Archive for the ‘Cancer’ Category

D.C.I.S. Breast Cancer Misdiagnosis

July 24th, 2010

DCIS, D.C.I.S., Ductal Carcinoma in Situ

Far too many women know the horror of discovering a breast lump and then waiting for the verdict. Do I have cancer, they wonder? Will I live? Unfortunately, getting a diagnosis may not end the anxiety. According to a recent article in the New York Times, doctors regularly misdiagnose a type of breast cancer called ductal carcinoma in situ, or D.C.I.S., particularly in its earliest stages.  The article claims, "17 percent of D.C.I.S. cases identified by a commonly used needle biopsy may be misdiagnosed."

The article quotes Dr. Shahla Massood, the head of pathology at the University of Florida College of Medicine in Jacksonville as saying that the diagnosis of D.C.I.S. "is a 30-year history of confusion, differences of opinion and under- and over-treatment.  There are studies that show that diagnosing these borderline breast lesions occasionally comes down to the flip of a coin."

Even the definition of D.C.I.S. is controversial. According to the Medicinenet.com website, D.C.I.S. is a precancerous condition in which "malignant cells" are found in the lining of a breast duct without any evidence of having spread beyond. Medicinenet also claims that, "DCIS is clearly the precursor (forerunner) of invasive breast cancer." 

The Mayo Clinic has a slightly different viewpoint. "Ductal carcinoma in situ (DCIS) is considered the earliest form of breast cancer," says its literature. "In DCIS, abnormal cells multiply and form a growth within a milk duct of your breast. DCIS is noninvasive, meaning it hasn’t spread out of the milk duct to invade other parts of the breast." 

The National Cancer Institute offers yet another take. According to their website, "In some cases, DCIS may become invasive cancer and spread to other tissues, although it is not known at this time how to predict which lesions will become invasive." In other words, although D.C.I.S. is characterized by the appearance of "abnormal" cells in the lining of breast duct, what happens from there is unpredictable.

So just which opinion hits the mark? Is DCIS the "precursor of invasive breast cancer," or "invasive "in some cases," or "noninvasive"?  The problem with DCI S clearly extends beyond misdiagnosis to questions about just what is being diagnosed. All this adds up to a lot of anguish and confusion for women who do get a positive DCIS diagnosis that leaves them wondering how scared they should be and how they should proceed.

And why is diagnosis so inaccurate? CBS news correspondent Dr. Jennifer Ashton says that the difficulty diagnosing D.C.I.S. has several causes. First, as I’ve written before, mammography is far from perfect. "It can see things there that are not cancer and it can miss cancers that are there." Diagnosis has gotten increasingly difficult over the past three decades as mammograms continue to turn up lesions that are smaller and smaller.

Next, the biopsy process is prone to error. In biopsy, a sample of tissue from the affected area is removed and studied microscopically by a pathologist.  The level of the pathologist’s skill and experience, the quality of the sample, and other factors contribute to the accuracy of the diagnosis. In fact, the New York Times article highlights the case of a woman who was misdiagnosed as positive for D.C.I.S. and later found out that, in all likelihood, she never had the disease — and this after undergoing partial mastectomy, radiation, chemo, and tremendous emotional and psychological stress. Let that stand as evidence of the importance of getting second, third, and maybe even fourth opinions!

Finally, the controversy around defining D.C.I. S. makes diagnosing it that much more difficult. Even worse, it makes prescribing a medical treatment plan nearly impossible. Some experts believe that the disease does not require early treatment because it doesn’t necessarily become invasive. Others claim that D.C.I.S. is definitely invasive and should be treated immediately.

Interestingly, the Doctors Company, a malpractice insurance company for doctors, states in its loss prevention guidelines on breast biopsy and fine needle aspiration, that a large percentage of their misdiagnosed cases relate back to biopsy. According to its review of 218 cases, "Fifty-four percent of breast biopsy claims involved the false-negative diagnosis of breast carcinoma, while 35 percent were for the false-positive diagnosis of carcinoma." Translated, that means a lot of women either didn’t get appropriate treatment, or were treated needlessly. Even more problematic, of all the malpractice claims handled by the company, a full 22 percent involved "breast specimens" — samples taken from a variety of procedures for diagnosing breast conditions.

I’ve written previously about how mammograms miss up to 30 percent of all tumors, and may deliver a false positive diagnosis as much as 90 percent of the time. On top of that, there’s the radiation exposure to worry about. Biopsy, the backup procedure used to verify the findings of a mammogram, clearly isn’t foolproof either, particularly in early D.C.I.S. cases.

So what should women do to ensure they get an accurate diagnosis? First, remember that there are alternatives to mammography that don’t involve radiation exposure. Thermography is relatively cheap, safe, and effective. Breast sonograms also provide a safer, relatively inexpensive alternative, and according to the American Journal of Radiology, sonography detects twice as many cancers as mammography. Plus, there’s a new imaging technology called elastography, which when used in conjunction with sonography not only finds tumors, but also reveals if they’re cancerous…without biopsy. Next, inquire about the experience of your pathologist.  The doctor accused of misdiagnosing the woman in the New York Times article said he read only about 50 breast biopsies a year. That’s not very much experience to base a sound diagnosis on.  So make sure that your pathologist has considerable experience reading breast biopsies. Also, as mentioned earlier, collect several opinions before acting on a diagnosis. And finally, remember there are alternative treatments available — and prevention through diet and lifestyle choices is always an option.

:hc

Posted in Cancer | No Comments »

Vitamin B Reduces Lung Cancer Risk

July 6th, 2010

Vitamin B6,Methionine, Lung Cancer

Here’s news that should make you breathe easier, even if you’re a smoker. A study published in the Journal of the American Medical Association (JAMA) showed that higher levels of B6 in the blood cut the risk of lung cancer by half. The study, funded by the World Cancer Research Fund and other groups, analyzed the levels of four B vitamins (B2, B6, folate, and B12) as well as the amino acids methionine and homocysteine in the blood of participants recruited into the European Prospective Investigation in Cancer (EPIC) between 1992 and 2000. 

Of the 519,978 participants, drawn from 10 European countries, some 385,747 gave blood samples. Among those, 899 lung cases of cancer were detected by 2006. The blood of those individuals was compared to that of 1770 healthy individuals. The researchers divided the participants into four groups based on the levels of B6 in their blood. After controlling for smoking, the analysis indicated that those with the highest levels of B6 in the blood reduced lung cancer risk by a whopping 56 percent. Those with the highest levels of methionine in the blood reduced their lung cancer risk by 48 percent.

