|
Jeremy,
You state that you do not see the
contradiction, but I do and so does Professor Jaworowski (a former president of
UNSCEAR).
I refer you to the famous quotation below about
fooling people.
----- Original Message -----
Sent: Friday, December 12, 2003 12:51 AM
Subject: Re: Health effects of radiation: Making it real
You can fool some of the people all of the time, and all of the people some
of the time, but you can not fool all of the people all of the time.
Abraham Lincoln
(1809 - 1865), (attributed)
----- Original Message -----
Sent: Tuesday, February 03, 2004 2:14
PM
Subject: [MbrExchange] RE: [cdn-nucl-l]
UNSCEAR distorts scientific info? Fw: My letter to NN, Jan 2000, Re:
Dose-response follow-up for nuclear medicine I-131 t herapies
UNSCEAR is indeed a high-grade scientific
organization, not (one assumes) given to distorting information. I would
look elsewhere for the source of apparent contradictions.
In
this case, based on the information given below I don't see the
contradiction. The UNSCEAR statement about elevated thyroid cancer
appears to be supported by the referenced paper, as quoted in Jerry's email
further down the thread?
Jeremy Whitlock
Can it be that UNSCEAR distorts scientific
information?
The scientists who authored the study [F13]
stated clearly that there was a decrease in overall cancer incidence and
mortality. How can UNSCEAR state in Para. 265 that the risk
is elevated? What else did they distort?
And I thought UNSCEAR is a high-grade
scientific organization.
Jerry Cuttler
265. Two recent studies [F13, R17] found an elevated risk of
thyroid cancer mortality following adult 131I treatment for
hyperthyroidism, which is in contrast to previous studies of hyperthyroid
patients [H14] or patients examined with 131I [H6]. The reason for
referral, i.e. the underlying thyroid disorder, could have influenced the
risk, since the highest risk was seen less than five years after exposure.
The thyroid dose (60-100 Gy)
received by most hyperthyroid patients had previously been considered as
having a cell-killing rather than a carcinogenic effect.
----- Original Message -----
Sent: Tuesday, February 03, 2004 6:27 AM
Subject: Re: My letter to NN, Jan 2000, Re: Dose-response
follow-up for nuclear medicine I-131 therapies
Dear Jerry,
You may be interested in seeing how skilfully
the consultant of UNSCEAR distorted the information from the Birmingham
study. See paragraph 265, in page 497, Annex J, UNSCEAR Report
2000.
Best wishes,
Zbigniew
----- Original Message -----
Sent: Saturday, January 31, 2004
12:40 AM
Subject: My letter to NN, Jan 2000,
Re: Dose-response follow-up for nuclear medicine I-131 therapies
Jim, see my letter to Nuclear News of 2000
Jan 31:
When I think about the linear no-threshold
(LNT) hypothesis of radiation carcinogenesis, I am reminded of the famous
quotation: "The great tragedy of
science is the slaying of a beautiful hypothesis by an ugly
fact."2 How
can the LNT hypothesis continue to be an exception to this fundamental
requirement of science? Are
political, social and economic considerations preventing us from opening
our minds to a different hypothesis?
The University of Birmingham study of
radioiodine treatment of hyperthyroidism, recently published in The
Lancet,3 provides yet another of the hundreds and hundreds of
ugly facts that contradict the LNT hypothesis.4 This study of 7414 adult patients,
treated in Birmingham UK between 1950 and 1991 with a mean cumulative dose
of 308 MBq of iodine-131, identified 638 cancer diagnoses and 448 cancer
deaths in 1971-91 among the treated patients. This was compared with National
Statistics data on cancer incidence and mortality for England and Wales,
specific for age, sex and period: 761 and 499. The standardized incidence ratio
is 0.83 [95% confidence interval 0.77-0.90] and the standardized mortality
ratio is 0.90 [0.82-0.98].
"There were increases in incidence and mortality for cancers of the
small bowel and thyroid, although the absolute risk of these cancers was
small." The scientists
concluded, "The decrease in overall cancer incidence and mortality in
those treated for hyperthyroidism with radioiodine is reassuring."
It certainly is reassuring when we realize
that a dose of 308 MBq corresponds to ~280 mSv (or 28 rem) to the whole
body.5 This is
more than ten times the average dose of 15 mSv (or 1.5 rem)
received by the evacuees from the 30-km zone around the Chernobyl
disaster.6
According to the radiation hormesis model,4 a dose below
the NOAEL point stimulates a protective response and results in overall
beneficial effects. If the
dose is above this point, defense mechanisms are weakened and overall
adverse effects result.
I just can't get over the irony of this
situation. We design, build
and operate each of our nuclear plants to keep its likelihood of a severe
accident below once in a million years. And if this event actually did
occur, the doses to people outside the plant would likely be
beneficial! Yet we continue
to use the LNT hypothesis, and most people associate every nuclear
activity and incident with their likelihood of getting a cancer, and they
are just terrified of cancer.
Can we expect the prospects for nuclear
power to improve as long as LNTH continues to thrive?
Sincerely,
Jerry Cuttler
References:
2.
Huxley TH (1825-95), "Collected Essays 1893-94
Biogenesis and Abiogenesis."
3.
