BIG NEWS - CT Causes Leukemia ?

[William Bromberg]

Caesar — so when are you going to allow the return?

Did you think I'd let THAT one go?

Bill

>>> "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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>
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