What do B6 and methionine do? B6 is involved in a variety of metabolic functions. Among them, it is necessary for the production of red blood cells and immune system cells. It helps control blood levels of the potentially dangerous amino acid, homocysteine, which is associated with heart disease. B6 also helps the body manufacture several neurotransmitters and hormones that regulate mood and the body’s clock. Methionine helps the system to break down fats, assists the digestive system, and works to remove heavy metals from the body. It is also an antioxidant and is involved in the metabolism of B vitamins. More significantly, both nutrients appear to protect against DNA damage.

Head researcher Paul Brennan, PhD, of the International Agency for Research on Cancer in Lyon, France, told WebMd, "We found that vitamin B6 and methionine are strongly associated with reducing lung cancer risk in people who never smoked, those who quit, and current smokers."

The experts contend that the anti-cancer effect may have to do with a factor other than the vitamin B6 or methionine, such as the beneficial effects of consuming a particular food that those nutrients are found in. In fact, Dr. Brennan cautioned against taking supplements in hopes of preventing lung cancer. "There is no evidence that vitamin supplements may reduce cancer risk and even some evidence that they may increase cancer risk," he said.

But "au contraire," a scan of the research didn’t turn up any studies showing that B6 may increase cancer risk. Quite the contrary! A 2006 study out of Harvard Medical School, for instance, found that of 33,000 women, those taking the highest dose of vitamin B6 supplementation, five times the recommended daily intake, had the lowest incidence of colon cancer. That study also found that those women who had the highest levels of vitamin B6 in their blood had a 44% lower incidence of colorectal cancer and a 58% reduced risk of colon cancer. Several studies also point to lowered levels of breast cancer among women with high levels of vitamin B6 in their blood. A 2008 study found a 38% reduction in breast cancer among women over the age of 65 who supplemented with folic acid, vitamin B12, and vitamin B6.

Perhaps Dr. Brennan was referring to the ATBC trial that concluded that beta carotene supplementation potentially increased lung cancer risks in smokers. But that trial was fatally flawed in that it tested the use of synthetic beta carotene derived from acetylene gas, not a natural beta carotene complex. Synthetic beta carotene and natural beta carotene are about as similar as Ripple wine and a 1787 Chateau Lafite. Technically, you can call them both wine — but beyond that…  In any case, the ATBC trial did not examine B vitamins.

Dr. Len Horovitz, of Lenox Hill Hospital in New York also added a cautionary note, but he was concerned about dose rather than about the advisability of taking B6 supplements. "Optimizing B6 levels to reduce lung cancer risk is seemingly straightforward, and probably a good idea if not taken to excess," he said, "but precise dose is unclear. One message about taking any supplements to reduce risk is that the appropriate dose needs to be found, and that more is not necessarily better."

In fact, if you take too much vitamin B6, you can develop nerve problems in the hands and feet, but that’s only if you take it in a form other than pyridoxamine, which leads to no such effects. In any event, toxicity doesn’t usually develop unless you take more than 100 mg a day. Just check your supplements to make sure that the vitamin B6 is in the form of pyridoxamine. As for methionine, the doctor’s warning actually may be appropriate. Studies have found that people taking more than five times the normal dose had elevated plasma homocysteine, problematic for heart health. One 2009 study found that high levels of methionine are associated with greater risk of Alzheimer’s disease, and other research has linked the amino acid to hardening of the arteries, liver disease, and acidosis. Also, too much methionine has been known to exacerbate psychopathological symptoms in schizophrenic patients.

In other words, when it comes to methione, look to diet first, accompanied by light supplementation. Good sources of methionine include beans, garlic, lentils, onions, and fish. Dietary sources of B6 include bananas, whole wheat, free range eggs, avocado, brown rice, oats, chicken, fish, potatoes, and peanuts. But for lung cancer protection, your best bet is to avoid smoking, smokers, and dirty air, to the best of your ability. Oh, and keep in mind that the very act of smoking rapidly depletes B vitamins from your body.

:hc

Cancer Causes Debated: Health Blog

May 27th, 2010

Causes of Cancer

Historically, the medical community has pointed to lifestyle factors and heredity as the principal causes of cancer, but now, a movement is afoot to pass some of the blame on to environmental factors. The President’s Cancer Panel recently issued a report claiming that environmental pollutants and toxins play a much larger role in causing cancer than previously thought. The panel consisted of 46 physicians, health experts, and environmental scientists from diverse organizations such as the National Cancer Institute, Columbia University Medical Center, Duke University and the National Institute of Environmental Health Sciences. Currently, the National Cancer Institute estimates that about four percent of cancer deaths, or approximately 20,000 deaths per year, result from occupational exposures to chemicals and pollution, while two percent — or 10,000 deaths per year — result from environmental exposures. According to those estimates, smoking causes 29 to 31 percent of all cancer deaths, diet 20 to 50 percent, infectious disease 10 to 20 percent, ionizing and ultraviolet light five to seven percent, and occupational exposure two to four percent. The National Cancer Institute estimates don’t quantify genetic factors, even though, as I mentioned earlier, the medical community considers them a major player. In any case, according to the American Cancer Society, genetics play a particularly significant role in certain cancers; for instance, up to 10 percent of breast cancers are directly attributable to genetic factors.

Most of the above estimates were established back to 1981, leading the panel to call them “woefully out of date.” The panel says that “the true burden of environmentally induced cancers has been grossly underestimated,” and that the public faces “grievous harm” from chemicals and pollutants in air, food, products, and water supplies. The report cites the fact that of the 80,000-plus chemicals in use in the United States, only about 200 have been evaluated for safety.

The track record for those 200 doesn’t bode well for the rest of the lot. So far, research has indicated that 54 (better than 25 percent) of the tested compounds qualify as known human carcinogens, according to the US 11th Report on Carcinogens. Topping the list are chemicals such as benzene, known to cause leukemia and present in automobile exhaust; radon, commonly found in homes and implicated in lung cancer; arsenic, found widely in water supplies and linked to skin, liver, bladder and lung cancer; asbestos, found in building materials and another lung cancer causative agent; and a long list of chemicals found in common household items, food wraps, industrial waste, insecticides and herbicides, cosmetics, plastics, and even baby products. Even more disturbing is if that 25 percent figure holds up across the 80,000-plus chemicals that have not yet been tested. Then you’re talking about an additional 20,000-plus carcinogens assaulting our health on a daily basis.

According to Kenneth A. Cook, president of the Environment Working Group, “There are far too many known and suspected cancer-causing chemicals in products people, young and old, use every day of their lives. Many of these chemicals are believed to be time bombs, altering the genetic-level switching mechanisms that lead to cancerous cellular growth in later life.”

