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US citizens exposed to radiation fallout during Cold War tests
Newsdesk US citizens exposed to radiation fallout during Cold War tests “We also wanted to find out if were exposed to fallout from both there were any health effects from domestic and foreign tests and people radiation fallout in born nearest to 1951 general,” she added. seem to have the “As part of the highest chance of study, the National developing cancer. Cancer Institute has Estimates of radianalysed the link ation dispersal were between health and made using computer nuclear fallout in analysis of weather Nevada but our patterns as well as study also examined population trends. whether it would be Researchers warn, feasible to look at however, that the other geographical radiation doses reareas,” said Burden. ported in the project Preliminary esshould not be used to timates of dose and A typical nuclear weapons test. determine cancer health risks from outcomes because of exposure to radioactive fallout from the low precision of the estimates. nuclear weapons tests conducted from Formal recommendations are 1951 until 1962 at both the Nevada expected after the report has been Test Site, as well as from global tests, peer-reviewed by the US National are presented in the study. Academy of Science. All US residents born after 1951 Georgina Kenyon Courtesy of www.ozones.com
Over 17 000 US cancer deaths and 20 000 non-fatal cancers have been linked to radioactive fallout from Cold War nuclear weapons tests, according to a leaked report by the US Department of Health and Human Services (DHHS), Centers for Disease Control and Prevention, and the National Cancer Institute. According to the report, “Fallout radiation appears to have the greatest impact on risks for thyroid cancer.” Risk of leukaemia from nuclear fallout is assessed to be lower but still prevalent. “In 1998, the US Congress requested the DHSS to conduct the study to look at whether or not it was feasible to carry out larger studies to look at the health effects of radiation, not just on thyroid cancer, which was already partly documented,” says Bernadette Burden, spokesperson for the Centres for Disease Control and Prevention in Atlanta (GA, USA).
Testicular cancer: risks of treatment vs risks of recurrence Cisplatin-based treatment of disseminated testicular cancer is now so successful that patients may be at greater risk from the long-term toxic effects of treatment than from a recurrence of the disease, according to the results of two long-term studies of morbidity, 13 or more years after chemotherapy. Sophie Fosså’s group at the Norwegian Radium Hospital (Oslo, Norway) evaluated renal function in 85 men with malignant germ-cell tumours treated with retroperitoneal lymph-node dissection alone (14), radiotherapy alone (18), or cisplatinbased chemotherapy with or without surgery or radiotherapy. Renal function had fallen by a mean of 8% in radiotherapy patients and 14% in chemotherapy patients. Renal damage was subclinical but “may become clinically relevant, for example during treatment with any drugs that are eliminated by the kidneys” (Ann Oncol 2002; 13: 222–28). Dirk Strumberg and colleagues
THE LANCET Oncology Vol 3 April 2002
(University of Essen, Germany), who evaluated secondary morbidities in 32 men with metastatic germ-cell cancer treated with cisplatin-based chemotherapy, found abnormal left ventricular function in 30% of patients, increased cholesterol in 82%, raised triglyceride in 44%, and hypertension in 25%. 23% of patients had hearing loss, 28% symptomatic neuropathy, and 6% disabling polyneuropathy (Ann Oncol 2002; 13: 229–36). Strumberg warns that patients “should be made aware that they might have a greater risk of cardiovascular disease than of suffering a recurrence of their cancer or a second malignancy. Then they can take measures to minimise this risk.” Testicular cancer strikes mainly young men and cure rates are impressive (eg, 90% survival for stage I nonseminomatous germ-cell tumours). “In a way, patients have become the victims of the success of treatment,” says Karim Fizazi (Institut Gustave Roussy, Villejuif, France). “It is now
http://oncology.thelancet.com
vital to direct research towards moderating side-effects and ranking different treatments in the order in which they may disrupt a patient’s future quality of life.” Donald Bissett (University of Aberdeen, UK) notes that “modern chemotherapy regimens for testicular cancer still produce significant longterm morbidities, and the results of these two studies again caution against overtreatment, particularly in stage I disease”. He adds, although adjuvant chemotherapy is commonly recommended in stage I non-seminomatous germ-cell tumours with vascular invasion, it is estimated that about 50% of these may be cured by orchidectomy alone. “Improvement in staging techniques may allow more men with this stage of disease to be managed by orchidectomy and surveillance. However, further attempts to reduce the morbidity of chemotherapy must not compromise the current excellent cure rate in this disease.” Dorothy Bonn
197
For personal use. Only reproduce with permission from The Lancet Publishing Group.
