Application of Low Doses of Ionizing Radiation in Medical Therapies

All too often the family physician, orthopedic surgeon, dentist or chiropractor is met with radiophobic concerns about X-ray imaging in the clinical setting. These concerns, however, are unwarranted fears based on common but ill-informed and perpetuated ideology versus current understanding of the effects of low-dose radiation exposures. Themes of X-ray hesitancy come in 3 forms: 1. All radiation exposures are harmful (i.e. carcinogenic); 2. Radiation exposures are cumulative; 3. Children are more susceptible to radiation. Herein we address these concerns and find that low-dose radiation activates the body’s adaptive responses and leads to reduced cancers. Low-dose radiation is not cumulative as long as enough time (e.g. 24 hrs) passes prior to a repeated exposure, and any damage is repaired, removed, or eliminated. Children have more active immune systems; the literature shows children are no more affected than adults by radiation exposures. Medical X-rays present a small, insignificant addition to background radiation exposure that is not likely to cause harm. Doctors and patients alike should be better informed of the lack of risks from diagnostic radiation and the decision to image should rely on the best evidence, unique needs of the patient, and the expertise of the physician—not radiophobia.

Section: Radiophobic Concern #2: Radiation Exposures Are Cumulativementioning

confidence: 99%

Section: Radiophobic Concern #2: Radiation Exposures Are Cumulativementioning

confidence: 99%

X-Ray Hesitancy: Patients’ Radiophobic Concerns Over Medical X-rays

Oakley

Harrison²

2020

“…Many successful clinical trials were carried out in the 1980s and 1990s using low doses of radiation to cure cancer, and there have been several case reports recently on successful treatment of serious diseases, employing low doses of radiation. 3 Analyses of radium dial painter data revealed an intake threshold of 100 mg for malignancy and a 10 Gy threshold for bone cancer. 3 Nasopharyngeal radium irradiation therapy was employed widely from 1940 through 1970 on between 0.5 and 2.5 million children and at least 8000 military personnel to shrink swollen tissue in the nasopharyngeal cavity (to remediate adenoid inflammation and ear dysfunction).…”

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confidence: 99%

“…Although the dose was rather high, Figure 1, the many worldwide studies carried out on these patients did not confirm a definite link between these treatments and any disease. [3][4][5] This strong evidence contradicts the consensus opinion that children are especially sensitive to radiation. A reanalysis of the leukemia data of the Hiroshima atomic bomb survivors revealed an acute dose threshold at about 1.1 Gy for initiation of this cancer in blood-forming stem cells, which are more radiosensitive than other cell types.…”

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confidence: 99%

The LNT Issue Is About Politics and Economics, Not Safety

Cuttler¹

2020

Self Cite

The Sykes commentary advocates “a more sensible, graded approach for protection from low dose ionizing radiation” until the LNT dose-response issue is resolved. It urges scientists to stop criticizing the LNT model that links radiation to a risk of cancer and accept regulatory use of the threshold model to “protect” people, but with higher limits. It fails to mention the 120-year history of successful low-dose treatments of a wide variety of serious diseases, including cancers. The commentary ignores published evidence of a threshold at 1.1 Gy for radiogenic leukemia and a dose-rate threshold at about 0.6 Gy per year for lifespan shortening. LNT came from politicized science, replete with scientific misconduct and conflict of interest. Its acceptance created a false cancer scare that was likely intended to stop atomic bomb testing, but it has severely damaged human welfare. Many vitally important low-dose therapies were discarded when the radiation scare was disseminated in 1956. The rapid growth of nuclear energy ended with the media-inflamed public panic after the Three Mile Island accident in 1979. Extreme implementation of the precautionary principle made it uneconomic. Availability of a low-dose therapy for lung inflammation could have dramatically decreased the impact of the COVID-19 pandemic.

“…A recent review of medical therapies using low doses of radiation discusses the evidence and mechanism by which radiation upregulates adaptive protection systems against many diseases. 9 It identifies high dose thresholds for the onset of harmful effects.…”

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confidence: 99%

Unethical not to Investigate Radiotherapy for COVID-19

Cuttler¹,

Bevelacqua²,

Mortazavi

2020

Self Cite

The primum non nocere letter by Boon et al. urged caution and careful examination of the evidence and logistics of low-dose radiotherapy in COVID-19 patients. This is exactly what was requested in March and what has occurred since late April 2020 when the first phase I/II clinical trial was approved at the Winship Cancer Institute, Emory University Hospital. The preprint of day-7 interim results by the investigators concluded, “In a small pilot trial of 5 oxygen-dependent patients with COVID-19 pneumonia, low-dose whole-lung radiation led to rapid improvement in clinical status, encephalopathy, and radiographic infiltrates without acute toxicity or worsening the cytokine storm. Low-dose whole-lung radiation appears to be safe, shows early promise of efficacy, and warrants larger prospective trials.” Preliminary results from another clinical trial gave similar results. In conclusion, the authors believe it would be unethical not to investigate radiotherapy as a potential remedy against COVID-19 induced pneumonia