But the report doesn’t only point to the industrial chemicals bombarding us as major causes of concern. It also cites exposure from medical imaging, electromagnetic energy from household appliances, cell phones, military sources, airplane travel, and so on. The cumulative impact of these exposures can’t be measured, the report says, because the effects take hold over an indeterminate period of time and they intermix with genetic and lifestyle factors. “It’s like looking at strands of a spider web and deciding which one is important,” said Dr. Ted Schettler, director of the Science and Environmental Health Network. 

In spite of the obvious avalanche of carcinogenic toxins in the environment, some took issue with report, including the American Cancer Society. Dr. Michael J. Thun, MD, the ACS vice president emeritus of Epidemiology & Surveillance Research, comments on the ACS blog, “Unfortunately, the perspective of the report is unbalanced by its implication that pollution [a rather soft term for what might just as easily be described as ‘highly toxic environmental carcinogens'] is the major cause of cancer, and by its dismissal of cancer prevention efforts aimed at the major known causes of cancer (tobacco, obesity, alcohol, infections, hormones, sunlight) as “focused narrowly.” Dr. Thun further argues that the report “is most provocative when it restates hypotheses as if they were established facts. For example, its conclusion that “the true burden of environmentally (i.e. pollution) induced cancer has been grossly underestimated” does not represent scientific consensus. Rather, it reflects one side of a scientific debate that has continued for almost 30 years.”

Dr. Thun and others who join the choir criticizing the report claim they worry that the public will get the wrong message from it — that they’ll stop paying attention to the more important issues of diet, smoking and so on. But it seems to be a silly concern: the report does not say environmental issues trump lifestyle issues — it simply implies that environmental factors are worthy of being taken seriously and that regulation of pollutants must occur. In other words, the “war against cancer” must proceed on all fronts. Interestingly, given that estimates attribute up to 50 percent of cancer deaths to diet, the critics don’t consider how contaminated our food source is. There’s no way of knowing at present what role chemical residues on food, or synthetic growth hormones and heavy metals within the food itself, play in diet-related cancers.

In response to Dr. Thun, a number of readers posted comments on the ACS blog. Perhaps the most articulate among them, a reader named Shannon, responds to his statement about how unfortunate it would be if the effect of the report trivialized modifiable risk factors. “What would be quite unfortunate, indeed,” she says, “would be to CONTINUE to overlook the overwhelming and quite “modifiable” role of the toxins in our environment while narrowly focusing on “modifiable risk factors.” In fact, by not joining the cause to address the lack of adequate regulation and safeguards for consumers, you do us a grave disservice.”

While the scientists and the consumers slug it out over where to point the finger, one thing seems undeniable: that the vast majority of cancers are caused by factors under your control. Smoking can be stopped; diet can be changed; and regular detoxing can remove many of the environmental toxins you may pick up along the way. It’s all up to you.

:hc

Posted in Cancer | 2 Comments »

PSA Testing – Too Much of A Bad Thing: Health Blog

May 11th, 2010

PSA Testing for Prostate Cancer

When the inventor of the primary screening test for prostate cancer calls it a “hugely expensive public health disaster,” you’d think doctors might take the hint.  If only!  Instead, the medical profession acts like an enabling spouse, and the pharmaceutical industry plays the role of the neighborhood bar.  There may be too much dignity to be lost for the medical profession and too much profit to be given up by big Pharma to allow them to make the changes that the reality of prostate cancer screening requires. 

In a recent Op Ed column for the New York Times, Dr. Richard Ablin, the discoverer of PSA (prostate-specific antigen, an enzyme made by the prostate), says the annual bill for PSA screening in the U.S. is $3 billion, even though the test “is hardly more effective than a coin toss.”  According to Ablin, the test does not detect the presence of prostate cancer.  It merely shows how much prostate antigen a man has in his blood. “Infections, over-the-counter drugs like ibuprofen, and benign swelling of the prostate can all elevate a man’s P.S.A. levels, but none of these factors signals cancer. Men with low readings might still harbor dangerous cancers, while those with high readings might be completely healthy,” he says.

In fact, Dr. Ablin points out the test got approved by the FDA after a study came out showing that it could detect a mere 3.8 percent of prostate cancers, “which was a better rate than the standard method, a digital rectal exam.” One might think a psychic reader having a good day could do a lot better than 3.8 percent!

But the problem extends beyond the questionable accuracy of the test. There’s also the fact that even when it does detect prostate cancers, in many cases, that finding makes not one whit of difference. In 2008, the United States Preventive Services Task Force (USPSTF) recommended that screening for men over 75 years old be discontinued. The task force found that most prostate tumors are slow growing, and that’s particularly true for older men. Men of that age will almost certainly die of other causes before their prostate tumor kills them or even before they experience symptoms, even without treatment. In fact, studies show that up to 44 percent of all identified cases of prostate cancer have been found at a point where the disease won’t affect life expectancy. And yet one out of every three men older than 75 gets screened for prostate cancer, and if diagnosed, those men typically get shuttled through a series of treatments that can be debilitating and painful and completely unnecessary.

But even for younger men, the value of the test is questionable. According to a study published in the New England Journal of Medicine in August of 2009 by the Department of Veterans Affairs, “[u]sing the most optimistic assumption about the benefit of screening — that the entire decline in prostate cancer mortality observed during [the study] period (1986-2005) is attributable to this additional diagnosis — we estimated that, for each man who experienced the presumed benefit, more than 20 had to be diagnosed with prostate cancer.” In other words, 20 men received treatments like radiation and surgery, but only one of them lived longer because of it. The study concludes that this has led to the diagnosis of prostate cancer in over one million additional men, and “most of this excess incidence must represent over diagnosis.” A similar European study of 182,000 men found that while screening did lead to a slight decline in death rates, 48 men had to be treated to prevent one death. And the author of yet another similar study, Dr. Gilbert Welch of Dartmouth University, said, “For every man who avoids a prostate cancer death due to PSA screening, about 50 men have to be treated unnecessarily — and a third of these men will have serious problems with treatment.” These problems include impotence, incontinence, breast enlargement, and rectal bleeding.

The American Cancer Society has started backing off its insistence that every man needs the test even if he’s older than Albus Dumbledore. In its revised guidelines, it cites a study of 76,600 men that found that annual PSA and rectal exam screenings made no difference in cancer deaths at 10-year follow-ups. But still, the new recommendations remain wishy-washy. They basically suggest that men over 50 in good health should talk to their doctors about whether the testing makes sense — and guess what they’re going to recommend? Meanwhile, the American Urological Association still suggests regular screenings.

