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FYI : More on cancer and medical radiation exposures
#1
Much has been written over the increased cancer risks associated with radiation exposures in medical imaging and questioning the medical community on the clinical rationale for exposing patients to unnecessary x-rays and CT scans etc and here is the latest study demonstrating an association with an aggressive form of thyroid tumor. We have a local ER where CT scans are done on most acute back pain patients if they have leg pain even though a CT is not indicated nor helpful and it is a whopping radiation dose. Serial /neck spine X-rays to " monitor changes " also has no clinical application yet almost routine in litigation cases such as comp and PI. Always ask - will the test outcome change treatment ?


LITTLE FALLS, N.J., April 20 -- Thyroid cancer patients with a history of radiation exposure appear to develop more aggressive disease than those without such exposure, a retrospective chart review showed. Action Points
Explain to interested patients that the study authors said this study suggests that patients with thyroid cancer who have been exposed to radiation may require more aggressive treatment.
Patients who had been exposed to radiation were more likely to have stage IV and multifocal disease, as well as distant metastases, than the general thyroid carcinoma population, according to Jeremy Freeman, M.D., of Mount Sinai Hospital in Toronto and the University of Toronto, and colleagues.

These patients may require more aggressive treatment, they wrote in the April Archives of Otolaryngology -- Head & Neck Surgery.

Although there's a well-known association between radiation exposure and thyroid cancer, studies exploring whether radiation is associated with more advanced disease have yielded mixed results.

So Dr. Freeman and colleagues examined the charts of 125 patients who had been exposed to radiation and who had been surgically treated for thyroid cancer at Mount Sinai over a 44-year period.

Radiation exposure was classified as occupational, environmental, related to treatment for acne or other benign conditions, diagnostic, or related to therapeutic exposure to radioactive iodine.

Mean age at the first exposure was 19.7, and the mean time to diagnosis was 28.7 years.

More than half (56%) had a history of direct exposure to the head and neck for the treatment of benign conditions.

Almost a quarter (23%) were exposed to radiation in the workplace -- for radiographic technicians and dental assistants -- or through repeated diagnostic exposure.

The rest were exposed through the environment (11%), through direct exposure to parts of the body except for the head and neck (6%), and through radioactive iodine treatment (4%).

Most patients underwent total or near-total thyroidectomy (83%), with the rest undergoing subtotal or partial thyroidectomy.

Through a mean follow-up of 10.6 years, 16% developed recurrent thyroid cancer.

At the end of follow-up, 86% were alive and free of the disease, while 4% were alive with recurrent disease, 4% were alive with distant metastases, 4% had died of the disease, and 2% had died of unrelated causes.

When the radiation-exposed patients were compared with 574 matched patients who had thyroid cancer but did not necessarily have a history of radiation exposure, they seemed more likely to:

Have undergone total or near-total thyroidectomy (83% versus 38%)
Require additional operations (23% versus 2%)
Have stage IV disease (16% versus 5%)
Have distant metastases (9% versus 2%)
Have thyroid cancer at follow-up (8% versus 3%)
Die from the disease (4% versus 1.5%)
Undergo external radiotherapy (6% versus <1%)
Have multifocal disease (63% versus 36%)
Have extrathyroid spread (26% versus 8%)
Although statistical comparisons were not possible because of the study design, the researchers said, "the differences observed between groups must be taken seriously."

"They suggest the need not only for further careful study but also for consideration of more aggressive treatment of malignant thyroid nodules in patients who were exposed to radiation compared with those who were not," they said.

They noted some limitations of the study, including the heterogeneity of the patient exposures to radiation, treatment by multiple surgeons, and variability in reporting.

Dr. Freeman holds the Temmy Latner/Dynacare chair in head and neck oncology.
The authors made no other financial disclosures.


Primary source: Archives of Otolaryngology -- Head & Neck Surgery
Source reference:
Seaberg R, et al "Influence of previous radiation exposure on pathologic features and clinical outcome in patients with thyroid cancer" Arch Otolaryngol Head Neck Surg 2009; 135: 355-59.
 
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#2
so as well as our injury we are to worry about this as well?
........I love cats, I just cant eat a whole one by myself......







 
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#3
for a 3rd one, all for different parts of the body.

At my last MRI the medical staff questioned my about the cancer diagnosis.
They did mention a link to radiation. Due to my history the medical staff refused to do an MRI using contrast.

Here's the confusing part........
A different medical facility/doctor has ordered a MRI with contrast of the head.

I have questioned this doctor about the radiation & cancer link; he knows of no such information and insists on an MRI with contrast.

The MRI was to have been last week and I cancelled it until I receive more information on this subject.

I believe the concern of the first medical staff is the issue of my recent cancer diagnosis and cancer surgeries.
 
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#4
There is no radiation exposure with that procedure.
 
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#5
ok I had 3 MRIs of the cervical area with and without and do to some really bad headaches am gonna ask for another to see if I have blown another disc....are you saying I am putting myself at a higher risk for cancer by doing so.
........I love cats, I just cant eat a whole one by myself......







 
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#6
No Jayne, you'll be fine. MRI is perfectly safe as it does not involve radiation. CT scans are the big culprit in musculoskeletal medicine because it is a a huge radiation dose. There are numerous other medical conditions that may result in radiation exposures as well that need be considered as it isthe cumulative dose that seems to be the important factor.

I didn't post the article to suggest something more to worry about from past exposure, but rather as informative info for future consideration of any interested party as physicians are often quick to order tests but not always cognizant of the bigger picture such as how many have there been in the past, what other radiation exposures has this patient had, both medical and non-medical, can the information, if really necessary, be obtained by other means, etc.
 
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