march 20, 1997
"Health Effects of Ionizing Radiation" (HEIR) Reports
Let's begin with the book's conclusion, as stated on the back cover:Our estimate in this book is that about 75% of breast cancer is caused by earlier irradiation. There is absolutely no doubt that reducing unnecessary x-radiation will prevent vast numbers of future breast cancers.A year ago, i had worked up three chapters from the first edition -- 1, 41, and 42 -- to provide an overview of the book's essential conclusions. The second edition, released in April, 1996, contains the additional fifth section, Response to Critiques of the First Edition. Since then i have crafted multiple-format (fancy & plain html, and ASCII text) web versions of ALL of Sections One, Four, and Five as well as four of the segments at the back:
We hope that all physicians will join with health scientists in a determination to reduce unnecessary x-radiation. As discussed in this book, this effort can succeed without ever interfering with a single essential x-ray examination. That is the main route to prevention of breast cancer. Women will not be willing to forgive anyone who stands in the way of this objective.
Section One - Introduction
1. Our Conclusion: A Large Share of Breast-Cancers Need Not Occur, p.1 2. "Incubation Times" for Radiation-Induced Cancer, p.7 3. Early-Onset Breast-Cancer: Evidence on Radiation-Induction, p.11 4. Three Key Concepts in Our Analysis, p.19 5. The Rationale of Our Study: Methods and Materials, p.29
Section Four - Our Finding and Recommendations for Action
39. Bottom Line: The Master Table, p.265 40. Conversion-Factors: The Basis of Column "V", p.273 41. Some of the Uncertainties and Certainties of Our Finding, p.285 42. Prevention of Breast-Cancer, Starting Now, p.291
Section Five - Response to Critiques of the First Edition
43. The Process of Genuine Peer-Review p.301 44. Criticisms in the Journal of the American Medical Assn. p.309 45. Three Remarkably Similar Reports on the Safe-Dose Fallacy p.317 46. "War in Britain": The Natl. Radiological Protection Board p.329 47. Seven Short Objections from Other Sources p.345 48. Susan M. Love, M.D.: Is Radiation Overdosing a Past Problem? p.353 49. What Happens Next? p.373
Table 1, Annual Breast-Cancer Cases in USA, 1960-1994, p.377 Table 2, Growth of Population in USA, 1850-1994, p.378
Author: Biographical Information and Curriculum Vitae, p.379 References, p.383
With everything except Sections Two, Three, and the Index now online, the point has finally been reached where the full summation of the author's findings are available to anyone who can access the web, or knows someone who can.
THE UNEQUIVOCAL FOCUS HERE IS PREVENTION. Everyone who takes the time to read all or key portions of this book will themselves become life-promoting agents to correct such tragically mis-informed statements promulgated through media conduits as "even the best doctors have no idea what causes breast cancer". From Chapter 1:I've recently received in the mail a request for funds to help breast-cancer research. It said: "Breast cancer is the most commonly diagnosed cancer in American women today. It is the leading cause of death among women ages 40 to 44, and the leading cause of cancer death in women 20 to 54." No argument about that. Every part of that statement makes it all the more important for women to know precisely why we say that breast-cancer is largely preventable. Then the letter added:Dr. John Gofman is exceedingly well-qualified in numerous relevant and complementary disciplines to have researched and written this book, given the record of his life as a dedicated physician and scientist who himself, cites "a prime rule for physicians [as being] ``First, do no harm.''" (Chapter 42). This is consistent with his being given the "Gold-Headed Cane Award" from UC Medical School, 1946, "presented to the graduating senior who most fully personifies the qualities of a ``true physician.'' (For more qualification, see his exemplary Curriculum Vitae, included at the bottom of this file.)
"What's worse, even the best doctors have no idea what causes breast cancer or how to cure it." Cure is indeed problematical, and when successful, the process itself can be highly unpleasant. All the more reason why prevention is so very important.
But how can anyone in 1994 say that "even the best doctors have no idea what causes breast cancer"? This error also went out over NBC national news during October 1994, in the television network's coverage of Breast-Cancer Month. In reality, medical science has clearly known for some 20 years already that ionizing radiation is a prominent and proven cause of breast-cancer. Ionizing radiations include x-rays and gamma rays, as well as beta, alpha, and some other high-speed particles. (Radium is used in medicine as a source of powerful gamma rays.)