According to Dr. Ablin, the test still gets performed on over 30 million men annually, and the fact that pharmaceutical companies keep pushing the tests helps keep the screening momentum up. While he concedes that in some cases, testing makes sense — where there’s a family history of the disease, for instance, he also concludes, “I never dreamed that my discovery four decades ago would lead to such a profit-driven public health disaster. The medical community must confront reality and stop the inappropriate use of PSA screening. Doing so would save billions of dollars and rescue millions of men from unnecessary, debilitating treatments.”

Of course it’s interesting that the medical community assumes that diagnosis absolutely indicates the usual treatments will follow, but that’s a subject for another time. Given the inaccuracy of the tests and the likelihood that those with a positive diagnosis will fall prey to the typical radiation/surgery routines, it seems obvious that prevention and clean living make a lot more sense.

And finally, if your doctor insists on a PSA test, and if you always do what your doctor tells you, then at least press him/her for the updated PSA test, the Prostate Health Index. The Index test measures blood levels of three different types of PSA. Combined with annual biopsies, or tissue samples, it was about 70% accurate in singling out the aggressive tumors in a small study. Oh, I almost forgot to mention, although it’s now used in Europe, it’s still waiting for FDA approval in the U.S.

:hc

Melanoma on the Rise: Health Blog

April 6th, 2010

Skin Cancer and Melanoma

Sometimes I wonder about the things that medical researchers argue about. Just last month, Darrell S. Rigel, MD, clinical professor of dermatology at New York University Medical Center in New York City and a past president of the American Academy of Dermatology, published an argument that the significant rise in rates of melanoma is real.  This was a response to researchers who argue that the detection and reporting of more melanoma reflects better and more available diagnostic techniques. Either way, it seems to me the real issue should be how to improve prevention.

But if I had to weigh in on the debate at hand, I’d say that Dr. Rigel’s statistics make a strong case. According to Rigel, the average American’s risk of melanoma in his or her life time increased from one in 1,500 in 1930, to one in 250 in 1980 and one in 74 in 2000. The rate increased again to one in 65 by 2004, and now that risk is one in 58. “If this rate continues to rise at the same pace, the risk will be one in 50 by 2015,” he says.  That’s a lot of deadly skin cancer. 

Rigel says that there are a number of factors that make it clear that this is a real increase.  First, if the increase merely reflected more and better screening for cancer, “you would expect cases to pop up earlier, and then suddenly drop off.”  With a disease like prostate cancer, for example, when “better” screening (in the form of testing for prostate specific antigens, or PSAs) became available in the 1990’s, there was a short-term up-tick in the number of cases reported, and then the numbers went back down.  Clearly this is not the case with melanoma, where better screenings became available in the 1980s.  Instead, the numbers of cases reported has continued to skyrocket. Then again, maybe that’s not such a great comparison since recent studies have indicated PSA testing is highly inaccurate and may, in fact, actually be harmful. But that’s a different blog topic.

In any case, those who maintain that the upswing in cases simply reflects better diagnostics say the proof is in the fact that all sorts of skin cancers — not just melanoma — have been increasing. It’s a rather tautological argument — akin to saying if I document the world’s population increasing, it proves I’ve become better at recording all births, rather than that more babies are actually being born. Again, the fact that all sorts of cancers are on the rise doesn’t prove that diagnosis is better or that better diagnosis has caused the rise in cases. It merely proves that more cancer exists than was previously recorded. In fact, a whole lot more.

In fact, among Medicare patients, the incidence of non-melanoma skin cancers increased by 16% from 2002 to 2006. According to Dr. Howard Rogers, a dermatologist in Norwich, Connecticut and lead author of a study on the incidence of non-melanoma skin cancer, “The number has kept going up and up at a rate of 4.2 percent every year, on average, from 1992 to 2006.” The most common skin cancers are basal and squamous cell cancer. More than 250,000 new cases are diagnosed each year, of which about 2,500 will be fatal.

Even more alarming, according to WEBMD, is the fact that an estimated 40% to 50% of fair-skinned people who live to be 65 will develop at least one skin cancer. To put it into perspective, five times more people were diagnosed with non-melanoma skin cancer in 2007 than were diagnosed with breast or prostate cancers.

The good news is that both basal and squamous cell cancers respond well to treatment.  Melanomas, on the other hand, which account for about five percent of all skin cancers, are difficult to treat in later stages. Plus, melanoma is generally under-reported because the National Cancer Institute bases its counts on reports from hospitals and many melanoma patients get treatment right in the doctor’s office instead. And, melanoma, once it develops, is by far the most deadly skin cancer.

National Cancer Institute statistics show that in 2009, 12.6 percent of melanoma cases ended in death, a much higher proportion than for basal and squamous cell cancers, which had a .01 percent mortality rate. Melanoma is slightly more common in men than in women, but recently, the most pronounced increases have been in older white men and young women.

What’s causing the increase, if not “better diagnostics”? Dr. Catherine Harwood, consultant dermatologist for Cancer Research UK, thinks she at least knows why the incidence is higher in men.  She says, “The thickness of a melanoma, at diagnosis, is very important in determining the outcome of the cancer. Men seem to be generally less aware of mole changes than women and as a result they often present when the melanoma is already quite thick. Detecting a melanoma in its early stages means earlier treatment with a much better chance of survival.” The UK saw an astounding 31% increase in melanoma deaths among men in 2006.

Another cause of skin cancers is tanning, which is a relatively new phenomenon. Throughout most of history, Caucasian people dreaded sun exposure, using compounds like arsenic to whiten their skin and carrying parasols for protection. The tanning craze didn’t start until 1923, when socialite Coco Channel accidentally stayed on her cruise ship in the sun too long. The incident made the press and others soon imitated her, hoping perhaps that if they got tan, they’d also be considered glamorous and get rich. And so, the increase in cases may be that all those children of the 50s, 60s, and 70s who had carefree fun in the sun without sunscreen are now reaping the results of that early exposure. Dr. Rigel says “We know the cause of melanoma is too much exposure to ultraviolet (UV) radiation, whether from the sun or indoor tanning beds and lamps. Simple behavior changes can lower your risk.” That’s why use of a heavy-duty sunscreen is advised along with wearing hats and protective clothing and avoiding exposure when the sun is strongest, between the hours of 10 AM to 3 PM. (And while I agree with the protective clothing, I consider heavy use of sunscreen problematic — both because of the chemicals it contains and the fact that it severely limits vitamin D production.)

