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 Most of the 30 patients questioned for the study said they looked
online for information about the radiation hazards of tests like
computed tomography (CT) scans, since their doctors did not explain
the risks.
“Before completing this study, I believed I understood what patients
may wish to know and how to provide that information to them,” said
Dr. Raymond Thornton, the study’s lead author from Memorial
Sloan-Kettering Cancer Center in New York City.
“As we analyzed nine hours of participants’ conversation, however,
it became clear that a wide range of personal preference exists
regarding what information is desired and the optimal way to
transfer that information,” Thornton told Reuters Health by email.
Imaging techniques like X-rays, CT and positron emission tomography
(PET) scans expose patients to ionizing radiation, which damages DNA
and can lead to cell death or mutations that can increase the risk
for later cancers.
The benefits will almost always outweigh the risks when an imaging
procedure is performed for an appropriate reason, Thornton said.
In cancer patients, "even negative or normal results add essential
information to clinical care,” he said.
For the study, a trained specialist moderated small 90-minute focus
groups in 2012, asking open-ended questions.
Altogether, 30 patients with varied types and severities of cancer
participated. They were a unique group, 80 percent white and 90
percent with a college degree, the authors write in the journal
Radiology.
It may be that among the general population of U.S. cancer patients,
knowledge and interest in this topic is different, the authors
caution.
Knowledge of which imaging methods involve ionizing radiation and
which do not, and how these tests differ from the radiation used for
cancer treatment, varied greatly between patients.
The participants were generally grateful for the benefits that the
imaging tests provide but were concerned about the cumulative risks
of having several scans. They would have liked their doctors to
explain in more detail which tests were being ordered when, and
their associated risks.
Patients generally preferred to have these discussions with their
personal physician and believed that the time constraints of office
visits make that difficult.
“Our findings portray a gap between current practice and what
patients say they want,” Thornton said.
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Creating scripts and educational tools for doctors who aren't
radiologists to facilitate discussions is one way to bridge that
gap, he said. Written materials, including trusted Internet sources,
that address patient concerns is another.
There is no mechanism in schools, government sources, healthcare
establishments, or non-government organizations to teach people how
to think about health risks or to assess their own risk, said Janet
Busey of the radiation department at the University of Washington in
Seattle.
“Although the individual radiation risks for diagnostic imaging
scans are small, they need to be communicated to patients,” Busey,
who wasn’t part of the new study, told Reuters Health by email.
“The 'benefit vs. radiation-risk' issues are generally different in
terms of CT scans for patients who are (or were) being treated for
cancer, as opposed to CT scans on individuals who do not have
cancer,” said David J. Brenner of the radiation oncology department
at Columbia University Medical Center in New York City.
“For example, in many situations for cancer patients, long-term
follow-up with CT scans is absolutely essential,” said Brenner, who
was not part of the new study. “By contrast there are situations
among non-cancer patients where there are options as to whether to
do a CT scan or to do another type of exam.”
Doctor-patient communication issues in the study are likely common
to both cancer and non-cancer patients, he noted.
SOURCE: http://bit.ly/18V0PTp
Radiology, online March 24, 2015.
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