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This interview originally appeared at www.womentlc.com/interview-gofman.html. As of 2005 the domain name and site no longer exist so we are reproducing it here. --ratitor.




The Patient's Right-To-Know
An Exclusive Interview With Dr. John Gofman
The Women's Menopausal Network
June 2000


Dr. Rappaport:

This may be one of the most important topics that we can possibly discuss: your health. What causes the major illnesses that kill us and cause the scariest diseases we have? Most of us would do anything we could to get rid of the problem. Let's say you found the power lines outside your house were causing most of the illness in your house. Let's say that they were even causing your husband or yourself to have coronary heart disease, heart attacks, or even cancer. Suppose you knew that your risk of getting cancer was increased by ten fold by the power line outside your house what would your reaction be? You would think about what congressmen you could scramble to call and whom you could write letters to and call up the radio and the news stations. You would do what ever you could to take this power line or whatever the threat was away from you family. What could you do about it to change it as long as that power line were outside your house? You would feel threatened I'm sure. Suppose that it were your water or something close in the environment.

I'm sure we would all take action to change the risk to our health especially for something that was dangerous. We know about cigarettes. That's one example of a product that's not healthy for us and we know what's happened with the root of cigarettes. The companies are being sued into oblivion at the moment and the cigarettes have been around for a long time, but we know the response from many people is to be outraged and now to sue the cigarette makers and everybody involved with the products. We are wondering whether milk with high cholesterol might be the next one to be sued.

Let's look at something that may be much more hidden that may be causing pervasive disease. What if the cause of cancer and heart disease (which kills most Americans) is something that were very pervasive in the American way life? In fact what if the danger were related to very establishment that was charged with protecting our health? What would our response be then?

We're speaking with Dr. John Gofman, author of the recent publication, Radiation from Medical Procedures in the Pathogenesis of Cancer and Ischemic Heart Disease: Dose-Response Studies with Physicians per 100,000 Population. This 699 page book, published in 1999, is an extremely involved and lengthy indictment. It is a well thought out, well written book, by a leading expert, which indicates that maybe 60 to 100 percent of our cancers and coronary heart disease might be coming from a silent odorless tasteless impossible to sense killer, radiation. We're not aware of the radiation in our environment. But we're talking about radiation related to medical exposure; radiation from x-rays, cat-scans, fluoroscopes and all the kind of procedures that we normally use in order to diagnose.

Thank you for joining us Dr. Gofman. You have had an extremely illustrious of history and I see you have been a professor emeritus at University of California Berkley molecular and cellular biology. You've done a lot of work with radiation and you've had a lot of positions of authority and have done a lot of work in laboratories with lipoproteins, cholesterol, and tryglicerides. Would you to elaborate to our listeners on how much work you have done in this field or about your background?

Dr. Gofman:

No I think you've covered it. I started out working for a Ph.D. in chemistry and got into nuclear chemistry and that's how I got into the entire issue of medical radiation.

Dr. Rappaport:

There's an unusual award you received, the Annual Gold Headed Cane Award. Do you want to tell us something about that?

Dr. Gofman:

Every year in the medical school at the University of California in San Francisco one person is chosen to be the person in that class that represents the true physician values and in 1946 I was awarded that gold headed cane. You actually carry the cane and pass it to subsequent medical people.

Dr. Rappaport:

I'm sure that was well deserving. How did you get into coronary heart disease, research and cholesterol?

Dr. Gofman:

Well I got into research and cholesterol by the fact that there was a lot of controversy in the 40's as to whether blood cholesterol or cholesterol and foods meant anything. There had been one study by Dr. Lionel Duff showing that if you made animals diabetic with a drug called Raloxin, with this they would develop enormous levels of cholesterol and other lipids in their blood. But they didn't develop much arterial disease, the disease we call multiple arthrosclerosis, which underlies most clinical coronary disease. I wondered if this were due to the way the cholesterol was being carried in the blood stream. It's just at that same time powerful centrifuges became available where you could get sources that are the order of 300,000 times gravity. I got one of these instruments and was able to develop a systematic way to study the blood cholesterol lipids and then we tied that to clinical studies of coronary heart disease and that was how the whole thing began.

