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No increase, or less, cancer after I-131 treatment of hyperthyroidism
Denis, Group,
An RSH "Topical Report": :-)
Recall that Dr. Yalow in our Nov 1994 and Jun 1995 ANS sessions reported
on studies by Gene Saenger ('68 and '71) and Lars-Erik Holm (1991) that
showed, e.g., no increase in leukemia as a result of 10,000s of persons
treated for hyperthyroidism by I-131 vs. other treatments. The whole
body doses varied widely, but were estimated at 10-15 cGy. See Yalow
(1994) in:
http://cnts.wpi.edu/RSH/Data_Docs/1-2/3/2/1232list.html
See also, Pollycove 1995, near the bottom on that page.
See the cite to Saenger et al (1968) JAMA [No Abs]
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=5695509&form=6&db=m&Dopt=b
[You may need to put the url back together. Once you have the url for
the first, you can just paste in the revised uid# as the only difference
between them.]
Saenger et al (1971) Science [No Abs]
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=5544865&form=6&db=m&Dopt=b
Holm et al (1980) N Engl J Medicine
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=7383089&form=6&db=m&Dopt=b
Hoffman et al (1982) Int J Epidemiol
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=7129736&form=6&db=m&Dopt=b
Hoffman et al (1982) Am J Epidemiol
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=7058783&form=6&db=m&Dopt=b
Holm et al (1991) J. Natl. Cancer Inst.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=1875414&form=6&db=m&Dopt=b
See also: Hall et al (1992) Int. J. Cancer
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=1555888&form=6&db=m&Dopt=b
Hall et al (1992) Lancet
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=1351599&form=6&db=m&Dopt=b
Hoffman et al (1992) J Natl Cancer Inst
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=6571923&form=6&db=m&Dopt=b
Significant:
Ron et army (1998) JAMA [several LNT apologists including Ron]
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=9686552&form=6&db=m&Dopt=b
See also especially the full cite for the abstract below:
Franklyn et al (1999) Lancet (Jun)
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=10382695&form=6&db=m&Dopt=b
Finally: In the case of I-131 therapy for thyroid cancer rather than
hyperthyroidism, in 1497 patients: "estimated average dose was 0.34 Sv
to the bone marrow and 0.80 Sv to the whole body. After a mean follow-up
of 10 years, no case of leukaemia was observed, compared with 2.5
expected according to the coefficients derived from Japanese atomic bomb
survivors (P = 0.1)."
de Vathaire et al (1997) Br J Cancer
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=9043033&form=6&db=m&Dopt=b
80 rem whole body - 34 rem bone marrow - NO leukemia after 10 years!?
Needless to say, when we argue that 100's of studies contradict the LNT,
and no substantial and substantiated studies confirm it,
including/especially considering studies at the "large" doses in excess
of 10 cGy, it is solidly based on the evidence, even when the evidence
has not been as substantially pursued as it could/should have been.
Certainly significantly higher doses, and a few small studies show
increases in cancer, but not consistent with the LNT, especially with
these contrary examples of "moderate" doses with no negative, and some
positive, effects.
When the LNT supporters says "we can't know about low doses", they are
dissembling while ignoring doses and populations that would/must be
definitive in showing adverse effects IF the LNT had a biological basis.
And when they say "substantial data exist that support the LNT", they
are misrepresenting the evidence (though most who repeat this from their
academic experience just don't know).
Of course, such inquiries could continue on many specific topics (and
should retrieve/review full papers, which are included in much of the
RSH "Data Document" as a resource). It is hard staying ahead of it :-)
Regards, Jim Muckerheide
muckerheide@mediaone.net
========================
Denis Beller wrote:
>
> Eisenbud says 15.5 rem/micro-Ci ingested by a child, and a micro-Ci is
> 37,000 Bq. So 300,000,000*15.5/37000 = 126,000 rem to the thyroid.