But what if you grew up in the “decades of the sun,” before anyone thought of prevention? Then your primary concern becomes one of detection. You have to keep an eye on your moles and freckles. Harold S. Rabinovitz, MD, a dermatologist at the University of Miami Miller School of Medicine, says that you should look at your moles and check for what he calls the ABCs–asymmetry (one half unlike the other half); border (irregular, scalloped or poorly defined); color (varies from one area to another), shades of tan and brown, black; sometimes white, red or blue; diameter (the size of a pencil eraser or larger); evolving (changing in size, shape or color).

In either case, melanoma is on the rise, and not a statistical fluke. If you can, prevent it. If you can’t prevent it, then detect it and eliminate it. It’s easily treatable if detected early.

:hc

Posted in Cancer | 3 Comments »

Third Hand Smoke…Again: Health Blog

March 30th, 2010

Third Hand Cigraette Smoke

One of the pernicious things about bad habits is the way they adversely affect people who aren’t involved in them.  It’s old news that smoking cigarettes does terrible things to both smokers and the people around them. We also know that secondhand smoke, inhaled by hanging around smokers is also dangerous. Well, a new study ups the ante yet again.  Led by researchers at the Lawrence Berkeley National lab, the study revealed that long after a cigarette is put out, the tobacco smoke residue that clings to surfaces reacts with the common indoor air pollutant nitrous acid to produce dangerous carcinogens.

I recently wrote about the lingering effects of third-hand smoke.  In that article, I focused on the 250 poisonous gases, chemicals, and heavy metals contained in cigarette smoke and how these toxins which desposit on household surfaces pose significant dangers to infants, toddlers, children and adults alike. As I said, the dangerous components of cigarette smoke include a hair-raising array of poisons, including hydrogen cyanide, used to create chemical weapons; carbon monoxide; butane, which is a component of lighter fluid; ammonia; toluene (found in paint thinners); arsenic; lead; cadmium (a component of batteries); and the highly radioactive polonium-210. In fact, cigarette smoke contains eleven carcinogens categorized as Class 1, the most dangerous kind. And these carcinogens settle on every exposed surface when the butt goes out, so when kids crawl, roll, lounge, and play on the carpet or floor on which these compounds reside, there is real danger for them.

The new study adds an alarming wrinkle. Previously, nicotine itself was thought to be relatively nontoxic, even if addictive.  Wrong, wrong, wrong, according to Hugo Destaillats, a chemist with the Indoor Environment Department of Berkeley Lab’s Environmental Energy Technologies Division.  Says Destaillats, “…residual nicotine reacts with ambient nitrous acid [and] forms carcinogenic tobacco-specific nitrosamines — known as TSNAs. TSNAs are among the most broadly acting and potent carcinogens present in unburned tobacco and tobacco smoke.”  In other words, in addition to all its other toxins, cigarette smoke leaves a residue of nicotine on your household surfaces, and nitrous acid, which is everywhere in most households (it comes from un-vented gas appliances, for instance), converts it into very nasty stuff.

And lest you think that we’re talking about paltry amounts of TSNA carcinogens hanging around your house as a result of nicotine residues, think about this. Samples exposed to “high but reasonable” concentrations of nitrous acid were found to contain 10 times higher levels of newly formed TSNAs than what was present in the samples prior to exposure, plus the conversion rate is very fast.  In other words, a little nicotine goes a very long way and acts very quickly in creating carcinogens. The study showed an up to .4 percent conversion of nicotine to TSNAs in the first hour alone.  Lead study author Mohamad Sleiman said, “Given the rapid sorption and persistence of high levels of nicotine on indoor surfaces, including clothing and human skin, our findings indicate that third-hand smoke represents an unappreciated health hazard through dermal exposure, dust inhalation and ingestion.”

Even on metal surfaces the danger is quite significant. The surfaces of the stainless steel glove compartment in the truck of a heavy smoker revealed substantial levels of the TSNAs known as NNN and NNK. Both are potent carcinogens.  A 1980 study published in Cancer Research showed that, “NNN induces lung adenomas in mice, esophageal and nasal cavity tumors in rats, and tracheal tumors in hamsters.” NNK was found to be even more carcinogenic.

And TSNAs don’t only cause lung and esophageal cancer. They’ve also been linked to oral cancer and cervical cancer. In fact, studies have shown you don’t need to smoke nicotine to reap the punishment. NNN and NNK have been strongly linked with the excess of oral cancers found among snuff users.   That ought to give you chills when you think about your toddler putting a toy in his mouth that he dragged across a carpet that smells of tobacco smoke.

Even if you go outside to smoke, the nicotine residue that you bring back into the house (or car) on your clothes and skin rubs off on household surfaces and poses a threat.  Children and toddlers are most at risk because their young skin is so vulnerable to dermal uptake of TSNAs.

As I’ve said previously, you’re not being overly fussy when you try to avoid being in the presence of tobacco smoke or its residue.  Previous research on third-hand smoke supported regulations banning smoking in public buildings and places. Based on this new research, maybe we should require smokers to wash their clothes, shower, and clean the carpet (not to mention the inside of their car or truck) after each cigarette.

I know this might sound a bit mean or vindictive when it comes to smokers. But, really, what’s meaner? Warning smokers about the dangers they present to others one more time, or allowing a toddler to get cancer because they’re crawling on a carpet that stinks of cigarette smoke.

:hc

Diet Influences Genetic Changes in Smokers: Health Blog

February 2nd, 2010

Cancer Prevention, Lung Cancer

The evidence is overwhelming: diet plays a huge role in your vulnerability to cancer. If you know what foods to avoid and which to embrace, you lower your risk substantially. The avoids are fairly obvious — processed foods, high-fat items, deep-fried and charred items, meats, things laden with sugar, anything not organic. So too are the helper foods — leafy greens, fruits, green tea, food high in antioxidants. Research keeps reinforcing these facts, and now a new study has found that smokers can actually influence genetic changes that would otherwise lead to lung cancer by eating the right foods.

The study, out of the Lovelace Respiratory Research Institute in Albuquerque, New Mexico, involved 1100 current and former smokers, 75 percent of whom were female. All the subjects had at least a 15-year smoking habit of a pack or more daily. At the outset, the subjects provided samples of spit and completed questionnaires about their eating habits. The research team then analyzed the spit for methylation of the cells, a process that “turns off” genes, blocking their function by depositing methyl molecules. Smoking causes methylation, one of the chief reasons smoking causes cancer. As Dr. Jacob Kagan of the Cancer Biomarkers Research Group commented, “Aberrant gene methylation is a known mechanism in the development of cancer from cigarette smoke carcinogens.”