Franklyn JA, Maisonneuve P, Sheppard M, Betteridge J
and Boyle P, "Cancer incidence and mortality after radioiodine treatment
for hyperthyroidism: a population-based cohort study," The Lancet 353, 1999 June 19, pp
2111.
4.
Calabrese EJ, Baldwin LA. "Radiation hormesis:
origins, history, scientific foundations," BELLE Newsletter 8:2, University of Massachusetts,
School of Public Health, Amherst, MA 01003, 1999 December. See also
http://www.belleonline.com/home82.html
5.
Eisenbud M, "Environmental Radioactivity,
2nd Edition," Academic Press, New York, 1973, pp 421-425.
6.
"Chernobyl - ten years on: radiological and health
impact," an appraisal by the NEA Committee on Radiation Protection and
Public Health, Nuclear Energy Agency, Organisation for Economic
Co-operation and Development, 1995 November, pp
47.
-----------------------------------------
----- Original Message -----
Sent: Friday, January 30, 2004
11:05 AM
Subject: Dose-response follow-up
for nuclear medicine I-131 therapies
Friends,
Please
review the following abstract for the significance of measured acute and
late effects, as chromosomal damage, of I-131 therapies.
What are
dose conversion estimates (whole body, not thyroid) for 300-3700
MBq doses?
This study
is one of the very few studies that have been conducted to measure human
biological responses in the 10s of millions of patients that are exposed
to nuclear medicine procedures. (The primary interest is in diagnostic
procedures. I have not distributed various papers on P-32 for
polycythemia vera because it is fundamentally high-dose therapy.
I-131 is also, but the high dose is to the thyroid with a low to
moderate dose to the whole body - with epi follow-up as reported in our
early studies by Rosalyn Yalow and others, primarilty from work by
Las-Erik Holm and others from Swedish data.)
The failure to conduct dozens of such studies to follow
human biological responses from injection and ingestion of radionuclides
in the face of the "LNT debate" is unfortunate, if not unforgivable. I
invited Dr. Carretta, as past president of the SNM, to address this
in our Nov 2000 sysmposium on medical applications, but he then did not
do so.
Do you know
of any other such studies that are being conducted?
I do not
have access to this journal. I would appreciate a copy and any comments
on the significance of this study to the assessment low-dose
response.
Thank
you.
Regards, Jim
Muckerheide
====================
Eur J Nucl Med Mol Imaging. 2004 Jan 28 [Epub ahead of print]
Iodine-131 treatment and chromosomal damage:
in vivo dose-effect relationship.
Erselcan T, Sungu S,
Ozdemir S, Turgut B, Dogan D, Ozdemir O.
Department of
Nuclear Medicine, Cumhuriyet University School of Medicine, P.K. 806,
Sivas, Turkey.
Although it is well known that radiation induces
chromosomal aberrations, there is a lack of information on the in vivo
dose-effect relationship in patients receiving iodine-131 treatment, and
the results of previous studies are controversial. In this study, the
sister chromatid exchange (SCE) method was employed to investigate acute
and late chromosomal damage (CD) in the peripheral lymphocytes of 15
patients who received various doses of (131)I (259-3,700 MBq), either
for thyrotoxicosis (TTX) or for ablation treatment in differentiated
thyroid cancer (DTC). The SCE frequencies in cultured peripheral
lymphocytes were determined before treatment (to assess basal SCE
frequencies), on the 3rd day (to assess acute SCE frequencies) and 6
months later (to assess late SCE frequencies). The basal, acute and late
SCE frequencies (mean+/-SD) were 3.19+/-0.93, 10.83+/-1.72 and
5.75+/-2.06, respectively, in the whole group, and these values differed
significantly from each other ( P<0.001). In order to perform a
quantitative evaluation of the present data and a comparative analysis
with the results of previous studies reported in the literature, we
defined acute and late effects using a "damage ratio" (DR) and a
"recovery ratio" (RR), based on the basal, acute and late data for
individual patients. No statistically significant difference was found
in the DR between DTC and TTX patients (76.4%+/-11.5% vs 67.6%+/-9.0%),
while the mean RR was higher in TTX patients than in the DTC group
(75.2%+/-24.4% vs 36.8%+/-13.7%). The DR on the 3rd day was not related
to the administered (131)I dose in the whole group, but a negative
correlation was found between the (131)I dose and the RR at the 6th
month ( r=-0.60, P=0.04). The best fit for this relationship was
obtained by a linear-quadratic model, as y=104.89 x-28.4 x(2)+38.1 (
R(2)=0.51, P=0.04). On the other hand, comparative analysis with the
results of previous studies with comparable sampling times revealed that
the best fit for the relationships between the administered dose of
(131)I and DR and RR were obtained with a linear-quadratic model (
Y=alpha D+beta D(2)) rather than a linear one. However, there was an
interesting difference in comparison with in vitro studies, in that we
found the coefficient beta to have a negative value, suggesting the
disappearance of damaged lymphocytes from the peripheral circulation in
a dose-dependent manner following (131)I treatment. Further studies are
therefore needed to clarify the effect of the negative beta value on the
biological dosimetry approach in continuous internal low LET radiation,
as in the case of (131)I treatment.
|