Healthcare | Dr. Dennis J. Courtney M.D.

A high school teacher turned medical doctor and medical director of his private practice, “The Center For Complementary Health,” in Bridgeville, Pennsylvania. Always with an eye for non-conventional therapies to treat everyday medical problems, Dr. Dennis J. Courtney has devoted himself to non drug treatments whenever possible. His series “From a Different Perspective” appears here with each issue. Listen to Dr. Courtney weekly on his radio show entitled: “A M Impact on Your Health,” which can be heard Monday, Wednesday and Friday from 8:00 - 9:00 am on KHB 620.

Another Point of View

We have come to expect that each advance in medical technology will automatically benefit us during our lifetime. Every advance achieves “breakthrough” status the month it makes it into a national publication. Besides the impact of a new technology, it is just as fascinating to observe when an existing technology is suspected of a potential for harm that was not previously appreciated.

This is precisely what happened as I read a flurry of articles about CT Scans. The point of the articles focused on “Unnecessary CT Scans Exposing Patients to Excessive Radiation” or “CT Scans raise cancer risk, often unjustifiable, study warns”. The issue of this technology, while noting its efficacy, is that it is a double-edged sword. On the one hand, it offers great potential benefit; on the other, it harbors a capability for producing horrible consequences. Each article seemed to focus on three irrefutable conclusions:

1. CT scans provide medical doctors with pictures that allow them to help patients in ways that they couldn’t if they didn’t have such information.

2. The amount of radiation exposure from each scan is considerable, and as such, is known to have the potential to provoke cancer.

3. One third of all CT scans performed are medically unnecessary.

What prompted the articles was the published work of David Brenner of Columbia University, a lead investigator and author of the study reported in the New England Journal of Medicine in November, 2007. His study raised legitimate concerns about the use of CT scans because of what he considered to be a lack of understanding of the potential harm that can come to patients receiving the CT scans.

The conclusions, as I have outlined them, are accurate and thought-provoking. Additional points in the articles compel the consumer to act in his or her own interest or at least to initiate a dialogue with their doctor. These points include:

1. Today, 62 million CT scans are performed nationwide.

2. “On average, we now get double the radiation exposure
we got in 1980 because of the increase in CT scans”.

3. “Anyone who presents in the emergency room with belly pain or headache will automatically get a CT scan.”

4. “Medical exposure to radiation, mainly through CT scans, has replaced environmental radon as the dominate source of radiation exposure for the US population”.

5. As many as 5 million scans are now done on children, who are 10 times more sensitive to radiation than adults.

6. New uses for CT scans are being found at an alarming rate. Doctors now scan smokers and ex-smokers for cancer screening. “Virtual colonoscopies to check the colon and CT angiography to check for coronary blockages are all new uses for CT scans”.

7. Brenner went on to state: “Many doctors don’t realize that a scan or two expose a patient to the same amount of radiation that Hiroshima survivors received while standing a mile or two from ground zero.”

So, will the article by Dr. Brenner lead to our medical professionals examining how technology will be harnessed in order to assure the safety of the public, or will this just be a minor blip on the medical economics screen that won’t be remembered a month from now? Although the hypothetical question posed here will play itself out in the future, you can take control of this matter in your own situation. Consider an approach to x-ray procedures “from a different point of view”:

• Insist on a dialogue with your doctor when it comes to x-ray procedures (regular x-rays, CT scans, fluoroscopy).

• Ask your doctor if some other diagnostic procedure could be used instead of a CT scan that doesn’t have any x-ray exposure associated with it. (ie. ultrasound, sonogram, thermogram) When sophisticated images are required, always ask your doctor to consider an MRI in place of a CT scan. MRI images are just as good as those of a CT scan, but MRI has NO associated radiation.

The harmful effects of radiation are both cumulative and additive. You should insist that the “dose” of radiation be kept to a minimum.

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