The researchers particularly wanted to know if methylation had occurred in those genes responsible for suppressing tumor growth and repairing DNA, because when methylation occurs in those genes, lung cancer risk increases substantially. Even more, they wanted to see if dietary intake would affect the rate of methylation, and so they analyzed the connections between methylation and 21 dietary variables.

And guess what they found? The more leafy green vegetables the subjects ate, the less methylation they had in their genes. The researchers assumed that the high levels of folates in the green vegetables were responsible for the effect, although they also found significant reduction of methylation in subjects who took multivitamins.

According to study director Dr. Steven A. Belinsky, director of the Lung Cancer Program at Lovelace, “There was a dose response with consumption of vegetables and sustained vitamin use, and increased duration was associated with better protection. Multivitamins and leafy green vegetables have things other than folate, although that is the common link…”

Interestingly, only the leafy green vegetables protected against methylation. The researchers found no benefit from other foods (including other high folate vegetables), which on analysis throws doubt on the idea that folates alone made the difference. After all, fruits, beans, liver, and even fortified cereals have plenty of folates. Could it be, then, that calorie-for-calorie, leafy greens simply have more nutritional punch than most other foods, and that their balance of minerals, vitamins, phytonutrients, flavenoids, and fiber works together in a unique and powerful way? (Certainly folates have benefits, and those benefits extend beyond their anti-carcinogenic properties. They’ve also been found to benefit the cardiovascular system, to lessen depression, and to protect against birth defects. But again, a close look at the study makes it doubtful that folates alone are the key to preventing lung cancer.)

Given the results, the researchers recommend that smokers make like Popeye and eat their spinach. “Most cancers arise through inactivating genes by methylation, so I don’t think consumption of leafy green vegetables and a multivitamin would do anything negative, and it could help,” Dr. Belinsky admits.

Meanwhile, a simultaneous study found that drinking a cup of green tea daily has a profound impact on lung cancer prevention, even among smokers. The study, from Chung Shan Medical University in Taiwan, found an amazing 13-fold lower risk among green-tea drinking smokers and a seven-fold lower risk among non-smokers. Participants included 170 lung cancer patients and 340 healthy patients. In this case, the researchers credit the antioxidants in green tea for the benefit. It’s also worth noting that demographic studies have indicated that green tea consumption might provide a possible explanation as to why the Japanese, who are among the world’s heaviest smokers, have such a low incidence of lung cancer.

That said, the experts expressed concern that the irresponsible public will learn of these studies and go haywire smoking because they now will know how to counter the effects. The head of the American Lung Association, Dr. Norman Edelmen, said, “What the American Lung Association is really afraid of is that people will look at this and think, ‘Oh, well, I can smoke as long as I have a few cups of green tea.’ Nothing could be further from the truth. Smoking is extremely toxic, obviously, and extremely detrimental to your health. And nothing changes this fact. So the most important thing here is that we don’t want anyone to get the message that it’s okay to smoke so long as I drink green tea.”

Let’s hope we’re not that stupid. In any event, to paraphrase Dr. Belinsky, it sure couldn’t hurt to drink green tea, especially if you have a history of smoking. Better yet would be to not smoke at all, drink green tea anyway, and eat lots of organic chard, kale, spinach, collards, and the like.

:hc

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Pomegranate Fights Cancer: Health Blog

January 14th, 2010

Pomegranate, Breast Cancer, Ellagitannins

If an apple a day doesn’t keep the doctor away, its look-alike cousin the pomegranate just might. A new study has found that a substance in pomegranates can slow or even stop the growth of breast cancer tumors. The study, just published in Cancer Prevention Research, found 10 phytochemicals in pomegranates that seem to inhibit the growth of estrogen-responsive breast tumors. The phytochemicals, called ellagitannins, work by blocking an enzyme called aromatase, which feeds estrogen and plays a key role in breast tumor growth. The ellagitannin called urolithin B had the strongest inhibitory effect.

As I’ve discussed previously, different fruits have different mixes of ellagitannins, with each mix providing a different emphasis of benefits. Whereas the mix of ellagitannins in red raspberries appears particularly well suited in combating colon cancer, it now appears that pomegranates provide special benefits when dealing with breast cancer. The study also confirms what I’ve been saying for years about ellagic acid — that the health benefits in pomegranates and raspberries are in the ellagitanins, not the ellagic acid as offered by some supplement manufacturers.

Many of the key drugs given to patients who have estrogen-dependent breast tumors act in a fashion similar to the ellagitannins, also inhibiting aromatase. But the director of the study, Dr. Shiuan Chen of the City of Hope Cancer Research and Treatment Center in Duarte, California, said patients should not try to substitute pomegranate for their medications. “We do not recommend people start taking this as a replacement for the AI’s,” Dr. Chen said. “They (pomegranate compounds) are not as potent as the real drugs so we think that the interest probably is more on the prevention end rather than in a therapeutic purpose.”

Other experts also caution against relying on pomegranate as a substitute for drugs. According to Gary Stoner of Ohio State University, “It’s not clear that these levels could be achieved in animals or in humans because the (compounds) are not well absorbed into blood when provided in the diet.”

The researchers didn’t expect to find the pomegranate derivatives to be as effective as they were. “We were surprised by our findings,” Dr. Chen said. “We previously found other fruits, such as grapes, to be capable of the inhibition of aromatase. But phytochemicals in pomegranates and in grapes are different.”

The surprising factor here is that the researchers found their results surprising. After all, back in 2004 I wrote about the cancer-fighting properties of pomegranates, specifically mentioning breast cancer. That’s one of the reasons I included pomegranate in my Superfood formula, writing on August 30, 2004 that, “Supplementation with pomegranate extract makes sense if you are looking at cancer prevention, maintaining a healthy heart, reducing bad cholesterol, lowering blood pressure, and protecting against free radicals and aging.” That same year, The European Journal of Cancer Prevention published a study discussing the breast cancer-fighting properties of pomegranate juice and pomegranate oil when administered to mice.

The fact is, supplementing with antioxidant-rich pomegranate couldn’t hurt, at worst. The scientists think the compounds in pomegranates may play a role in regulating estrogen levels and regulating menstrual and menopausal symptoms. This means that pomegranate might help reduce cramping, mood swings, hot flashes, and so on. And then there are all the other benefits associated with the fruit — and there are plenty of those.

