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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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