Dear Doctor Garner,
I recently heard you talking about the dangers of CAT scan on your TV show.
I am concerned, because I have had so many scans to evaluate my cancer.
You said that five Cat scans for an individual gave a risk for developing cancer similar to a Hiroshima atomic bomb survivor. Is there anything I can do to lessen my risks?
Cat scan Concerns in Canarsie
Dear CAT scan Concerned- I was just discussing the issue of medical radiation with my dear friend and loyal Tablet reader Mary Kay Gallagher. I would like to take this opportunity to wish her a happy birthday, and many more years to come.
It is true that Cat scans give off a lot of radiation. Some CAT scan radiation may be equivalent to as much as 700 chest x-rays.
In your case, the cat scans were ordered to help in your treatment and evaluation for cancer. This is appropriate use of Cat scans. The benefits of these scans far outweighed the risk to you from the extra radiation.
The big concern is for people having unnecessary Cat scans when other tests without radiation, such as MRI and Sonograms, could have been performed.
While the risks for cancer increase in people having many Cat scans, it is in the risk range of 1 in 500.
For an individual, this is not a high risk, but when you take into consideration that there are about 100 million Cat scans done each year, there clearly will be many cancers occurring directly related to the radiation from Cat scans.
A new study published this week adds to the concern. It estimates that because of CAT scan radiation each year that there will be 29,000 new cases of cancer in the country and 15,000 deaths.
To help minimize the risks, I believe that each patient should ask his or her doctor the following 5 questions before obtaining a CAT scan, or any test that involves radiation for that matter.
1. Why am I getting this test? – It is a good idea to understand why a test is being done and how it will help your management and treatment. It also may help to have your doctor focus on your situation and decide if the test is really necessary.
2. Is there another test, such as MRI or sonogram that can get the same results without using any radiation? – This is important, as it is estimated that one third of all Cat scans are unnecessary, and could have been avoided, using a non radiation producing procedure.
3. Is the facility taking the CAT scan accredited? There is great variation in the amount of radiation one is exposed to during exams at different hospitals or facilities.
There is more likelihood that the radiation will be less at an accredited facility.
4. Is the technologist using the lowest dose technique possible? What is your dose from this exam? These are very important questions. There was an error in the radiation exposure from Cat scans at Cedars Sinai Hospital, a major hospital in California. Due to an error in the setting of the CAT scan machines, patients received exorbitant doses of radiation and some even lost their hair. Had patients asked the above question, it is quite possible that the error, which went undetected for about a year, would have been picked up much sooner.
5. Are you aware of my radiation exposure history? Keep a list of all your Cat scans and other x-rays, and present it to your doctor whenever he orders an exam. Often, the ordering physician is not even aware that a patient has had similar tests done.
The bottom line is that one should never refuse a CAT scan if the patient and doctor understand the test to be an important part of the work up or treatment of a medical condition.
The patient should help to insure, that he or she is getting a test that is needed and has benefits that outweigh the risks.
The above five questions should help to ensure that the appropriate test is being performed.
This is the last column for the year 2009. It has been a pleasure answering your questions this year and I look forward to New Year ahead. I wish you all a happy New Year and most importantly, good health.
*Reprinted with permission of The Tablet
