On the Cautionary front: In his book “One Doctor” Prof. Brendan Reilly MD of Weill Medical College writes: “Seventy million CT scans are performed annually in the United States—all of them expensive and many of them unnecessary. (Worse, it is estimated that ionizing radiation from these CT scans will cause fifteen thousand to thirty thousand cancers annually—1 to 2 percent of all new cancers diagnosed.)” This is a general assessment so expect the percent of CT caused cancers to be higher in our younger community members already prone to developing secondary cancers in the absence of any CT scanning. This fact should be a wake-up call especially for women. Women, in general, live longer than men and a woman who is 65 can reasonably expect to make it to 85 in the oft touted 20 year time frame for a possible secondary cancer to show its ugly self. As treatments promise longer OS (Overall Survival) does this not, in itself, argue for heightened discretionary CT use in patients under 65? The younger you are the more you should be aware.
Since the 2009 LRF Conference in Brooklyn NY, Oncologist lecturers have been spreading the message that CT scans are being over used. At the LRF Conference 2013 Dr. Matthew Davids, Harvard Medical School & Dana Farber Institute and Dr. Kieron Dunleavy, National Cancer Institute, as part of their formal presentations, sent the message discouraging the need for CT scanning in CLL.
What sent me to my doctor was cervical and submandibular enlarged lymphnodes. My family Doc had seen a few CLL cases and sent me immediately to the hospital for a CBC and CMP (blood-work) That blood-work was enough to firm up his guess of CLL and later cytology nailed it down. It was the Onc who ordered a CT. Much later when I finally dropped out of the NIH CLL History study to begin therapy it was because I was unable to comfortably breathe in a prone condition. I did not need a CT to tell me I had too much internal tumor to continue in W&W. I had no “B” symptoms although I was quite anemic.
This from the AAPM 2008 report 96 on Effective Dose for ionizing radiation. “It is important to recognize that the potential biological effects from radiation depend not only on the radiation dose to a tissue or organ but also on the biological sensitivity of the tissue or organ irradiated.”
PLEASE click on this link and at least go to Paragraph 6 “Common medical Imaging ...” and read the last sentence plus “Key Points”
Radiation exposure from medical imaging: A silent harm?
Some other reference reading fleshing out the case for concern:
NY Times Op-Ed, Jan. 31: “We Are Giving Ourselves Cancer,” by Rita F. Redberg and Rebecca Smith-Bindman
Estimated risk for full body CT scans. <http://www.ncbi.nlm.nih.gov/pubmed/15273333?dopt=Abstract>
Questions you might raise before you are scanned:
On top of everything else, due to human & technology error one cannot rule out getting improper dosages of radiation. <http://jama.jamanetwork.com/article.aspx?articleid=185197>