Dr. Rappaport:

So you're one of the original pioneers who helped to discover the different types of cholesterol that we measure in our typical chemistry panels in the doctors office, right?

Dr. Gofman:

That's correct. It was done by my graduate students and myself over a period starting in 1948 continuing even to the present.

Dr. Rappaport:

Can you describe the work you did with the Lawrence Livermore Lab?

Dr. Gofman:

Actually Ernest Lawrence, the developer and the laboratory in Berkley bear his name and the one in Livermore bears his name. They decided in 1962-1963 that they would accept the invitation from the Atomic Energy Commission to set up a biomedical division in the Livermore branch of the Lawrence Laboratory. I have been working in the Berkeley branch since 1948 and I did accept the responsibility to organize a biomedical division there at Livermore and I became an associate director over the entire 5,000-man laboratory. Our mission was quite clearly stated, find out the role of radiation of all types of procedures engaged in by the U.S. Atomic Energy Commission weapons testing, weapons manufacture, fallout from weapons testing, anything that had to do with radiation in any form. Our mission was to try to figure out the amount of harm that would ensue.

Dr. Rappaport:

So basically you have been spending your entire life investigating the effects of radiation on biological tissue of human beings and the likes. I believe it's fair to state that you are one of the world's leading experts in the effects of radiation on humans and populations.

Dr. Gofman:

I've published several books on radiation and this one you mentioned for radiation and for medical procedures.

Dr. Rappaport:

I think because the subject that we are talking about is very difficult, I wanted our listeners to understand how important your reputation is and your stature in this field. Could you give us a little bit more of a background about what radiation is, what it does to our body tissues and perhaps comment a little bit about the relative destructiveness of the x-rays we use typically in clinics as opposed to something from outer space like cosmic rays?

Dr. Gofman:

Radiation is described as an electromagnetic phenomenon. You can think of it as having some of the properties that way, but it's much more easily understood if we think of another property. Mainly that there is a packet of energy. When you are in your home you have electric lights. Light represents packets of energy in a certain punch. Then there are a little bit more punch in packets of energy from ultraviolet such as sunshine. Then if you go up one more step beyond ultraviolet you have packets of energy that have enough punch more than ultraviolet to just yank an electron out of atoms of all kinds in our body. Those packets just above the ultraviolet expand into the kinds of powerful gamma rays that were generated in Hiroshima and Nagasaki. That whole region is called the x-ray and gamma ray region.

Dr. Rappaport:

These are basically going to rip our atoms apart. They're going to rip electrons off of the atoms and cause dangerous free radicals in our tissues, I imagine.

Dr. Gofman:

Medical x-rays cause exactly those free radicals by ripping electrons out of atoms. An x-ray won't do anything except when an x-ray hits your body. Some of the x-rays go right through your body and come out the other end and they don't cause any damage. The damage is caused when the x-ray in your body interacts with the tissue to take an electron out and those electrons are traveling at speeds nearly the speed of light in your body. It's those electrons that cause the destructive effects by injuring our chromosomes and DNA, which are all the instructions that tell cells what to do.

Dr. Rappaport:

As far as radiation goes what would you say about the relative destructiveness of things like the regular x-rays we take of lungs and mammograms compared to things like cosmic rays from outer space?

Dr. Gofman:

X-rays would be very low in the whole spectrum going up to cosmic rays. X-rays are the first of the series of destructive radiations above ultraviolet. At the other end of the string is radiation from microwaves and electric power lines. Those are exceedingly low energy, much less energy available per photon or per packet of energy.

Dr. Rappaport:

Now it's pretty well known how x-rays cause cancer. Can you give us an idea of how important is radiation as a causative factor in causing cancer?

Dr. Gofman:

X-rays have been known to be capable of causing cancer for the past 40 or 50 years and even before that in animals. So we have known this for a long time, but you've raised a very important point. Namely you're asking how important is medical radiation among other possible causes of cancer? That was the answer that was not available because we didn't have any way to know how much radiation each person in the population had received, because it isn't measured. That is a big part of our story because we think it has to be measured. We want to do this on a routine basis on all measurements. What we are able to work out is using the number of physicians per hundred thousand people as a surrogate, as a stand in for the x-rays that weren't measured and with this we are able to get an estimate of relative radiation in various parts of our population. We are able to do this from 1920 to the present time.