For one thing, research shows that pomegranate reduced heart disease risk factors not only in lab tests, but also in preliminary human trials. A 2004 study published in the Journal of Clinical Nutrition found that by taking the equivalent of a cup of pomegranate juice daily for one year, patients who had severe carotid artery stenosis reduced arterial plaque by 35 percent, reduced bad cholesterol by 20 percent, reduced cholesterol oxidation by 90 percent, and reduced blood pressure in just two weeks. One year later, a study published in the American Journal of the College of Cardiology found that in just three months, drinking a cup of pomegranate juice daily improved the amount of oxygen getting to the heart muscle of patients who had heart disease. All in all, it makes you wonder what Gary Stoner was referring to when he said, “[These compounds] are not well absorbed into blood when provided in the diet.”

As for the cancer-fighting properties of pomegranates, several studies have found pomegranate useful in combating prostate cancer. Research out of Stanford University completed this past August found that men with prostate cancer who drank a glass of pomegranate juice daily had far slower cancer cell proliferation than those who didn’t drink the juice. The researchers followed 48 men over a five year period, and those who drank the juice took four times as long for their PSA test markers to double compared to the non-juice drinkers. Studies also have found that pomegranate juice may prevent skin and lung cancer.

Other conditions that show improvement after consuming pomegranate include erectile dysfunction, arthritis, dental plaque, and diarrhea. Plus, pomegranate juice is antibacterial and antiviral.

To enjoy pomegranate’s benefits, you can drink pomegranate juice (but make sure it isn’t sweetened, and raw chilled juice is best — not so much pasteurized), take pomegranate extract supplements, peel the fruit and eat it, or take it as part of a superfood formula.

:hc

Cell Phones Zap Alzheimer’s: Health Blog

January 12th, 2010

Cell Phone Radiation

There’s a joke in which a doctor tells a patient, “I have some good news and some bad news. The good news is that you have 24 hours to live. The bad news is that I forgot to call you yesterday.” Just like that joke, it seems that, given enough time, industry comes up with something positive to say for almost every toxic entity that adds profit to the economy while endangering health.

Take cell phones, for instance. In the wake of major reports that potentially tie cell phone use to brain cancer, a new study has found a miraculous healing effect “potentially” originating from the phones. According to a report just published in the Journal of Alzheimer’s Disease, extended exposure to cell phones starting at a young age may prevent and even reverse Alzheimer’s.

The study, out of the University of South Florida, involved 96 mice, including some genetically engineered to develop Alzheimer’s disease. The mice enjoyed an hour every morning and another hour in the evening with their cages arranged close to an electromagnetic transmitter. The transmitter, which emulates a cell-phone tower, emitted energy equivalent to what the human brain gets exposed to with a phone next to the head. The treatment continued for six to nine months, subjecting the mice to the human equivalent of 25 to 30 years of daily cell-phone use. After each zapping session, the mice got released into water mazes where they had to swim around and recall the location of underwater platforms.

After four months of treatment, all the mice did better on the memory tests. The normal mice performed better than normal mice who hadn’t been exposed to the radiation, making fewer errors and finishing faster, and the mice with Alzheimer’s did better than the Alzheimer’s mice with no exposure to radiation. Most strikingly, Alzheimer’s mice who had started the irradiation treatments at a very young age, prior to the onset of the disease, performed at a level equivalent to the normal mice. Even the Alzheimer’s mice who started irradiation at five months of age, when they were just starting to deteriorate mentally, showed no further signs of decline and in fact, the treatments seemed to begin reversing signs of Alzheimer’s — but this was only after they had received a full eight months of treatment. Prior to that, tests showed no measurable improvement.

The reason for the magic, according to the researchers, is that the amyloid protein that normally forms a gummy substance that clogs brains and causes Alzheimer’s remained in liquid form after radiation exposure. The researchers found this effect both in autopsies of the genetically altered mice and also when they placed amyloid protein in petri dishes and exposed it to the transmitter. Study director Dr. Gary Arendash attributes the amyloid protein melt to heat coming off the radiation. The mice had body temperatures a full degree higher than normal after months of exposure. Another theory postulates that the exposure to radiation activates the healing mechanism in the brain, triggering DNA repair.

On the other hand, Dr. Phelps of the National Institute on Aging warned that what works for mice might not work on humans. For one thing, while cell phones typically get pointed directly at the brain, the mice had whole-body exposure. Dr. Phelps postulated that the exposure might have stimulated a biological response elsewhere in the body that later got carried to the brain. In other words, radiation in general might be helpful, but not directed radiation aimed at the head. Also, Alzheimer’s works differently on humans than it does on mice. Although both species develop amyloid plaque with the onset of Alzheimer’s, in humans Alzheimer’s victims suffer neuron loss and the formation of neurofibrillary tangles, neither of which occur in mice. Breaking up the brain plaque might not be enough to reverse the disease in humans.

“This is no call for anyone to self-medicate,” said Dr. Bill Thies, the medical director of the Alzheimer’s Association. But still, the research team has big dreams. “If we can determine the best set of electromagnetic parameters to effectively prevent beta-amyloid aggregation and remove pre-existing beta-amyloid deposits from the brain, this technology could be quickly translated to human benefit against AD [Alzheimer's disease],” says research team member Dr. Chuanhai Cao. “Since production and aggregation of beta-amyloid occurs in traumatic brain injury, particularly soldiers during war, the therapeutic impact of our findings may extend beyond Alzheimer’s disease.”

And yes, the researchers may well be onto something. Massive exposure to cell-phones may well zap Alzheimer’s. But given that unlike the mice, the researchers weren’t genetically modified to become forgetful, they seem remarkably oblivious to the fact that restoring memory might not be such a benefit when the possible side effects involve brain cancer. On the other hand, the scientists don’t seem to buy the cell-phone-causes-brain cancer story. Dr. Cao says that this study “provides evidence that long-term cell phone use is not harmful to [the] brain.” And Dr. Arendash concludes that there is “no evidence” of much risk [of brain cancer from cell phone use].

Certainly, the Environmental Working Group disagrees, as I’ve pointed out in earlier blogs. After careful review of 200 studies on the subject, the EWG issued a report citing increased incidence of brain tumors and celluloid lung cancer, increased risk of hyperactivity in children, salivary gland tumors, migraines and vertigo. Meanwhile, the International EMF Foundation, comprised of an illustrious panel of scientists from 13 countries, also issued a report last year cautioning that industry has grossly underreported the dangers that cell phones pose, including significant increased risk of brain cancer and genetic damage, with that elevated risk hovering around 20 percent for each year of cell-phone use. The state of Maine also disagrees — lawmakers there are considering making warning labels mandatory on cell phones.

