Helping or hurting?. . . . .

[Happiness]

My mother in law (who has now passed) had skin cancer many many years ago and recieved radiation as a treatment. Later in life she developed lukemia as a direct result of the radiation. She was asked by a family member if she was angry because of the this and her response was "No it gave me an extra 25 years in this world and I was able to meet my grandchildren" To me that just says it all.

[HERBIE1]

How many times are people going to pay $1000+ in cash for a CT Scan? Of course if something is found it will have to be repeated.

We could also complain about mammograms. But, for the underprivileged where the screening have been eliminated due to cutbacks, they might think denying them access to these tests is not very fair. As well, if you don't have insurance, you will NOT get a CT Scan unless you put up the cash or come through the ED and say the right words.

Think cumulative effects. If we are concerned about exposure, 1 or 2 exams aren't the problem.

Less invasive is the trend for medical procedures now, which means good imaging is a must. Exploratory surgeries are no longer the norm- diagnostic imaging is the preferred method, which means many more studies than before.

A simple example was when I started in the ER, DPL's (diagnostic peritoneal lavages) were one of the determinations of whether or not an abdominal trauma patient bought a trip to the OR. CT's and MRI's were used sparingly back then because of cost. Now, although they are still pricey, the images are quicker, better, and they are used to rule out internal bleeding. Granted a DPL isn't the same as exploratory surgery, but it was invasive nonetheless.

[medic0surgeon]

My mother in law (who has now passed) had skin cancer many many years ago and recieved radiation as a treatment. Later in life she developed lukemia as a direct result of the radiation. She was asked by a family member if she was angry because of the this and her response was "No it gave me an extra 25 years in this world and I was able to meet my grandchildren" To me that just says it all.

I can respect that. I just wish there was a better way to handle that situation so that she didn't have to go though that again. . . you know?

[HERBIE1]

I can respect that. I just wish there was a better way to handle that situation so that she didn't have to go though that again. . . you know?

No treatment- especially something such as radiation therapy- are free from side effects. Sometimes the effects are immediate, sometimes delayed. I'd say 25 good years is a pretty good trade off, and if given the choice, I'd take that in a minute. Obviously we never know at the time what is in store for us later.

[fireflymedic]

There is always concerns with radiation exposure, however, there is less exposure with CT scan than with plain films and also it's a bigger booboo if you miss something that could have easily been found on CT scan which is considerably faster than MRI and much easier to accomodate seriously ill patients (unless you have an open scanner which few hospitals around here do). And in the case of pulmonary embolus and things nuclear scans and thoracic CT's are your big diagnostic things. Miss that and you've got a BIG miss and a dead patient. I think I'd error on the side of caution and worry about causing issues later. What they fail to mention though is that the treatment with radiation and some chemotherapy drugs may cure the type of cancer they currently have, but they develop another type as a side effect. It's a risk/benefit ratio you have to look at. You WILL die from one, you MAY develop the other. Just my opinion, but I think you're looking at bigger choices there.

[HERBIE1]

There is always concerns with radiation exposure, however, there is less exposure with CT scan than with plain films and also it's a bigger booboo if you miss something that could have easily been found on CT scan which is considerably faster than MRI and much easier to accomodate seriously ill patients (unless you have an open scanner which few hospitals around here do). And in the case of pulmonary embolus and things nuclear scans and thoracic CT's are your big diagnostic things. Miss that and you've got a BIG miss and a dead patient. I think I'd error on the side of caution and worry about causing issues later. What they fail to mention though is that the treatment with radiation and some chemotherapy drugs may cure the type of cancer they currently have, but they develop another type as a side effect. It's a risk/benefit ratio you have to look at. You WILL die from one, you MAY develop the other. Just my opinion, but I think you're looking at bigger choices there.

Yep. Most procedures have inherent risks- anesthesia complications, PE's, unknown underlying medical issues, etc. Even a simple IV stick has the potential of causing problems. In the case of chemo and radiation, we know how toxic they are to the body, but like you say, it's a risk/benefit thing. If you are treating an aggressive form of cancer, you worry about the more immediate consequences of the disease vs something that may happen down the road because of treatment.

[tniuqs]

There is always concerns with radiation exposure, however, there is less exposure with CT scan than with plain films

Good Point with cxray any experts on the rads films vs CT ? I was always under the impression that a cxray was higher ?

I dunno even where to look

cheers

[chbare]

Good Point with cxray any experts on the rads films vs CT ? I was always under the impression that a cxray was higher ?

I dunno even where to look

cheers

I would like to see Fireflies sources as the "radiation" exposure varies significantly from CT machine to CT machine. Additionally, the type of scan and the type of tissue scanned are considerations as well. For example, scanning in 5 mm slices is going to have a different exposure than scanning in 3 mm slices. However, doing the math goes something like this, a PA chest X-ray is one "shot" through the back to the plate. An acute abdominal series would include three "shots."

"Average" background radiation exposure over a year is ~ 3 mSv

"Average" PA chest = ~0.02 mSv

"Average" Abdominal CT = ~10 mSv

Take care,

chbare.

Oh yeah, before people start screaming for me to show the money shot:

http://www.pueblo.gsa.gov/cic_text/health/fullbody-ctscan/risks.htm

http://www.diagnosticimaging.com/dimag/legacy/db_area/onlinenews/2003/2003111901.shtml

Take care,

chbare.

[fireflymedic]

I would like to see Fireflies sources as the "radiation" exposure varies significantly from CT machine to CT machine. Additionally, the type of scan and the type of tissue scanned are considerations as well. For example, scanning in 5 mm slices is going to have a different exposure than scanning in 3 mm slices. However, doing the math goes something like this, a PA chest X-ray is one "shot" through the back to the plate. An acute abdominal series would include three "shots."

"Average" background radiation exposure over a year is ~ 3 mSv

"Average" PA chest = ~0.02 mSv

"Average" Abdominal CT = ~10 mSv

Take care,

chbare.

Oh yeah, before people start screaming for me to show the money shot:

http://www.pueblo.gsa.gov/cic_text/health/fullbody-ctscan/risks.htm

http://www.diagnosticimaging.com/dimag/legacy/db_area/onlinenews/2003/2003111901.shtml

Take care,

chbare.

Okay guys - first of all - I didn't quote anything because I am relaying what was told to me a number of times by varying physicians. I am in agreement - obviously if you are doing smaller slices, there is going to be greater radiation as you are doing more pictures. It's definitely something I will look into. However, if I am wrong, I will definitely stand corrected, so please do not take the word as gospel.

[chbare]

No worries, even what I stated is going to vary quite a bit.

Take care,

chbare.