On a common sense basis we said, Look you don't go order an x-ray as a person in the population. A physician orders the x-ray and another physician, specialist, or radiologist actually, administers the x-ray. Therefore we presume that it was reasonable to say that if you knew there were a number physicians per hundred thousand of the population in one part of our country versus another those would stand to each other as the radiation doses would stand to each other.

In 1993 the United Nations said that in the examinations per unit of population and the number of physicians per unit of population they were able to find a linear correlation between these two. Taking that we were able to find what the number of physicians per hundred thousand people was all the way back to 1921. On the other side we had the mortality data for people who died of all sorts of diseases from hypertensions, strokes, coronary disease, and all forms of cancer. We put these two things side by side and were able to show that there was virtually perfect correlation between the number of physician per hundred thousand and these mortalities from cancer and from heart disease.

Dr. Rappaport:

I'm looking at a graph here that you have presented and it shows an incredible correlation between the number of physicians and the population per hundred thousand specifically in cancers and ischemic heart disease. In biological systems and populations we rarely see such an incredible correlation of data. Is that correct Dr. Gofman?

Dr. Gofman:

That's exactly correct. Seeing that first graph just knocked us out. We hadn't seen anything like this on the scene.

Dr. Rappaport:

This graph is basically showing for males and females that there's an extremely tight correlation between cancers, also specific kind of cancers like breast cancer, and the number of physicians for the population and also ischemic heart disease and the number of physicians in the population. I know some people say does that mean we should go out and get rid of all our physicians -- that they're causing all our cancer.

Dr. Gofman:

I don't think we need to get rid of the physicians. But we have a very simple thing to do. If every x-ray were taken after a dose of radiation where you get the minimum needed to give a good picture that would be fine. But that's not the situation. We have excellent evidence that some places are giving you the right dose, some places are giving five times that dose and some are giving you ten times that dose. As long as that happens you can't take advantage of medical x-rays for diagnosis without getting into trouble. Because if somebody in an installation doesn't measure the doses they're giving you, you may actually be getting ten times the dose needed. Then you're getting one part diagnosis and nine parts risk of cancer and heart disease.

Dr. Rappaport:

Dr. Gofman is there something else that physicians may be doing besides radiation that would explain the data? We prescribe drugs and things like that. Could other factors that the medical profession is doing describe this incredible data that you have presented?

Dr. Gofman:

I think that what we can say is other factors co-act along with medical x-rays. I don't think there's any way of getting out of the fact that the medical x-rays are involved to the degree we are saying. For example, in breast cancer 80 and 90 percent of all breast cancers have medical x-rays in their correlation. But those medical x-rays can interact with certain things like drugs or food we're eating or combining of pollution. And together you're getting the whole effect. As long as you're finding that medical x-rays are involved in anywhere over 50 to 60 percent of all cases you can't get away from that. But you can possibly help yourself by getting rid of these co-acting factors.

Dr. Rappaport:

Now this is a very important point that we have arrived at. We know cancer is a very complicated affair. It probably takes initiating and promoting events and perhaps whole series of different events that actually lead to and cause cancer. Some of them might involve smoking for some people; some might involve poor diet, environmental factors and of course medical radiation. The fact that we are stressing medical radiation is responsible for a high proportion of cancer, how does this interact with our knowledge that these other factors like cigarettes and diets are so important also? Does this detract from their importance?

Dr. Gofman:

This doesn't detract from their importance. If you have smoking added to medical radiation your situation is worse than if you didn't have the smoking. So the rules that tell us what we must do are this: very few cancers or heart disease are due to a single cause. Most of these diseases like cancer as you mentioned just a moment ago may have three, four, or five other factors in a chain of events. It goes from the first injury to the cell to the final clinical cancer in the person. And so as long as there are multiple factors involved, if you can single out those that are the most important that's where you should put your efforts first. The story of our medical x-rays does not denigrate the importance of these co-acting factors such as smoking and the wrong diet.

