Health Care Paradigms

Medical Imaging Cancer Risks

Are you considering having an MRI, mammogram, X-ray, or CT scan? If so, have you asked your doctor about your “cumulative medical imaging radiation exposure”?  If not, then you should before you decide on any medical imaging procedures.  The President’s Cancer Panel’s annual report from 2008-2009 included warnings about the cumulative exposure of radiation from medical imaging.

“While ionizing radiation exposures from”¦other sources have remained essentially stable over the past 30 years, Americans now are estimated to receive nearly half (48%) of their total radiation exposure from medical imaging and other medical sources, compared with only 15 % in the early 1980’s.”

Medical imaging technology is currently our single greatest source of harmful radiation.  We know that radiation exposure is cumulative, meaning that all radiation to which you have ever been exposed accumulates risk over the course of your life.  Even smaller exposures, like flying in an airplane, can become significant risks if you fly very often for a long period of time.

“”¦for those who fly frequently, such as aircrew and some business travellers, the annual exposure may be comparable with or exceed that of radiation workers in ground-based industries”¦”

This means that every dental x-ray, every MRI, and every mammogram accumulates radiation exposure in your body and increases your risk of cancer measurably.  Obviously, many of these technologies can be life-saving, but they also must be used judiciously.  And while we trust our doctors to use these technologies with intelligence and restraint, the President’s Panel report had some troubling comments:

“Many primary care physicians and other referring medical professionals are unaware of the magnitude of radiation exposure from various imaging or nuclear medicine procedures, or the potential cancer risk of increasing a patient’s lifetime cumulative radiation dose.  In a recent survey of radiologists and emergency room physicians, three-quarters of the group significantly underestimated the radiation dose from a CT scan; further, more than half of the radiologists and 91 percent of emergency room physicians surveyed did not believe that CT scans increased lifetime cancer risk.[They do.] A speaker noted that many tests are ordered at least in part as protection against possible future litigation based on accusations that the physician withheld the most cutting-edge technology from the patient.”

As doctors become more forced into practice models that focus on protecting their own profession, it becomes the responsibility of the patient to be informed about these risks.  And nowhere are these risks greater than with our children.  Children are three to five times more sensitive to the harmful effects of radiation than adults.  The Panel’s report estimates that as many as 33% of all CT scans on children are unnecessary.  If your doctor has suggested that your child receive any kind of medical imaging radiation, make sure the test is absolutely necessary, and that the risks of the test outweigh the benefit of any other alternative.  Then make sure the following four steps are taken to reduce exposure:

1.      Reduce or “child size” the amount of radiation used.  Reduce dose as low as reasonably achievable to produce a quality image.

2.      Scan only when necessary.

3.      Scan only the indicated region.

4.      Scan once; multiphase scanning is usually not necessary in children.

There are currently no regulations in the medical industry for health care providers to track the accumulated radiation exposure of a patient over the course of his or her lifetime from medical imaging.  This means that your doctor is probably not taking into consideration your lifetime radiation exposure when determining the risk/benefit of a particular medical procedure.  This then becomes the responsibility of you, the patient.  Remember that x-rays, MRI’s and CT scans use radiation.  Even ultrasounds, or sonograms, are classified as radiation by the U.S. Department of Energy.  Medical imaging technology can be a life-saving gift, if used wisely.  Be a wise and informed patient, and you can get the most out of medical imaging, while avoiding unnecessary risks.

 

 

 

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