Pain, swelling or lumps on the testicles are concerns for men, as they may be symptoms of testicular cancer. Younger men are already more inclined to develop testicular cancer than older men, but the treatment of testicular cancer also poses a health concern.
A recent study by a former UC Davis Medical Center (UCDMC) doctor shows that frequent CT scans may play a part in the development of secondary cancers.
Active surveillance, a process where patients undergo various CT scans – a method of medical testing that develops precise imaging to help diagnose and treat medical conditions – may present dangers in terms of its radiation exposure. Along with chemotherapy and retroperitoneal lymphnode dissection – an incision spanning from the sternum to just underneath the bellybutton – active surveillance is one of three usual practices doctors take to treat testicular cancer.
“The radiation exposure is 30 to 40, maybe 100 times that of a routine X-ray, depending on the type of CT scan,” said Karim Chamie, a urologist at the UCLA health center.
Chamie said that 30 percent of the time there is something that cannot be seen in original CT scans, which is the reason why many guidelines recommend so many CT scans. But Chamie warns against excessive CT scans.
Chamie said that active surveillance may be bad for two reasons.
“First, you’re exposing all men who are compliant to an intense CT schedule with the attendant radiation exposure,” Chamie said. “Second, those who don’t comply with the regular schedule run the risk of having their cancer progress and can expect a significant detriment to their quality of life as well life expectancy, even though they are not being exposed to the radiation of CT scans.”
Patients need to stick to a schedule and follow up with their doctors, Chamie said. If they don’t, they are exposed to unnecessary radiation and risk further development of cancer.
Chamie said that he recommends surgery for men diagnosed with testicular cancer.
“People who don’t get surgery are more likely to die of their testicular cancer,” Chamie said. “In studies, those that didn’t get surgery had a higher incidence of an unrelated secondary malignancy and a higher cancer mortality rate.”
He said that he believes doctors should tell their patients about the risk of CT scans. Chamie said that risks can sometimes be downplayed when explained in contrast to chemotherapy, which causes hair loss and surgery and involves a fairly large incision.
John Boone, professor of biomedical engineering at the UCDMC and vice chair of urology at the center, said that the use of CT scans in medicine has skyrocketed in the United States over the past 30 years.
“There will likely be around 80 million CT scans in the US this year; 30 years ago, that number was around four to five million,” Boone said.
He attributed the efficiency of CT scans as one of the primary reasons that they are so widely utilized.
“CT scans are so attractive because they can scan the body in about 15 seconds,” he said.
However, Boone also said that there is an over-utilization of CT scans in the U.S. He said that perhaps as much as 30 percent of the use of CT scans is thought to be in the practice of defensive medicine – in other words, to avoid possible malpractice lawsuits.
Boone also pointed out the high doses of radiation that come with every CT scan.
“In a year, a person receives three millisieverts of radiation from background exposure; a typical CT scan has ten millisieverts,” Boone said.
However, Boone said that CT scans should not be looked at negatively, as they provide many benefits – such as being able to quickly diagnose medical conditions in the case of emergencies. He said that the best thing people can do is ask their physicians if they really need a CT scan.
The American Cancer Society states that men, particularly between ages 20 and 54, should regularly do self-examinations and consult a physician if they find something that might be out of the ordinary – such as lumps, swelling or pain.
ERIC C. LIPSKY can be reached science@theaggie.org.
