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X-Rays vs. Sonogramse

April 2004

By Edward R. Rosick, DO, MPH, MS

LE Magazine April 2004
X-Rays vs. Sonogramse
Does Overuse of X-Rays and Underuse of Sonograms Endanger Patient Health?
By Edward R. Rosick, DO, MPH, MS

Multiple studies have been published showing that ultrasound can safely and effectively detect pathological changes in the carotid arteries that can lead to a stroke.12,13 A recent study published in the New England Journal of Medicine reported on the use of sonograms to detect thickening in the walls of the carotid arteries, a condition that strongly correlates with increased stroke risk. Using ultrasound, the researchers measured the carotid arteries of nearly 4,500 patients with an average age of 72 for a six-year period. Study participants who had the thickest arterial walls had more than three times the risk of suffering a stroke or heart attack compared to those whose carotid arteries showed little to no thickening. These results indicate that thickened walls of carotid arteries are a better indicator of increased risk for stroke or heart attack than high cholesterol or increased blood pressure. Unfortunately, ultrasound scans of the carotid arteries to prevent strokes are still thought of as “experimental” by most mainstream physicians.

Transcranial Doppler ultrasound (TCD) is another type of sonogram that can aid doctors in preventing strokes.14,15 TCD measures blood flow in the brain and can detect abnormalities in brain blood vessels that may be a precipitating factor for a stroke. TCD can also be used on patients before they undergo surgical procedures to determine whether they are at risk for strokes or other cerebrovascular problems that often manifest under significant stressors such as surgery. Like carotid ultrasound scans, however, TCD scans are still not part of routine physical visits.

Detecting breast and ovarian cancer, aortic aneurysms
Despite decades and hundreds of millions of dollars of research, cancer still strikes hundreds of thousands of Americans a year. Breast cancer, the second leading cancer killer of women, affects 180,000 women every year, causes 42,000 deaths each year, and is the leading cause of death in 40- to 44-year-old women. While 30 million x-ray breast mammograms are done each year to help detect this deadly disease, researchers are now showing that through the use of sonograms, doctors may be able to detect breast cancers they previously missed with mammograms.

A Japanese study in 2001 looked at the usefulness of combining mammograms with ultrasound during breast cancer screening.16

The researchers evaluated 15,139 women during a five-year period and found that the combination of mammograms and ultrasounds increased a doctor’s ability to detect breast cancer by an impressive 29%. They also found that cancers detected with the addition of ultrasound screening were more likely to be discovered earlier, and therefore were more susceptible to treatment.

An even more recent study published this year examined the ability of sonograms on their own to detect breast cancers in women with dense breasts, as mammograms done on women with dense breasts are less sensitive at detecting cancer. This study, done between January 2000 and January 2002, examined 1,517 women with dense breasts and normal mammograms.17 Sonograms done on these women detected seven cancers, leading the researchers to conclude that “screening breast sonography in a population of women with dense breast tissue is useful in detecting small breast cancers that are not detected on mammography or clinical breast examination. The use of sonography as an adjunct to screening mammography in women with increased risk of breast cancer and dense breasts may be especially useful.”

While breast cancer gets the most press in terms of female cancers, ovarian cancer is also a major threat to women, being the leading cause of death from gynecological malignancies. Approximately 15,000 women a year in America will die from ovarian cancer. The prognosis for women diagnosed with ovarian cancer has not significantly improved over the past 10 years, despite more aggressive surgery and chemotherapy.

One reason ovarian cancer continues to be a stubborn killer is that currently there are no well-accepted screening tests to detect ovarian cancer at its earliest stages. This is now changing with the publication of studies showing that transvaginal ultrasound can safely and effectively detect ovarian cancer at its earliest stages when it is most amenable to treatment and cure. A six-year study done at the University of Kentucky looked at the use of sonograms as a reliable screening method for the detection of early ovarian cancer in 6,470 women. The researchers found transvaginal ultrasound screening was, in their own words, “a safe, time-efficient screening method [for ovarian cancer] which is well accepted by patients.”18 Even more important, the authors of this study showed that sonograms could detect early-stage ovarian cancer and therefore significantly improve the chances of curing the women with cancer.

Few people are aware of the presence of deadly aortic aneurysms, a condition marked by a weakness or defect in the aorta, the largest blood vessel in the human body. If this defect grows to affect enough of the aorta, that part of the blood vessel can rupture, causing immediate and fatal results. This silent but deadly condition has been estimated to affect 7% of all men over the age of 60 and is responsible for the deaths of at least 30,000 Americans yearly. Dr. Paul Segall, a leading figure in the anti-aging and life extension field, recently passed away at the age of 60 due to this deadly condition. It is known that hypertension, smoking, and increased blood cholesterol levels are important risk factors, though the exact cause of aneurysms is unknown. While aneurysms can sometimes be detected during a physical examination, sonograms are proving to be the gold standard in aneurysm detection. Studies have shown that sonograms are effective in detecting aneurysms;19 furthermore, they are inexpensive, quite painless, and can change an almost certain death into a survival rate of 96-99%.

With the advent of modern antibiotics, many infectious killers of yesteryear such as smallpox and polio have largely been relegated to medical history books. Taking their place are chronic, debilitating killers such as heart disease, cancer, and other conditions that mainstream medicine has struggled to overcome. Taking appropriate supplements and getting annual preventive health examinations that include sonograms will help us improve our chances of living longer and healthier lives.

How to Talk to Your Doctor About Sonograms

One of the hardest things patients often face is talking to their physician about “alternative” medical practices, such as the routine use of sonograms. Many patients feel that they do not have the right or the knowledge to question their physicians about any type of treatment that is sometimes viewed with skepticism by mainstream practitioners. With a little foresight and preparation, however, you can quickly gain the confidence and skills needed to discuss alternative practices with your physician.

When talking to your physician about the use of sonograms, especially in the place of x-rays, you first need to educate yourself about the fundamental uses of sonograms. By reading this article, you have done just that. Second, either make a copy of this article for your physician to read or look up and copy some of the more specific references I used in writing this article. Finally, go to your physician with an open mind; remember that with the time constraints imposed on the vast majority of physicians by HMOs and ever-widening government regulations, it is near impossible for any doctor to stay up to date on all the changes in medicine. If you take the time to let your doctor know that you have read up on the use of sonograms to maintain your health, your doctor will be much more apt to take time out of his or her busy schedule to discuss with you the appropriateness of using sonograms for your particular need or condition.


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