Over 17 000 US cancer deaths and 20 000 non-fatal cancers have been linked to radioactive fallout from Cold War nuclear weapons tests, according to a leaked report by the US Department of Health and Human Services (DHHS), Centers for Disease Control and Prevention, and the National Cancer Institute. According to the report, “Fallout radiation appears to have the greatest impact on risks for thyroid cancer.” Risk of leukaemia from nuclear fallout is assessed to be lower but still prevalent. “In 1998, the US Congress requested the DHSS to conduct the study to look at whether or not it was feasible to carry out larger studies to look at the health effects of radiation, not just on thyroid cancer, which was already partly documented,” says Bernadette Burden, spokesperson for the Centres for Disease Control and Prevention in Atlanta (GA, USA).
Testicular cancer: risks of treatment vs risks of recurrence Cisplatin-based treatment of disseminated testicular cancer is now so successful that patients may be at greater risk from the long-term toxic effects of treatment than from a recurrence of the disease, according to the results of two long-term studies of morbidity, 13 or more years after chemotherapy. Sophie Fosså’s group at the Norwegian Radium Hospital (Oslo, Norway) evaluated renal function in 85 men with malignant germ-cell tumours treated with retroperitoneal lymph-node dissection alone (14), radiotherapy alone (18), or cisplatinbased chemotherapy with or without surgery or radiotherapy. Renal function had fallen by a mean of 8% in radiotherapy patients and 14% in chemotherapy patients. Renal damage was subclinical but “may become clinically relevant, for example during treatment with any drugs that are eliminated by the kidneys” (Ann Oncol 2002; 13: 222–28). Dirk Strumberg and colleagues
THE LANCET Oncology Vol 3 April 2002
(University of Essen, Germany), who evaluated secondary morbidities in 32 men with metastatic germ-cell cancer treated with cisplatin-based chemotherapy, found abnormal left ventricular function in 30% of patients, increased cholesterol in 82%, raised triglyceride in 44%, and hypertension in 25%. 23% of patients had hearing loss, 28% symptomatic neuropathy, and 6% disabling polyneuropathy (Ann Oncol 2002; 13: 229–36). Strumberg warns that patients “should be made aware that they might have a greater risk of cardiovascular disease than of suffering a recurrence of their cancer or a second malignancy. Then they can take measures to minimise this risk.” Testicular cancer strikes mainly young men and cure rates are impressive (eg, 90% survival for stage I nonseminomatous germ-cell tumours). “In a way, patients have become the victims of the success of treatment,” says Karim Fizazi (Institut Gustave Roussy, Villejuif, France). “It is now
http://oncology.thelancet.com
vital to direct research towards moderating side-effects and ranking different treatments in the order in which they may disrupt a patient’s future quality of life.” Donald Bissett (University of Aberdeen, UK) notes that “modern chemotherapy regimens for testicular cancer still produce significant longterm morbidities, and the results of these two studies again caution against overtreatment, particularly in stage I disease”. He adds, although adjuvant chemotherapy is commonly recommended in stage I non-seminomatous germ-cell tumours with vascular invasion, it is estimated that about 50% of these may be cured by orchidectomy alone. “Improvement in staging techniques may allow more men with this stage of disease to be managed by orchidectomy and surveillance. However, further attempts to reduce the morbidity of chemotherapy must not compromise the current excellent cure rate in this disease.” Dorothy Bonn
197
For personal use. Only reproduce with permission from The Lancet Publishing Group.