Dr. Rappaport:

We have an example. Say you have a third of the people that you think their cancer is due to smoking and radiation. Maybe a third is due to diet and radiation and another third just might be due to poor diet and all kinds of other factors. The radiation is involved in two of those groups. So if you take out the radiation in two of those groups you're already eliminating two-thirds of all your cancers without doing anything else.

Dr. Gofman:

That's correct. And I think that's exactly where we need to go. This is the most optimistic information concerning cancer and heart disease that I can imagine because we can do something constructive about this without losing a bit of the diagnostic value of our x-rays.

Dr. Rappaport:

This is really an incredible revelation and I think we need to underscore it. If I understand what you're saying is that the radiation that the medical profession relies on so heavily for diagnostic procedures for diagnosing diseases is that causing 60 to 90 percent of all cancer and coronary heart disease. I think what we're saying here is that we really have been unaware of this correlation because of the silent nature of radiation. It's just part of the way we do medicine everyday. Is that a fair statement Dr. Gofman?

Dr. Gofman:

That's a very fair statement and I might add one other thing. It's familiarity breeds contempt. Actually in the early years medical applications of a guide master radiation started on a large scale. Nobody did studies of five, ten, or forty years after you've had some injurious agent and as a result people didn't know that medical x-rays were causing these difficulties.

Dr. Rappaport:

So we've really had a period of time where we didn't know what was happening. Which is kind of excusable. But now we've been studying radiation for many years and we have collected a lot of data. We know the effects of radiation. It should be added that it doesn't matter how small the dose of radiation. It's cumulative and it's there the rest of your life. It keeps building up and those little small doses really add up fast.

Dr. Gofman:

Today if you get an excessive dose of radiation that small amount is going to add to other things. And that small amount has already given you a partial ticket to a cancer or heart disease 10, 20, 30, 40, or 50 years down the line. You just don't want to accumulate those partial tickets at all.

Dr. Rappaport:

In a single year on my recollection we get about 100 millirads, is that about right Dr. Gofman?

Dr. Gofman:

That's true from a variety of causes.

Dr. Rappaport:

A typical x-ray may have six to ten times that dose. Is that correct?

Dr. Gofman:

I'd say that's very close to right. A whole chapter in our book is based on measurements that have been available and we'd say about three-tenths of a rad to six-tenths of a rad is what we get on the average per year.

Dr. Rappaport:

So you can't control how much you get from the world around you. But when you go for a simple chest x-ray you might be getting five or six times that dose a year. When you go for a CAT scan we're not talking about millirads anymore we're talking about rads. So you might get if I understand it right five to ten rads which will be 50 to 100 times your baseline level of radiation.

Dr. Gofman:

You're absolutely correct. The one that I would change is the typical chest x-ray is not two or three times the background. They have that down to a point where it's a very small dose. The radiation in the chest for other reasons -- it can give you three to six times that dosage you're getting from background.

Dr. Rappaport:

What were the responses of the medical profession to his queries about this and also are the dentists implicated at all here?

Dr. Gofman:

The medical profession needs to hear about this. They haven't heard about it enough and they're going to have to hear about it from the people of our population in order to get the medical profession to be listening. Dentists are involved in this too. We didn't do a specific study on dentists, but the area that they radiate in the head and the neck is of consequence with respected tumors that can be reduced in these organs. There's no reason to exonerate dental radiation from this reconsideration.

Dr. Rappaport:

It's an interesting thought that in many of the holistic fields the Chinese and the new German kind of technology that goes along with it, they tell us that a lot of disease stems from problems in the mouth. They usually refer to the amalgams and the mercury and I just wonder if radiation also has an impact on health from problems that it's causing in the mouth?

Dr. Gofman:

I'm sure that's correct. But radiation is partially involved there too.

Dr. Rappaport:

You mentioned something to me previously about specific interactions with the American Cancer Society. What would be their response? You've discussed with them the need for looking at this incredible data and what was their response?

Dr. Gofman:

Their response is to say that it's not 50 or 90 percent. It's only four percent. The interesting thing about that is, let's suppose it were only four percent and one million people had risk of a disease that could be 40,000 deaths per year caused by the radiation. Where is the American Cancer Society with its concern for 40,000 thousand cases? When we say you can probably cut that in half by cutting the dose down. Is the Cancer Society not concerned about 20,000 people? We say the numbers are really several hundred thousand, but they surely ought to do better than to say that they don't have anything more to say about it and it's only four percent. Well four percent with 40,000 cases and the combined diseases are a lot of disease.

