Monday, February 1, 2010

Over Exposure

From past posts you'll recall that I am someone who feels we are over radiated. With the advent of technology, the push to own diagnostic equipment and thus pay for it, the fear of malpractice suits, and the ease of use - people are being scanned at a much higher frequency than probably intended by scan developers (not sellers or stock holders, but whoever thought of how seeing inside the body might help improve treatment outcomes). It is also true that people are getting radiation exposure in these scans and medical diagnostics at higher frequency(more scans per person and more lifetime exposure) and higher dose than intended. We are beginning to see that this ultra radiation may in fact cause far worse outcomes than misdiagnosing a stress fracture or back sprain. Additionally, there has been a push for using these machines for PREVENTION screening. One of the most blatant misuses, in my opinion, and also in the oncology and radiation community(say 50-50), is using CT scans to search for lung cancer in tobacco smokers. Remember, finding a tumor on a CT scan means the cancer has been in progress for years. The radiation that the patient receives and the false sense of security that their lungs are fine causes much more harm than good. Far better for the clinician to say, "Any amount or type of smoke that you inhale, is causing harm to your lungs and putting you at risk for COPD and Cancer. Quit. Here's how."

It would behoove us all to ask some questions before going under the scanner. What are you looking for? What is the radiation dose? How will the results of this scan change the recommended treatment? That last one is uber important. If you are told that the exact same course of treatment will be prescribed regardless of what the scan says, you might consider skipping it. [It won't hurt to ask the dentist the same thing about those Xrays]

Well, all this brings me to the point of today's post which is actually a positive thing! The National Institutes of Health will record the amount of radiation each patient is exposed to in each test they receive. Unfortunately, they are only one institution. It is hoped that others will follow suit and that it may even become a standard of care for all health care providers.

In a USA Today story about this decision, a graph was presented that showed the change in numbers of CT scans between 1980 and 2007. The latter number was 72 million. Incredible because in 1980 the number was 3 million.

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