We think "the best doctors" do indeed know about the role of ionizing radiation as a prominent, proven cause of breast-cancer, but it is astonishing that both lay and medical sources commonly fail to mention this outstanding fact of medical science: Past medical exposure to ionizing radiation, 10, 20, 30, 40, and more years back in a woman's life, can cause breast-cancer.
Radiation exposure in the first few months of life may be the most serious in causation of later breast-cancer. In fact, irradiation of the breasts between age 0 (newborn) and age 9-years may cause many-fold more cases of breast-cancer, over the subsequent lifetime, than does irradiation of women over 40 years of age with the same amount (dose) of ionizing radiation.
Along with the people he cites in the book's Preface And Acknowledgments, was the tell-tale expression of one who is eminently well-suited to the task of providing fastidiously independent research and analysis skills to study this critically important subject:Lastly, there is one special place in my heart, for an assist which was absolutely essential. That place is occupied by the superb library of our medical school at the University of California in San Francisco. What a treasure -- a collection so rich as to make the trip back through 100 years of medicine an easy one. And the cooperation of the librarians was superb.Make no mistake: the level and degree of unconditional obedience to the "Rules of Research"2 has been scrupulously adhered to in the breadth-and-depth of information studied and presented in Preventing Breast Cancer. Combine with this the description in Chapter 1, Part 2. For Whom Is This Book Intended?, and you have some sense of this book's monumental import and significance for any lay person, as well as professional:This book is intended for anyone interested in breast-cancer, and its prevention. Interest in the problem is the only requirement. The book is for medical professionals and for individuals with the greatest personal concern: Women in general --- and their families. Readers do not need to know every medical term in the stories, because the meaning of the stories will be clear anyway. No medical skill or knowledge is essential to understand what will be presented.Thus the conclusions presented are verfiable to the concerned reader no matter what one's "professional" background. This is precisely the sort of genuinely independent analysis of life-and-death issues so essential in our day-and-age to provide all of us with information that can restore our experience of true participation in the critical decisions we make every day affecting our own lives and the lives of those in our communities.
Many chapters will begin with a description of what happened, and will end with specific calculations based on the events. Of course, many readers will skip the numbers. The "easy readers" should feel no guilt for skipping the latter part of various chapters. Lots of professionals, also, read scientific journals without ever examining the calculations and tables there. But numbers are in journals, and also in this book, for a very important reason: To allow people to check for themselves exactly how the quantitative conclusions were reached, and to evaluate the validity for themselves.
Which brings us to a fundamental point every person in our society needs to be constantly re-minded of. As is stated on the back side of the title page,
Research in this field is not commercially viable. Most radiation research, analysis, and publications are sponsored by government grants. CNR neither requests nor would accept any government funding. The low price of the HEIR Reports is made possible by the foundations and individuals who generously support these scholarly works, and by the refusal of the author to accept royalties or payment of any other sort from CNR.
People don't seem to re cognize that "Official Studies" and "Official Pronouncements" are themselves rarely disinterested -- especially since their funding has, on the most practical of levels, a host of "strings attached" irrespective of whether or not there are ever any explicit "guidelines" included when the funding is given. The monies themselves are the strings. John Gofman is well-acquainted with such matters in his own experience of losing all funding for continued research into the health effects of radiation conducted at Livermore Lab's Biomedical Research Division -- which he himself founded by invitation of the AEC in 1963. This loss of funding occured when he and colleague Arthur Tamplin became increasingly concerned about the dangers of such exposure in the late 1960s from their research in this area.3
Writing this book has been a happy task. It deals with a very serious problem, with a very happy ending. It would be hard to think of anything more rewarding for this effort that the knowledge that we can begin the task of breast-cancer prevention -- now.
John W. Gofman, M.D., Ph.D.
from the "Preface and Acknowledgements"
Along with other "paths of transformation", we need to seek out and pay attention to all the capable women and men independent research scientists we can find to provide us with precise life-affirming information and analysis so desparately needed to make the informed decisions about the host of issues confronting us and our collective future. Gofman is such a person and offers a fabulous wealth of such life-supporting facts. Another indication of the dispassionate concerns of such an independent researcher is expressed near the close of Chapter One's Part 1. The Bottom Line:
The finding of this book constitutes an example of what can happen from exposing people to new agents, such as x-rays, when no one knows the long-term consequences. Readers will see the innocent enthusiasm, the repeated assurances that the procedures were safe, and the power of the "technological imperative" to suppress the idea that there might be a problem with anything as wondrous and potentially useful as x-rays. This is a story of "disaster creep" --- a massive problem creeping up on society without any recognition.
