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  • Mechanical protection to thryroid during CTs?

    Recently, during one of Russell's office appointments, the discussion came up about protecting the thryoid and genital area during Chest Films and CTs. We were advised..."do it!" It has not been a practice, nor do I see the techs at my hospital going out of their way to protect patients. It seems to me that I recall that lead aprons etc can and should be used during exams. Anyone with information? I am going to have to reach into the mental archives and reserach as well. Livestrong, Sharon
    Click here to support my LIVESTRONG Challenge with Team LOVEstrong.

  • #2
    I did some research on this awhile ago, the yearly total radiation you get from these CT scans isnt even as high as the yearly total that some people live in, in certain parts of the world and these parts of the world(and im not talking about chernobyl) dont have an increase in cancer etc from the radiation.

    The only thing which could show it a concern is that your getting bursts of it rather than gradually.
    Aged 23 ;; 09/06 left I/O ;; Markers normal ;; 100% Seminoma Stage 1. ;; 10x8x16mm & 7x7x8mm ;; rete testis invasion. ;; no vascular invasion. ;; surveillance. ;; HRT.

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    • #3
      I never considered protection for the genital area because when its scan time, it's chest, abdomen, and pelvis. I thought the entire pelvic area including genitals are scanned.

      As for the accumilation of radiation, I don't know anything about the dose of each scan or what is considered high, but Anthonys oncologist told us that scans should never be taken lightly, because one ct scan is equal to about 300 xrays.

      Seems to me that would be quite a lot.

      Son Anthony DX 12/11/06
      L/O 12/20/06 Stage IIIA, 95% EC, 5% Yolk Sac
      4XEP 1/29-4/6/ 07
      AFP started increasing3 wks later
      Residual abdominal mass found on CT
      RPLND 6/8/07
      Cancer in pathology-
      80% mature teratoma, 20% Yolk Sac. --
      No adjuvent chemo and
      AFP normalised

      July 22, 2010 ---- 3 years all clear!

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      • #4
        Thanks for the replys. I am going to talk with some of the people that I work with. It was an MD who gave me the alert. Sharon
        Click here to support my LIVESTRONG Challenge with Team LOVEstrong.

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        • #5
          Here is what I have learned so far. If doing a regular chest film, the groin can be protected from behind. The chest CT would be too high, the protection would interfere with the exam. The groin could be protected during the upper scan and the thryroid could be protected during the lower scan, but they will probably not want to make any changes to the patients position, so as not to lose the line up of the scans. The radiation dose is high. Totals should be listed with each exam. The other problem with CTs is that it is a 3 dimensional exposure. New questions come to mind about MRI, will try to explore that one too. I'm sure it has been thought about. Take care, Sharon
          Click here to support my LIVESTRONG Challenge with Team LOVEstrong.

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          • #6
            I seem to remember reading that one CT scan is equal to about 4 times the amount of background radiation that a normal person would get in one year.

            Broken down a full brain/chest/abdomen/pelvis scan gives you about 12 millisieverts (mSv) this is equal to about 1.2 rad (old system of measurement).

            The yearly background radiation from just being in the USA is about 3 mSv or .3 rad. So assuming that we only need one CT scan a year we are getting 4 years of background radiation in 20 minutes. Of course this is not the case and usually we need at least 4 CT scans a year minimum if your just starting surveillance. This is 48 mSv or 4.8 rad, which is 16 years worth of normal background yearly radiation in one year. This is effective dose from the FDA website. This means the actually radiation is more but the absorbed amount is what I have stated above.

            To relate to everyday stuff.

            A trip to mars would expose you to 600 mSv or 60 rad (1 year of radiation from space. A lifetime NASA limit for astronauts is about 2000 mSv or 200 rad.
            Following normal 5 year surveillance protocol for cancer is about 200 mSv or 20 rad.

            If for me I start at age 29 by the time I am 35 I have had 200 mSv exposure. Then say I get a yearly scan until I am 80 years old. That's another 45 years of exposure to 12 mSv a year or 540 mSv or 54 rad. plus the first 5 year surveillance is 740 mSv or 74 rad.

            The Japanese have been reporting cancer associated with 20 mSv from survivors of the atomic bomb.

