2011/11/26

Why Cancer may not be the Main Concern about Radiation

After a nuclear accident, the one thing that is sure to appear along with the radioactive fallout, like a law of nature itself, is a number of scientists ready to appear in the media giving comforting and optimistic opinions that all precautions are being taken and health effects will be minimal. They have ready access to the media, while experts with contrary views have more trouble getting their voices heard.

The starkest difference between these two types of experts is that one speaks of cancer being the only effect of radiation, and that it will add only a small percentage to the cases of cancer that will happen anyway. The other type of expert cites research showing cancer is only the last of many effects to be suffered by a body that has been exposed over a long period to internal radiation.

These non-cancer effects have been demonstrated in people who absorbed high doses of fallout after weapons testing, soldiers and civilians in war zones who are exposed to depleted uranium, Chernobyl victims, people exposed to radiation during medical treatments, and people who were exposed through work in the nuclear industry.

I’m just an amateur, so far be it from me to question the comforting messages from the optimistic experts, but here’s what I’ve been able to figure out:
This chart is a simplified illustration of another one, inserted at the end of this article, which appeared in a Japanese medical journal.

If I have got something wrong here, I’m open to being corrected, but for the time being it’s a mystery to me how anyone with a medical degree could not have learned what I have learned in a short time about the basics of how radiation damages DNA and causes two possible outcomes: cell death or a mutation that lives on to become cancer. Increasing amounts of cell death lead to organ failure and the weakening of the endocrine and immune systems, or at some point a malignant growth sets in.

The human body puts up a pretty good fight against radiation. It eliminates most of the radionuclides, and cells kill themselves in most cases rather than reproducing and passing on genetic damage. But this survival strategy cannot last indefinitely if the onslaught continues, as it has done with children in Belarus who continue to consume contaminated food. The body forestalls cancer as long as it can by killing cells, but it suffers a lot of declining health in that struggle. It’s a sub-optimal trade-off to a threat to life.

This onslaught of radiation could be compared to a nation at war. It sends its healthy young soldiers into battle, but as more of them die, the society becomes less viable. It may survive for years in this way, but no one would say this is the normal way to live. This is why the health and quality of life of radiation victims has to count as much as, or more than, the lives lost to cancer. The number of people affected is much higher, as are the costs to society.

Cancer is the more famous example of radiation damage because it is seen in the dramatic cases of intense, short-lived exposure. A Chernobyl firefighter gets exposed to a massive dose and dies a few weeks later in a Moscow hospital. This is dramatic and frightening news, but also terribly irrelevant to the millions of people who have to live with the aftermath of Chernobyl and Fukushima. High level exposures are easily avoided. Experts appear in the media to tell us we are only minutely more likely to get cancer at some future time, but this is totally beside the point. The main concern is the non-cancerous effect of long-term, low-level internal radiation absorbed through food, water and air. It seems like some experts, knowing that the C-word is the bogeyman of popular consciousness, exploit the public’s fear of it and deliberately avoid discussing other effects of radiation.

Experts can also dismiss public fears because they know radiation doesn’t leave a trace in the body telling scientists that a tumor or a heart attack was ultimately caused by radiation exposure. But we do know that since the dawn of the nuclear age, rates of childhood cancers have increased, so, no, it’s not just that there is more cancer because people live longer (In the U.S., from 11.5 cases per 100,000 children in 1975 to 14.8 per 100,000 children in 2004 - a period that coincides with worldwide Chernobyl fallout that affected everyone born after 1986).

We also know that modern civilization suffers from “epidemics” of diabetes, chronic fatigue, immune disorders, depression and heart disease. All of this has co-occurred with the age of man-made chemicals and adverse changes in diet and lifestyle, so we’ll never sort out the confounding variables. If someone really wants to believe that radiation has not contributed to these health crises, he’s free to ignore all the evidence that points to a strong link. It is impossible to know for certain what the effects on populations have been, even though the effects have been more convincingly demonstrated in lab experiments on animals and living cells. We have to make our best judgment with the evidence available.

For most of the public, the causes of cancer and other health epidemics are just one big head-scratching mystery. We sign up for the latest corporate sponsored pink-ribbon campaign for breast cancer, or grow a mustache to raise awareness of prostate cancer. These efforts are always with our eyes fixed on feeding the research-pharma industrial complex in the hope that it will find “the cure.” Few note the irony of our increasing dependence on the nuclear industry to provide isotopes to diagnose and treat cancer. Of course, no one can deny that millions of lives have been saved or extended by this emphasis on treatment, but much more could be accomplished in the long-term by looking at the obvious causes, and taking actions to minimize them.

Naming names:

1. Shunichi Yamashita radiation specialist with decades of experience in Japan and Chernobyl, special advisor to the government on the Fukushima Dai-ichi disaster.

 “… we clearly know that animals who are very susceptible to stress will be more affected by radiation. .... Besides, mental-state stress also suppresses the immune system and therefore may promote some cancer and non-cancer diseases…. We know from Chernobyl that the psychological consequences are enormous. Life expectancy of the evacuees dropped from 65 to 58 years -- not because of cancer, but because of depression, alcoholism and suicide.

Dr. Yamashita here seems to claim that depression is caused only by social circumstances. He admits no neurochemical basis of depression. It is theoretically possible that radiation affected endocrine systems and neurochemistry to such an extent that it was the ultimate cause of depression and suicide.

