I recently interacted with a highly intelligent lady with carcinoma breast who believes that the only way to manage the disease is with alternative therapy.

I don’t really want to argue with the choice she has made – if you intelligently decide to follow a line of treatment, assuming of course it is done with the full knowledge of all data available, then so be it.

Her tumor is growing and she wants to compare its progression / regression. She has been doing so with successive breast MRIs and when I was asked to look at the breast MRIs, my first reaction was, Why…. why would someone do breast MRIs for comparison when the standard of care is PET/CT, given that she has metastatic breast cancer with bone involvement?

The answer I received was that she was scared of effects of the radiation from PET/CT.

And I felt sorry for her. She was misinformed and making bad decisions based on some delusional understanding of the ill-effects, if any, of radiation.

Diagnostic radiation has been around since 1895. In the last 120 years, there has been no data and I repeat no data that links diagnostic radiation to cancer. We are not talking of 10 or 20 or 30 years…this is 120 years. All the hype that comes in the newspapers and lay press is from extrapolation of nuclear blast data, which is unscientific and has no basis.

And even for a moment, assuming that diagnostic imaging related radiation does cause mutagenesis with the possible chance of cancer, this would take 20 odd years to manifest, by which time this 55 years old lady would have been 75.

I may have sounded mean, but I actually blurted out the fact that it was unlikely she would be alive for another 20 years and hence not doing a PET/CT was really just a completely rubbish decision.

Sometimes I feel it is best to not know a lot and to have some faith in modern medicine and data and clinical judgement calls. Ask the right questions, but also accept facts and management directions when presented by people who do know perhaps a little more.