With advancing medical technologies, health-care decisions are becoming more and more confusing for the general public. Patients need to take a proactive role in informing themselves about their health care.
A fundamental factor in making health-care decisions involves weighing the risks and benefits of interventions intended to diagnose and treat illness.
I am frequently asked about an issue in medicine that has drawn much attention in recent years – the effect of radiation exposure from diagnostic medical procedures on long-term health. With the increase in use of these procedures, including CAT scan and fluoroscopy, there has been a significant increase in exposure of Americans to ionizing radiation. Ionizing radiation is the kind of radiation that can damage the body’s cells.
It is interesting to note that the recent nuclear power plant disaster resulting from the Japanese tsunami created panic among some in the American public, when, in fact, the potential for radiation exposure here was very low. Yet ionizing radiation exposure from medical imaging now accounts for nearly one-half of all radiation exposure in the country each year.
Radiation is all around us. We are all exposed to very low levels of radiation in our environment from sources such as radon and cosmic rays. The body is well-suited to handle this type of exposure. Cells are designed with processes in place to repair any damage that may result from low-level radiation exposure. Indeed, exposure to radiation from a single diagnostic medical procedure is thought to produce little or no risk to the patient.
However, repeated exposure to ionizing radiation is becoming more common, particularly in acute medical settings such as hospitals. In one large inner-city hospital, the rate of CAT scans nearly doubled during a decade. A single CAT scan produces the average radiation equivalent of about 200 chest X-rays.
Ionizing radiation to certain highly active tissues in the body, such as the thyroid gland, has the potential to damage either the genetic material in cells or the defense mechanisms cells have in place to repair cell damage. There is a known risk of certain types of cancer related to radiation exposure. Most of this risk is known from studying survivors of the atomic bomb attacks on Hiroshima and Nagasaki. Cancer related to radiation exposure may not occur for many decades after the exposure. This makes studying the effects of technologies like CAT scan more difficult. In fact, from a statistical standpoint, it may never be possible to draw a direct link.
Let me be clear on a couple of important points. First, radiation from medical imaging procedures has never been directly linked to cancer. Moreover, imaging technologies like CAT scan, fluoroscopy and nuclear medicine tests have saved countless lives and will continue to do so every day in this country. The judicious use of these technologies is essential to providing quality health care in this era.
I would encourage patients to take a more active role in their health-care decision-making. Patients should routinely discuss the potential risks and benefits of any medical procedure with their physician and make informed decisions about what is best for them.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Health Center in Towaoc.