About anti-nuclear activists he says, “...they are not scientists, they are not doctors, they are not radiation specialists. They do not know the international standards, which researchers worked on very hard. It makes me sad that people believe gossip, magazines and even Twitter.” [or is it sad that they believe reports in magazines and tweets that quote experts who disagree?]

About the risks to residents of Fukushima: “I do not think there will be any direct effect of the radiation for the population. The doses are too small.

2. Alexey V. Yablokov, Vassily B. Nesterenko, Alexey V. Nesterenko - rebuttal to views of Professor Yamashita:

Researchers from the former Soviet Union who lived through the Chernobyl disaster have the advantage of knowing the local languages, the research that has been done in these languages, the victims and medical personnel who were on the ground at the disaster (many of them now dead), and the political and bureaucratic culture. In other words, they lived through it. They ought to know better than anyone. They don’t fly in from other countries with the preconception that they are visiting a backward country full of depressed, lazy, chain-smoking alcoholics. These scientists from Belarus, Russia and Ukraine published a comprehensive meta-study of the research, Chernobyl: Consequences of the Catastrophe for People and the Environment (most of the sources were in Slavic languages that UN agencies paid little attention to), in which they came to conclusions such as these:

“We believe it is unreasonable to attribute the increased occurrence of disease in the contaminated territories to screening or socioeconomic factors because the only variable is radioactive loadingIn independent investigations scientists have compared the health of individuals in various territories that are identical in terms of ethnic, social, and economic characteristics and differ only in the intensity of their exposure to radiation. It is scientifically valid to compare specific groups over time (a longitudinal study), and such comparisons have unequivocally attributed differences in health outcomes to Chernobyl fallout.

Endocrine dysfunction, particularly thyroid disease, is far more common than might be expected, with some 1,000 cases of thyroid dysfunction for every case of thyroid cancer, a marked increase after the catastrophe.”

This issue has also been covered in the HBO documentary Chernobyl Heart (2003). It is astounding that UN agencies and so many scientists have heartlessly dismissed the eye-witness testimony recorded in this and other documentaries. If the situation was critical enough for aid groups to send American surgeons to Belarus to repair childrens' damaged hearts, how can they say there is no proven link between cesium absorption and the health of the population?

3. Dr. Yoshiya Shimada of National Institute of Radiological Sciences, who is known for his claim that radiation exposure up to 100mSv/year is safe. (Follow this link to see video of students at Kyoto University demanding a chance to debate with him).

4. Toshiso Kosako

In contrast to Dr. Shimada, another expert government advisor and professor at Tokyo University, Toshiso Kosako, resigned primarily because of the government decision to allow children in Fukushima to be exposed up to 20 millisieverts annually (equal to the international standard for nuclear power plant workers). He said simply, I cannot allow this as a scholar.”

5. Gerry Thomas, Chair in Molecular Pathology, Department of Surgery and Cancer, Imperial College Hospital, UK

Even the Japanese government admitted before the end of March, 2011 that people in Fukushima should have been given potassium iodide pills. Nonetheless, New Scientist has for some reason repeated the lie that they did receive potassium iodide. It was reported on August 16, 2011, quoting Dr. Gerry Thomas:

"First, there was lower exposure to radioiodine [in Fukushima]. Second, iodine pills were quickly distributed. Third, the Japanese enjoy natural protection as there is a high amount of iodine in the diet [Enjoy?]. Finally, thyroid cancer is quite treatable, and Japan has efficient testing and treatment options." 

(Note the implication – from a cancer specialist – that for the patient, the surgical removal of the thyroid gland, followed by a lifetime of hormone replacement therapy, is no big deal.)

New Scientist repeated the lie two weeks later in another report (August 30, 2011), going again to the same expert for an opinion:

"’We've got to stop these sorts of reports coming out, because they are really upsetting the Japanese population,’ says Gerry Thomas at Imperial College London, who is attending the meeting. ‘The media has a hell of a lot of responsibility here, because the worst post-Chernobyl effects were the psychological consequences and this shouldn't happen again.’
Japan's Nuclear and Industrial Safety Agency report that the release of radioactivity from Fukushima is about 10 per cent that of Chernobyl [also not true – no final figure has been determined, but a recent report puts the number at 42%]. ‘The Japanese did the right thing at the right time, providing stable iodine to ensure that doses of radioactive iodine to the thyroids of children were minimal,’ she says."

The lie still goes uncorrected on the web site three months later, in both reports. The sad fact is that because of bureaucratic inertia and indifference, no one in Japan got iodine tablets (except for people in one town where the mayor disobeyed the central government order to hold back), as was reported in Asahi Shimbun and other mainstream media:

“The Japanese government has not instructed any residents to take iodine tablets since the start of the nuclear crisis.”

I’m not a chair of  a prestigious medical institution. I’m just a blogger and a professor of English at a middle ranked private university in Tokyo, but at least I’ve made an effort here to list reliable sources. But I suppose when one is urgently trying to blitz the media to “stop these sorts of reports coming out,” and to defend the nuclear industry in its time of peril, there is no time for fact-checking.

The diagram above is a simplified version of the chart below illustrating process by which long-term internal exposure to Cesium 137 gives rise to bladder inflammation and eventually cancer. The chart appeared in the medical journal cited below it.

chart excerpted from an article by Katsuhiko Kodama,  Head of Tokyo University Isotope Synthesis Center
チェルノブイリ膀胱炎: 長期のセシウム 137低線量被爆の危険性

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