            So I say it is a good idea to use the lead radiation sheets when at all possible.

            One chest X-ray is .02 mSv

            I think the actually risk in getting cancer from CT scans for someone my age starting a yearly scan is I think about 1 in 25 chance of getting CT related cancer or 4% chance. And the likelihood of getting TC is a person lifetime I think is 0.3%.
            Last edited by Physast; 09-18-07, 02:50 AM.
            08/28/07: Diagnosed Stage 1A nonseminoma (65% teratoma (mature and immature), 10% embyonal carcinoma, 25% yolk sac); AFP: 120 ng/ml HCG: 6.8 IU/L
            09/05/07: Right I/O; Clean CT
            09/13/07: AFP: 41 ng/ml HCG: 0.5 IU/L
            09/26/07: AFP: 12 ng/ml HCG: <2
            10/22/07: AFP: 2.2 ng/ml HCG: <2
            Surveillance All Clears: 11/09/07; 04/20/08;

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            • #7
              thank-you! I found this site, sounds similar!
              http:www.school-for-champions.com/health/xrays.htm Sharon
              Click here to support my LIVESTRONG Challenge with Team LOVEstrong.

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              • #8
                yeah as I was writing my post last night I kept thinking to myself that this doesn't sound good! I almost deleted it because it was turning out to be more of a downer than useful information.

                But if you think of it like this. Most TC survivors have about a 25% chance of relapse with surveillance. In my opinion the 4% chance of cancer from the CT scans might be warranted to catch a relapse.

                All in all it sucks but we have to work with what we are given. But I agree that we should be as careful as possible. Use the precautions when ever we can and make them known.

                I had no idea that they could cover up parts of your body during a CT scan. They didn't do that for my first one.
                08/28/07: Diagnosed Stage 1A nonseminoma (65% teratoma (mature and immature), 10% embyonal carcinoma, 25% yolk sac); AFP: 120 ng/ml HCG: 6.8 IU/L
                09/05/07: Right I/O; Clean CT
                09/13/07: AFP: 41 ng/ml HCG: 0.5 IU/L
                09/26/07: AFP: 12 ng/ml HCG: <2
                10/22/07: AFP: 2.2 ng/ml HCG: <2
                Surveillance All Clears: 11/09/07; 04/20/08;

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                • #9
                  Physast:
                  Thanks for not deleting your post. Sometimes the things we learn can be a bit unsettling but it's better to have the knowledge then not.
                  Son Jason diagnosed 4/30/04, stage III. Right I/O 4/30/04. Graduated College 5/13/04. 4XEP 6/7/04 - 8/13/04. Full open RPLND 10/13/04. All Clear since.

                  Treated by Dr. Rakowski of Midland Park, NJ. Visited Sloan Kettering for protocol advice. RPLND done at Sloan Kettering.

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                  • #10
                    Originally posted by Russell's Mom
                    Here is what I have learned so far. If doing a regular chest film, the groin can be protected from behind. The chest CT would be too high, the protection would interfere with the exam. The groin could be protected during the upper scan and the thryroid could be protected during the lower scan, but they will probably not want to make any changes to the patients position, so as not to lose the line up of the scans. The radiation dose is high. Totals should be listed with each exam. The other problem with CTs is that it is a 3 dimensional exposure. New questions come to mind about MRI, will try to explore that one too. I'm sure it has been thought about. Take care, Sharon
                    Sharon,

                    I asked Anthonys oncologist about using MRI's instead of so many CT's. I asked him..

                    1. Is an MRI just as good a diagnostic tool as a CT?

                    His answer- YES

                    2. Then why aren't we using MRI's instead of CT's?

                    His answer- I've been asking that question since I became a father years and years ago.

                    I thought that was an odd answer, but I assumed that the doctors do not necessarily have control over it?

                    So who decided that CT's have to be the main diagnostic tool? I'm going to bring this question up again at the next appointment, because I would like a better explanation for it.

                    We don't get radiation exposure from MRI's, yet an MRI is just as good as an CT, yet CT's are used far more than MRI's.. hmmmmmm

                    The only time Anthony had an MRI was for his head .. and twice the doctors chose CT's of the head, over MRI's ..