In science, every important discovery should be challenged and checked by others, and our finding certainly will be. We will welcome the genuine, thoughtful critiques. And we expect our finding to be validated. We arrive at our startling conclusion after underestimating the past dosage of x-rays, and after using conversion-factors (conversion from dose to subsequent cancers) which derive from real-world observations. There is just no doubt that past radiation exposure accounts for a major share of our recent and current breast-cancer problem. The evidence for our finding is overwhelming --- if one simply looks.
A year ago today a core hyper-linked segment of Dr. Gofman's 1990 book, Radiation-Induced Cancer from Low-Dose Exposure: An Independent Analysis was announced: Section 5: Disproof of Any Safe Dose or Dose-Rate of Ionizing Radiation, with Respect to Induction of Cancer in Humans.4 The implications of this analysis are "required reading" for everyone concerned about the integrity of our collective gene pool. As Gofman stated in the Fall of 1995, "We have found no refutation of our proof. On the contrary, our method is extensively confirmed in the 1993 report of the United Nations (UNSCEAR 1993, esp. pp.627-636, p.681, p.696 Table 17)."5
Radiation-Induced Cancer is the first in this series of HEIR reports. It is consistently referred to and built upon in greater detail throughout Preventing Breast Cancer. With the help of two women, work is proceeding to continue creating HTML versions of the remaining 33 chapters from Sections Two -- Stories of the Exposures in Our Master Table and Three -- Stories of Exposures Not in Our Master Table.6 i am also committted to working up the remaining chapters of Radiation-Induced Cancer until all of this immensely important and significant book is likewise accessible.
Grateful am i to have the chance of participating in and contributing to the building of a truly useful electronic world library where essential reading and information is freely available in its entirety (just as in any "conventional" library), and extended in this unique form to be fully interlinked with all associated cross-references hooked up. Gofman's subject matter and writing style readily lend themselves to such a hyper-linked format -- there is a great deal of explicit cross-referencing made throughout each chapter to other portions of both books or works he authored or studied prior to analyzing and writing up his own research.
The work of completing web versions of both CNR's HEIR reports will proceed. Beyond what is to come, there is SO MUCH valuable information already in place! i will conclude with the following examples of just a few of the notable areas of exploration awaiting you in Preventing Breast Cancer:
The above segments will give anyone sufficient appreciation of the wealth of information this book comprises and offers to all of us. i include below all of Part 4 in Chapter 48 since the message is so particularly exciting for me -- just consider the effect creation of such Independent Information will provide you and your community should you elect to pursue a collaborative endeavor to manifest an instance of this where you live.
Part 4. WIXMEASE: A Potential Way to Stop Much Careless Overdosing
A double-dose of wishful thinking represents a big obstacle to solving the overdose problem.
- The referring physicians who order the x-ray exams presently know virtually nothing about radiation, so they wish to believe that risks are just "hypothetical" and that they need not take any responsibility.
- The patients hate to irritate their physicians, with whom they would like to have a warm relationship, so they too wish to believe that radiation risks are just "hypothetical" and that there is no need for them to challenge anyone.
These two sets of people comfortably reinforce each other, while the overdose problem persists.
4a. Getting Realistic? The Meaning of WIXMEASE
On the average, an individual's personal risk from a single x-ray exam is small, and is even smaller from the share of radiation which is the overdose. So, it is not realistic to think that individual physicians or individual patients are going to look beyond their personal stakes and to take responsibility for the aggregate impact from millions and millions of overdoses, occurring year after year --- an impact particularly dangerous for patients who have inherited an extra vulnerability to ionizing radiation (see p.181; also Part 5, below).
Then does anyone care? The women who have committed themselves to preventing as many cases of breast cancer as possible, must surely care about the radiation-induced cases which result from careless overdosing.
It may be in their power to establish a practical service which would solve the careless overdosing problem while not disturbing the mutual comfort of the referring physicians and their patients. What about a Women's Independent X-ray Measurement Service? WIXMEASE.
