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Re: Study Finds Increased Lung Cancer Risk Following Treatment fo rHodgkin's Disease
Howard,
Regarding your repeated assertions that the use of non identical controls
invalidates findings from a case-control study, could you provide
documentation (references) to support your assertion? By the way, what is
an identical control?
Bill Field
At 06:54 PM 02/06/2002 -0800, hflong@postoffice.pacbell.net wrote:
>1. Non-identical "controls", prohibit inference that "radiation caused
>more cancer" here,
>2. --as in the Iowa Study.
>3. Also, the treatment dose was over the approx 50 rem "threshold" where
>benefit turns to harm (cited by Luckey and ignored by LNT)
>
>Howard Long
>
>"Jacobus, John (OD/ORS)" wrote:
>
> > Howard,
> > What are you talking about? What does this have to do with the Iowa study?
> > What threshold are you talking about? The minimum treatment?
> >
> > -- John
> > John Jacobus, MS
> > Certified Health Physicist
> > 3050 Traymore Lane
> > Bowie, MD 20715-2024
> >
> > E-mail: jenday1@email.msn.com (H)
> >
> > -----Original Message-----
> > From: hflong@postoffice.pacbell.net
> > [mailto:hflong@postoffice.pacbell.net]
> > Sent: Wednesday, February 06, 2002 3:57 PM
> > To: Dukelow, James S Jr
> > Cc: Jacobus, John (OD/ORS); RadSafe
> > Subject: Re: Study Finds Increased Lung Cancer Risk Following Treatment
> > fo r Hodgkin's Disease
> >
> > Cancer threshold?
> > As in the Iowa study, apparently "controls" here were different from cases
> > in ways that could explain association without the implied causality. In
> > Iowa, it was smoking (only 32% of controls). Here, sicker Hodgkin's Disease
> > patients would seem more likely to receive radiation, chemotherapy, and
> > especially both - and these are the very patients more likely to get other
> > cancers, (with or without the treatment, implied here to cause the other
> > cancer).
> > Common Cause.
> >
> > Above threshold dose also says nothing about rate of cancer with below
> > threshold dose (an argument you've seen before here).
> >
> > Only double-blind, placebo studies should imply "cause".
> > Others, like this one, are more accurately, "suggestive".
> >
> > Howard Long
> >
> > "Dukelow, James S Jr" wrote:
> >
> > > John Jacobus passed along to us:
> > > -----Original Message-----
> > > From: Jacobus, John (OD/ORS) [mailto:jacobusj@ors.od.nih.gov]
> > > Sent: Wednesday, February 06, 2002 9:21 AM
> > > To: RadSafe
> > > Subject: Study Finds Increased Lung Cancer Risk Following Treatment for
> > > Ho dgkin's Disease
> > >
> > > I received this from another mailing list and thought I would pass it
> > along.
> > >
> > > -- John
> > >
> > > <snip>
> > >
> > > National Institutes of Health:
> > > NCI Press Office (301) 496-6641
> > > EMBARGOED FOR RELEASE
> > > 4pm EST
> > > Tuesday, February 5, 2002
> > >
> > > Study Finds Increased Lung Cancer Risk Following
> > > Treatment for Hodgkin's Disease
> > >
> > > People with Hodgkin's disease (HD) who receive
> > > chemotherapy, radiotherapy, or a combination of the two
> > > treatments, are at higher risk of developing lung cancer,
> > > according to a report in the Feb. 6, 2002, issue of the
> > > Journal of the National Cancer Institute.* The study also
> > > finds a higher risk for lung cancer among smokers treated
> > > with both radiotherapy and chemotherapy.
> > >
> > > "It was the combined effect of smoking and treatment that
> > > accounted for the bulk of lung cancers in this study,
> > > underscoring the importance of smoking cessation in the
> > > management of patients with Hodgkin's disease," the
> > > authors conclude. "It is clear that the tremendous
> > > improvement in the treatment of HD far outweighs any
> > > therapy-related risks of lung cancers, especially when
> > > compared with the enormous burden imposed by tobacco,"
> > > said Lois Travis, M.D., Sc.D., of the National Cancer
> > > Institute's Division of Cancer Epidemiology and Genetics
> > > in Bethesda, Md., and first author of the study.
> > >
> > > <snip>
> > >
> > > For this study, the researchers looked at many different
> > > factors, but focused on three main measures: the type and
> > > cumulative amount of chemotherapy drugs, the radiation
> > > dose, and tobacco use. All three exposures contributed
> > > significantly to elevated lung cancer risks. Tobacco use,
> > > chemotherapy, and radiotherapy doses of five Gray (Gy) or
> > > more were reported in 96 percent, 63 percent, and 53
> > > percent of case subjects (those who developed lung
> > > cancer), respectively, and in 70 percent, 52 percent, and
> > > 41 percent of patients who did not develop lung cancer.
> > >
> > > Subjects who received either radiotherapy alone or
> > > chemotherapy with drugs called alkylating agents
> > > experienced a significantly increased risk of lung cancer.
> > > And when researchers looked at the group of patients who
> > > received both alkylating agents and radiotherapy, the
> > > numbers showed risks that were additive.
> > >
> > > <snip>
> > >
> > > =================
> > >
> > > Jim Dukelow comments:
> > >
> > > Something is strange here -- or, perhaps, I am missing something.
> > >
> > > It is reported that of the 444 control subjects (all of whom had been
> > > treated for HD and had not developed lung cancer), 52% are reported to
> > have
> > > had chemotherapy and 41% reported to have had radiotherapy. And the
> > missing
> > > 7% -- "Take two aspirin and call me in the morning"?
> > >
> > > Also, the press release talks about patients who received radiotherapy
> > ALONE
> > > or chemotherapy with drugs called alkylating agents [with an implied
> ALONE
> > > there also] having so much of a risk increase. This is disingenuous,
> > since
> > > 96% of the "cases" -- those with lung cancer -- were smokers.
> > >
> > > Best regards.
> > >
> > > Jim Dukelow
> > > Pacific Northwest National Laboratory
> > > Richland, WA
> > > jim.dukelow@pnl.gov
> > >
> > > These comments are mine and have not been reviewed and/or approved by my
> > > management or by the U.S. Department of Energy.
> > > ************************************************************************
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