several papers confirm adaptive response in occupationally
exposed workers, indicating that the premise that AR only works with a
'threshold' dose is invalid - seems like another effect of using in
vitro data that aren't equivalent to whole organisms.
Another item: preliminary data indicate a massive reduction in cancer
in the residents of the Co-60 contaminated buildings in Taiwan. But
while $millions are being spent for 'dose reconstruction' and medical
tracking, the age-based population data is not forthcoming. (The
non-age-adjusted raw data have a preliminary estimate of 6 cancer
mortalities where 160 are expected.)
Regards, Jim
muckerheide@mediaone.net
========================
FIELDRW@aol.com wrote:
>
> Mark,
>
> I think we have to be careful when we generalize that "demonstrable medical
> benefits" were seen with a specific dose. What were these medical benefits.
> How do you know that there were also not short-term or potential long-term
> adverse effects.
>
> In some cases, much higher doses are given than 150 rad to produce
> "demonstrable medical benefits."
>
> For example, the following paper:
>
> Strober,Tanay, Field, Hoppe, Calin, Engleman, Kotzin, Brown, and Kaplan,
> Efficacy of total lymphoid irradiation in intractable rheumatoid arthritis. A
> double-blind, randomized trial., Annals of Internal Medicine. 102(4):441-9,
> 1985.
>
> Abstract
> Twenty-six patients participated in a randomized, double-blind study of the
> efficacy of total lymphoid irradiation in the treatment of intractable
> rheumatoid arthritis. All 26 patients, for whom therapy with gold compounds
> and penicillamine had failed, would ordinarily have been considered
> candidates for cytotoxic or antimetabolite drug therapy. Thirteen patients
> randomly assigned to receive full-dose total lymphoid irradiation (2000 rad)
> and 11 patients assigned to receive control low-dose total lymphoid
> irradiation (200 rad) completed radiotherapy. Alleviation of joint disease
> activity was significantly greater in the high-dose group as judged by
> morning stiffness, joint tenderness, and functional assessment (global
> composite score) at 3 and 6 months after radiotherapy. The high-dose group
> had a marked reduction in both T-lymphocyte function and numbers, but this
> finding was not observed in the low-dose group. Complications seen in the
> high-dose but not low-dose group included transient neutropenia,
> thrombocytopenia, pericarditis, and pleurisy.
>
> The demonstrable medical benefit in this cases was the reduction in the
> patient's arthritic symptoms. Is there a potential for an adverse effect?
> You bet.
>
> My only point is that I don't think we should be to quick to put all our eggs
> in a single "hormesis basket" (isolated findings), without examining more
> indicators of the overall long term medical benefits. All of these factors
> need considered to determine the risk versus benefit of any treatment.
>
> A side note, in this case the 200 rad was the control. It would be
> interesting to see if the researchers compared the immune function of their
> "controls" to the immune function of a cohort of non-exposed rheumatoid
> arthritis patients.
>
> Bill Field
> Department of Epidemiology
> College of Public Health
> Iowa City, IA
>
> bill-field@uiowa.edu
>
> In a message dated 1/26/00 12:07:06 PM Central Standard Time, MRotman@snm.org
> writes:
>
> << Demonstratable medical benefits of low dose/low dose rate radiation have
> been seen using 150 rads (either whole or half body) given in 10 to 15
> fractions over 5 weeks. This has been done in Japan and in the US. This
> dose appears to be optimal for immune system stimulation creating an
> approximate 160% improvement in function. Interestingly enough it appears
> the spleen is the organ critical to success.
>
> As a nuclear pharmacist by training I prefer to think of using a long acting
> radiopharmaceutical, one that is naturally concentrated in the spleen.
> Perhaps Fe-59 as transferrin, or as labeled red blood cells.
>
> Way back in '92, while a Medical Visiting Fellow at the NRC, I imagine folks
> suing the NRC because their regs were depriving folks of medically necessary
> radiation....
>
> Yes, the regulatory landscape will undergo a paradigm shift when hormesis is
> finally accepted as the truth.
>
>
>
> Mark Rotman
> Government Relations
> Society of Nuclear Medicine
> 703-708-9000 ext 1242
> 703-708-9777 FAX
> mrotman@snm.org
> http://www.snm.org >>
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