It’s certainly interesting that one of the chief arguments put forth by those scientists who insist that cell phones are safe has been that the devices don’t put out enough radiation to have any effect on the brain, let alone grow tumors. Now those same scientists are eager to point out that cell phones emit enough radiation to break up amyloid plaque and possibly reverse Alzheimer’s. I guess in the world of science you truly can have your cake and eat it too.

:hc

CAT Scans Cause Cancer: Health Blog

December 22nd, 2009

CAT Scans, Cancer

The big “oops” of the week in the medical community concerns CT scanning, otherwise known as computed tomography or CAT Scaning (computer aided tomography). Touted as miracle technology when it first hit the scene in the 1970s (in fact, the developers of modern CT scan technology shared the Nobel Prize in 1979), CT scans provide three-dimensional images far more detailed and flexible than normal X-rays. Doctors love to rely on them, and so the number of CT scans performed in the US increased 23-fold from three million in 1980 to about 70 million by 2007. At a typical cost of $500 and up to $1500 per scan, which can mean $6000 or more for diagnostic scans of several body parts, it’s been a profitable addition to the medical bag of tricks.

Despite assurances from doctors that the benefits of getting such accurate diagnostic images outweigh the risks, new evidence indicates that the radiation received from CT scans increases cancer risk…by a substantial margin. A study just completed at four San Francisco hospitals found the median dose of radiation delivered during CT scans was higher than previously thought. Also, the radiation levels varied wildly for the same procedure from hospital to hospital and even within the same institution. In fact, there was a 13-fold difference between the highest and lowest doses of radiation for identical procedures.

To put the radiation exposure in perspective, a complete set of dental x-rays (about 18 exposures) provides an effective dose of about 1.5 mrem (or .015 mSv). The average person absorbs one millisiervert (mSv) of background radiation annually just from routine living. A single pelvic/abdominal CT scan, on the other hand, exposes the patient to an average of 31 mSv while a typical head scan puts out an average of two mSv. But those are just averages. The researchers discovered that while a head scan at one hospital exposed patients to only 0.3 mSv, the same procedure at another hosptial exposed patients to six mSv (about 400 times the exposure of a complete set of dental x-rays). The deviations become startling when considering variations in the radiation for the abdominal/pelvic series, where researchers found radiation as high as 90 mSv at one hospital — almost 60 units above the average. This represents a 13-fold variation in dose and means that some patients are getting far more exposure than necessary for an adequate image. Consider that the survivors of Hiroshima suffered increased cancer risk from radiation exposures estimated to be as low as 10 mSv, and that the typical CT scan delivers as much radiation as 74 mammograms and 442 chest X-rays.

Given these figures, it’s no wonder that a second study published in the Archives of Internal Medicine concluded that 29,000 new cancers would result from CT scans performed in 2007 alone. The majority of those cancers (14,000), not surprisingly, would result from scans of the abdomen and pelvis, according to the projections.  Another 4,100 would come from chest scans; 4,000 from head scans; and 2,700 from CT angiograms. The most vulnerable populations include younger adults and women. The researchers project that those aged 35-54 would develop one-third of the projected cancers while women would develop two-thirds of those incipient cancers.

Viewed through another lens, researchers estimate that one out of every 270 women and one of every 600 men who received a CT coronary angiogram at age 40 would develop cancer from that scan, while one in 8,100 women and one in 11,080 men who had a routine head CT scan at age 40 would develop cancer. The researchers also expect 2000 extra breast cancers to develop just from CT scans in 2007. These figures don’t account for those at far higher risk after receiving an abdominal/pelvic scan. They also don’t consider the cumulative effect exerted on those who had multiple CT scans, including repeat and follow-up scans, or for the factor of age, which doubles the risk for 20-year-olds and halves it for those 60 and older.

Certainly one heart-breaking reality here is that many of the CT scans performed on patients never needed to be performed in the first place. “CT is generally considered to have a very favorable risk-to-benefit profile among symptomatic patients,” said study director Dr. Rebecca Smith-Bindman of the University of California San Francisco. “However, the threshold for using CT has declined so that it is no longer used only in very sick patients, but also in those with mild, self-limited illness who are otherwise healthy. In these patients, the value of CT needs to be balanced against this small but real risk of carcinogenesis resulting from its use.”

While Dr. Smith-Bindman is right about the need for caution, “the small but real risk” part of her statement needs a reality-check. A one in 270 chance of getting cancer for a superfluous procedure in an otherwise healthy individual seems not-so-small at all, and remember, that’s just the tip of the iceberg. The odds go way up for young patients who have had several abdominal scans. Anyway, why should any otherwise healthy individual risk getting cancer to have a fancy diagnostic procedure done when other options exist? A more on-target viewpoint is the one expressed by the editor of the Archives of Internal Medicine, Dr. Rita Redber, who wrote that the study results “make us question if we have gotten carried away in our enthusiasm” for the use of CT.

The researchers suggest that practitioners exercise more restraint in prescribing CT scans in the first place, that radiation doses become standardized across institutions, and that medical institutions and practitioners track how many CT scans an individual has already had before wantonly assigning new ones — something that apparently (and appallingly) isn’t done. Also, in most cases, MRI or ultrasound or even simple X-ray procedures can get the same results as some very high-dose CT procedures that take multiple images of “slices” throughout the body.

Supposedly, the FDA is on the case after 260 patients at Cedars-Sinai Hospital in Los Angeles filed a class action suit after being exposed to eight-times the required dose of radiation during CT scans. Patients lost hair, suffered burns, and are at risk for forming cataracts as well as cancers. A class-action suit in Alabama claims patients there received 14-times the necessary dose. Investigators have found similar violations in other hospitals.

Lest you despair because you’ve submitted to a CT scan in the past, the good news is it could be worse. At least in some cases, CT scans do catch deadly problems that otherwise couldn’t be detected. So, maybe in a few cases, the risks really are worth it. Compare that to the nuclear stress test — where you ride a stationary bike or run on a treadmill while radioactive material lights up your heart to show how it’s functioning. Although doctors like to give those stress tests to patients as soon as they sprout a few gray hairs, the test delivers a huge dose of radiation with, as yet, no real evidence that the procedure offers any benefit at all. According to Dr. Michael S. Lauer of the National Institutes of Health, “The imaging technology today is amazing, it’s amazing how quickly it’s advanced, yet we haven’t answered the fundamental question of whether we’re actually helping people by doing this.”

The bottom line, it seems, is beware of doctors bearing imaging procedures. Do your homework, ask questions, and always go for the least amount of radiation necessary to find out what’s going on inside of you — which means preferably no radiation at all.

:hc

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