Dr. Rappaport:

If we are talking about over half of the cancers in the United States and if people are really interested then they should have their ears raised up and really get to work on what we can do about it. Has there been any feed back from the American Heart Association?

Dr. Gofman:

We've given the American Heart Association the data and we're trying to get it out in the form of a book or to experts and researchers in the heart disease field and in the cancer field. We feel the key thing (we have initiated this just recently) is a campaign to have people say, "we feel it's our right when we have an x-ray to have the dose measured and put into our record." If the people listening to this program would drop me a note at P.O. Box 421993, San Francisco, California, 94142-1993, we'll get them this petition that they can sign and then get other people to sign. [Read/print/sign X-rays: The Patients' Right-To-Know Policy Statement online petition at: http://www.x-raysandhealth.org/PRtKPS.html --ratitor] The medical profession is going to sit up and take notice when we have one million or a few million people saying, "We only are asking that our dose be measured."

Dr. Rappaport:

Wow that sounds like a pretty reasonable thing. Where can you be reached?

Dr. Gofman:

At the above address. We're also on the Internet at www.x-raysandhealth.org and at www.ratical.org/radiation/CNR/. You can read the first 50 or 60 pages of the Radiation from Medical Procedures book on the Internet at www.ratical.org/radiation/CNR/RMP/ without even getting the book. But some people would like to have the book right there.

Dr. Rappaport:

I think you certainly would agree that the first step is education and we probably need to educate physicians before we educate the public, because we are the ones who are dispensing this very dangerous diagnostic tool.

Dr. Gofman:

I'd like to have a lot of physician's sign this petition too, because physicians and their families get these diseases too. There is no denying that 45 percent of our death rate is due to the determination of cancers and ischemic heart disease i presuming the path of the causes of premature death. Every physician should be concerned for his family and him or herself and every other profession should be concerned. This is something that's just public health right out front that we need to do something about.

Dr. Rappaport:

I hope our listeners are going to help with that petition of yours. I'm sure you would probably support the use of other techniques, which we're trying to bring to this area like thermography, which does not use radiation for diagnostic purposes.

Dr. Gofman:

I think that's very important to try to get substitute procedures such as thermography that doesn't involve ionizing radiation.

Dr. Rappaport:

The medical professions as you're well aware of are very conservative. It's very difficult to change the way we do business. I don't know if you would have any further suggestions on how we might change the way we do business to cause less harm by the medical radiation?

Dr. Gofman:

We just have to get the data before them to see just what we're dealing with. We're not dealing with something that's a one percent of cancer or heart disease. In fact we're dealing with over 50 percent and that is education up front. But we really need to get those numbers like the 50 percent or more in the hands of physicians in all fields because they order x-rays. Unless they really realize that when the x-rays are poorly done by over dosing they're cause a great deal of harm. We're not trying to eliminate x-rays from medical use. That would be silly. We know the benefits of x-rays. We're trying to eliminate the excess dose, which we don't need. That excess dose really interferes with good diagnosis.

Dr. Rappaport:

Do you have any position on how much of cell phone radiation is a health hazard?

Dr. Gofman:

No. That's much less points per ray and I don't have a position on that. It's a very important separate subject. But my expertise does not extend to that.

Dr. Rappaport:

We have a caller on the line, Yasmine.

Caller:

Hi.

Dr. Rappaport:

Did you have a question for Dr. Gofman?

Caller:

Yes, I have two questions in fact. Dr. Gofman since you said that radiation causes cancer, what if you go to the dentist and they use radiation in one of their procedures. Can you get cancer from that?

Dr. Gofman:

I would say that we should be concerned that dental radiation is also using a dose that is only what's needed.

Dr. Rappaport:

Dr. Gofman it's been a pleasure talking with you and thank you so much for presenting the case for medical radiation causing cancer and ischemic heart disease.

Dr. Gofman:

It was my pleasure.



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