BIG NEWS - CT Causes Leukemia ?

[Ronald Gross]

Ceasar,
Clearly you DO scan these kids before sending them back to the football field or hockey rink.  I was wondering how many on this list do the same?  I admit that I too used to but ceased to do so about 2 or 3 years ago.  I just keep them out for the rest of the season and let them go back for the next.
Ron

>>> "caesar ursic" <cmursic at gmail.com> 11/30/2007 6:42 AM >>>
Within the last 24 hours I have had two patients cancel outpatient follow-up
CT scans that I ordered several weeks ago.  Both are teen-aged boys who
recently sustained grade III and IV splenic injuries on the football field
that were successfully managed nonoperatively.  In both instances I got a
call from the parent citing this TV report and telling me that they do not
want their kid to get cancer.  I spent over 30 mins. on the telephone in
each case, being asked things like "why are you putting my child at risk,
doctor?" and "how do you know he wont die of lymphoma when he's 50 yrs
old?"  Despite my honest attempts to relay the risk/benefit argument to
them, hard numbers and percentages (what they want to hear) re. risks and
outcomes and cancer incidences are lacking or simply beyond me.

I do not think that either patient will end up getting re-scanned.  But I
know for a fact that both parents will be calling me back soon to demand an
"OK to resume sporting activity" letter  so that Junior can return to his
dangerous gridiron activities. Oh well, at least they wear helmets.....

CM Ursic
Santa Fe, NM, USA



On Nov 28, 2007 6:46 PM, <KMATTOX at aol.com> wrote:

> I am co posting this to both Trauma and ccm-l lists because of the intense
> interest of both groups.
>
> Two years, TWO YEARS ago, this subject was discussed in  some detail on
> both
> of these list servers.    Today the NEJM and  tonight, the major national
> TV
> news programs made this subject a BIG DEAL.   What took them so long to
> discover what the debaters on these list servers  discussed two years ago.
>
> Today the New England Journal of Medicine and also published in a Ft
> Lauderdale paper are reports that CT is overused and it can lead to
>  cancer.      The
> NEJM article has some of the  following comments:
>
> 1.  Up to 1/3 of CTs in the United States are ordered unnecessarily,
>  often
> before the patient is ever examined (KLM Agrees with the later statement
>  but
> believes that the un necessary figure may be as high as 90%)
>
> 2.    Up to 20 million adults and 1 million children  have un necessary CT
> scans annually
>
> 3.    100-200 times more radiation is inflicted on a  body after a CT
> compared to a routine chest X-ray
>
> 4.    2% of cancers seen in 20 years will be secondary  to CT scans
> performed
> today.
>
> 5.    ECRI   (  _http://www.ecri.org/_ (http://www.ecri.org/)   ) has
> indicated that  3000 persons with cancer today are secondary to excess
> radiation
> secondary to CT  scanning.
>
> I do not know if these suggestions are true or not,
> so...............................I looked at population based incidence of
>  cancer in 1970, 1980, and
> the last 10 years thinking I would see a flat line  incidence of leukemia
> and
> lymphoma per 100,000 population.     However
> ......................................................
>
> I have been told by one of the most successful plaintiff attorneys that I
> know that she has attended a number of conferences preparing plaintiff
> attorneys
>  to sue on the basis of a patient having cancer, lymphoma, and leukemia
> secondary  to CT scanning earlier in life.   The focus of these seminars
> is to
> lead attorneys to focus on class action suits, especially against doctors,
> in
> patients with cancer and in whom there was ANY question of un necessary CT
> scanning or excessive CT scanning earlier in the cancer patient's  life.
>
> Anticipating this subject, several months ago, this and other subjects was
> put onto the Las Vegas Trauma Conference ( _www.trauma-criticalcare.com_
> (http://www.trauma-criticalcare.com)   )  It is all there.
>
> Think of this day and the attention that CT scanning has gotten the next
> time you give a verbal or written order for a CT scan, especially if you
> have
> not yet examined the patient and obtained a simpler more indicated  test.
>
> k
>
>
>
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