But aren't we living with ionizing radiation all the time so what's the big deal? Correct, the average yearly exposure of a US resident is 3 to 3.2 mSv (milli sievert). Brian Koffman who spends much of his time at 30 thousand feet flying all over the place to bring us great interviews is probably getting more as are folks who never fly but live at 7 thousand foot elevations or downwind of a nuclear facility. SI or sievert is the unit of effective dose measurement. I had decided to drop any detailed description for how the sievert is used because I don't want to have your eyes glaze over. For the curious, an in depth discussion can be found here: <http://en.wikipedia.org/wiki/Sievert> Remember, Ionizing radiation damage to our tissues is cumulative.
I will break down our examination of CT use into 2 contextual arenas with the first arena having “a” and “b” parts. 1,a) the Clinical Management of CLL during the W&W phase and 1,b) throughout the standard treatment phase as separate from; 2) the Clinical Trial phase of our respective journeys.
Looking at CT use in the first context of W&W and during standard therapy, YOU, as the patient or caregiver must be proactive in being an integral part of the decision to allow CT scanning! Don't accept the order for a CT scan without justification criteria that makes sense to you. Asking appropriate questions and assessing the validity of the answers to your “informed” satisfaction will reduce unnecessary scanning. CTs cannot diagnose CLL and are not required. Sadly, Doctor ignorance of CLL and possibly Dr. fear of litigation are probable drivers for over-scanning. Your polite refusal, if not satisfied for the reason behind being scanned, may be all the Doctor needs to protect himself.
The 2nd contextual arena is alerting you to believe that a Clinical Trial is not only in your future but may be key to your having a future at all. That Clinical Trial context will mandate a series of CT scans as part of Trial protocol, adding importance to PRIOR radiation exposure in Context #1a & b. Ionizing radiation is cumulative and not all repetition is due to senility or chemo-brain(-; Clinical Trials are becoming more attractive regarding benefit vs risk and a necessity for many patients who have run out of therapy options. The benefits from my and others participation in a Phase I Trial, which is the most-risk category of Trial, is proof enough for promotion of Clinical Trials in general. Clinical Trial participation and CT scanning cannot be separated.
Your age matters. Your sex matters. You should be acutely aware that the younger you are and if you are female, the more you need to question your risk vs benefit from CT scanning being ordered in Context 1a clinical management context of your journey!