>
> The value for adults is 1.9 rem/micro-Ci, or 15,400 rem for 300 MBq.
> Bevelaqua (Health Physics) says typical doses are 50,000 rad, and the
> thyroid dose commitment is 6.6 rem/micro-Ci in the thyroid. 300 MBq
> corresponds to 50,000 rem to the thyroid if 93% of the I-131 ends up in the
> thyroid (but Eisenbud says only 20 to 30% does).
>
> Eisenbud also says the whole body dose is 0.0035 rem/micro-Ci ingested,
> which corresponds to about 28 rem whole body.
>
> Bottom line: 50,000 rem to the thyroid and 28 rem whole body.
>
> Denis
>
> At 06:31 PM 7/22/99 -0400, you wrote:
> >The International Centre for Low-Dose Radiation Research (ICLDRR) at the U
> >of Ottawa faxed me an interesting paper that was published in The Lancet,
> >Vol. 353, June 19, 1999, pp 2111-2115.
> >
> >I've provided the summary below. Had more cancer been observed, would the
> >authors have concluded the I-131 radiation caused the increase? The authors
> >did not suggests the observed decrease might be another example of radiation
> >hormesis. They just said it was reassuring.
> >
> >The cumulative dose administered in most cases was about 300 MBq of I-131.
> >I wonder what the corresponding dose in Sv (or rem) would be to the neck and
> >to the thorax regions.
> >
> >
> >Jerry Cuttler
> >CUTTLERJ@AECL.CA
> >
> >---------------------------------------
> >
> >Cancer incidence and mortality after radioiodine treatment for
> >hyperthyroidism: a population-based cohort study
> >
> >Summary
> >
> >Background: Radioiodine is used increasingly as first-line treatment for
> >hyperthyroidism, but concerns remain about subsequent risk of cancer,
> >especially in those treated at a young age. We investigated cancer
> >incidence and mortality in patients treated with radioiodine for
> >hyperthyroidism.
> >
> >Methods: We did a population-based study in 7417 patients treated in
> >Birmingham, UK, between 1950 and 1991. We compared details of all cancer
> >diagnoses and deaths in 1971-91 from the UK Office for National Statistics
> >with data on cancer incidence and mortality for England and Wales specific
> >for age, sex and period.
> >
> >Findings: During 72073 person-years of follow-up, 634 cancer diagnoses were
> >made, compared with an expected number of 761 (standardized incidence ratio
> >[SIR] 0.83 [95% CI 0.77-0.90]). The relative risk of cancer mortality was
> >also decreased (observed cancer deaths 448, expected 499; standardized
> >mortality ratio [SMR] 0.90 [0.82-0.98]). Incidence of cancers of the
> >pancreas, bronchus, trachea, bladder, and lymphatic and haemopoietic systems
> >was lowered. Mortality from cancers at all these sites was also reduced but
> >findings were significant only for bronchus and trachea. There were
> >significant increases in incidence and mortality for cancers of the small
> >bowel (SIR 4.81 [2.16-10.72], SMR 7.03 [3.16-15.66] and thyroid (SIR 3.25
> >[1.69-6.25], SMR 2.78 [1.16-6.67]), although absolute risk of these cancers
> >was small.
> >
> >Interpretation: The decrease in overall cancer incidence and mortality in
> >those treated for hyperthyroidism with radioiodine is reassuring. The
> >absolute risk of cancers of the small bowel and thyroid remain low, but the
> >increased relative risk shows the need for long-term vigilance in those
> >receiving radioiodine.
> >
> >
>
> Denis E. Beller, Ph.D.
> Systems Engineering and Integration Group
> Technology and Safety Assessment Division
> ---------------
> e-mail: beller@lanl.gov
> phone: (505) 667-1357
> fax: (505) 665-5283
> ---------------
> Mailing Address:
> TSA-3, MS F607
> Los Alamos National Laboratory
> Los Alamos, NM 87545
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