                    Another question that maybe someone here knows .. With so many guys having RPLND surgery, what about hundreds of metal clips left in the body?? Can an MRI be used for people that have metal clips in their body?

                    Son Anthony DX 12/11/06
                    L/O 12/20/06 Stage IIIA, 95% EC, 5% Yolk Sac
                    4XEP 1/29-4/6/ 07
                    AFP started increasing3 wks later
                    Residual abdominal mass found on CT
                    RPLND 6/8/07
                    Cancer in pathology-
                    80% mature teratoma, 20% Yolk Sac. --
                    No adjuvent chemo and
                    AFP normalised

                    July 22, 2010 ---- 3 years all clear!

                    Comment


                    • #11
                      The question comes to mind about surgical clips and MRI. I am going to check with the surgeon. I know that some metals are ok and I don't recall any warning post-op. Like most routines, I believe that it is easier to just do the scans..not worry about the extras. I am going to push the limits a little bit here. An article that I read last night talked about the small increase worth the risk in order to capture a new lesion...yes...but the fact that a person already is prone to cancer needs to be considered when increasing total lifetime dose of radiation. Scott, maybe this is something to bring up in Washington next year?!? I spoke with a tech/friend yesterday, will try to talk with a director soon. Dadmo, I agree about the subject matter. If there are laws of equal and opposite, we should all be heading toward a pretty good time! Lovestong, Sharon
                      Click here to support my LIVESTRONG Challenge with Team LOVEstrong.

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                      • #12
                        I have metal clips in my retroperitoneum from my RPLND in 1988. In 2004 I had an MRI of my spine. They told me if the clips have been in place for several years, they are anchored by scar tissue and will not move. Nobody was willing to commit to a specific time frame that was considered safe for such clips to be in place.

                        As for choosing CT over MRI: the spinal MRI took about 20-30 minutes. My chest, abdomen and pelvis CT takes about 2 minutes. But I don't know how long an MRI of the same would take.

                        Personally, when I look at CT's vs MRI's I think the CT's have more detail and are easier to read, but that's only a laypersons opinion.
                        Fish
                        TC1
                        Right I/O 4/22/1988
                        RPLND 6/20/1988
                        TC2
                        Left I/O 9/17/2003
                        Surveillance

                        Tho' much is taken, much abides; and though we are not now that strength which in old days moved earth and heaven; that which we are, we are; one equal temper of heroic hearts, made weak by time and fate, but strong in will; to strive, to seek, to find, and not to yield.

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                        • #13
                          Interesting about the clips. I sat with Russell when he had his brain MRI. I had rings on...they said ok!!?? The MRI did take longer. Russell had a difficult time. He is a drummer and the rythym of the machine made great sounds. The urge to toe tap and slap his thighs a bit were almost more than he could handle!! Sharon
                          Click here to support my LIVESTRONG Challenge with Team LOVEstrong.

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                          • #14
                            You're absolutely right about the sounds!

                            Even as I've searched for info on MRI's its hard to get straightforward answers on interactions with metal. As I said, the techs I spoke to were not inclined to give definitive answers. I also read that even traditionally non-magnetic metals can become magnetized by exposure to the strong fields that the MRI generates. Hopefully, we'll find out what's up. I should have another MRI of my spine, but I had my gall baldder removed in DEC 04, and I'm concerned about having recently placed clips displaced.
                            Fish
                            TC1
                            Right I/O 4/22/1988
                            RPLND 6/20/1988
                            TC2
                            Left I/O 9/17/2003
                            Surveillance

                            Tho' much is taken, much abides; and though we are not now that strength which in old days moved earth and heaven; that which we are, we are; one equal temper of heroic hearts, made weak by time and fate, but strong in will; to strive, to seek, to find, and not to yield.

                            Comment


                            • #15
                              Russell is ok if an MRI is needed. There are many clips, right kind of metal. I am eventually....going to create a care plan (see other thread, with all of this information) It will avoid many questions and possibly overtreatment in the future. Still want to know if MRI could be used instead of CT. Onward Ho. Sharon
                              Click here to support my LIVESTRONG Challenge with Team LOVEstrong.

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