4b. The Effect of Information
The first step in any serious effort to eliminate careless overdosing would seem to be an independent measurement system to find out where the overdoses occur. A lot could be accomplished just by using TLDs, which can measure entrance dose during an examination without interfering with the x-ray image (see p.298).
For years, a Monitoring-by-Mail Service has existed --- but not for the public --- at the University of Wisconsin's Medical Physics Lab in Madison, Wisconsin (Telephone: 608-262-6320). The Mail Service supplies TLDs to physicians and others who irradiate people, receives the TLDs back by mail, and evaluates the dose on each TLD.
Women of course are perfectly capable of developing their own expertise, or of hiring expertise, to run a similar service --- with one big difference: The TLDs might belong to the patients, and the dose information would become part of a growing database, openly accessible to other patients, referring physicians, and x-ray offices. Finally, it would become possible, on a current basis, to avoid places which typically give higher doses (or more repeats) than other places. Careless places would have either to "shape up," or to fail.
If information on comparative doses were readily available (for instance, on the Internet), what physician would refer patients to a high-dose facility, or to one which declined to participate --- and what patient would go? After a while, insurance systems might refuse reimbursement to non-participants in an independent, trustworthy measurement service. WIXMEASE would not need to remain the only service, if others decided to provide similar, accessible services. The more competition, the more protection against carelessness and corruption at any single service.
4c. The Effect of Independent Information
We do not underestimate the problems of getting a pilot project funded and successfully underway in one or more metropolitan areas. However, we certainly do not underestimate the talent and tenacity of the women who, in the past few years, collected 2.6 million signatures from U.S. citizens demanding a more intense national effort to reduce the incidence of breast cancer, who managed to increase the federal budget for breast-cancer research by a great deal, and who managed to establish a special tax in California to do something new about preventing breast cancer (Chapter 43, Part 3).
Nor do we underestimate the probable resistance from some physicians who will be fearful of patients "having information which they can't understand."
Today, patients who ask x-ray offices about doses often receive answers --- and those answers may sometimes be pure fiction, looked up in a manual of what the dose should be. Isolated answers, even if true, do nothing to eliminate the undeniable overdose problem. By contrast, independent, credible, systematic, current sources of information, based on actual measured doses, would do a very great deal to eliminate careless overdosing.
to be open to the limitless unknown possibilities of existence and its manifestation within through consciousness is what it's all about. nothing else occupies this pre-eminent position and imperative in our lives and our being. this is the gift we ALL possess for the entirety of our lives. it is always "here" with us, ready to join with our awareness as we choose to be open to it in the moment.
--dave the ratitor
Entry point to this book is at
See "Part 4 -- Some Basic Rules of Believable Bio-Medical Research" from the incisive presentation, Bio-Medical "Un-Knowledge" And Nuclear Pollution: A Common-Sense Proposal By John Gofman, M.D., Ph.D., On the occasion of the Right Livelihood Award, Stockholm, December 9, 1992.
See The Plowboy Interview: Dr. John W. Gofman, Nuclear And Antinuclear Scientist for more of the details on how the funding was cut as well as The Harassment Starts: Low-Level Radiation and following sections from Chapter 4, John W. Gofman, Medical Physicist of Leslie Freeman's tremendous work, Nuclear Witnesses, Insiders Speak Out
Entry point to this book is at
Readers are urged to study the immensely accessible essay, What Is Factually Wrong with This Belief: "Harm from Low-Dose Radiation Is Just Hypothetical --- Not Proven," Gofman, Fall 1995, especially Part 3 -- Where's the Controversy, in View of Such Evidence?
Listed here are the remaining sections of chapters still to be created in hyper-linked web form:
[ April 13, 1997:
and Index and Glossary
April 5, 1998: electronic representation of the complete book now in place. ]
Section Two - Stories of the Exposures in Our Master Table
|6.||The "Enlarged Thymus" Story: Start of a Long Controversy,||p.37|
|7.||Benefits of Thymus Irradiation: Delusion or Reality?,||p.43|
|8.||Thymus Irradiation before Age One: Start of Our Master Table,||p.55|
|9.||Irradiation to Reduce Sudden Death in Childhood,||p.55|
|10.||Thymus Irradiation before Anesthesia and Surgery in Childhood,||p.75|
|11.||Ending of the Era of Radiation Therapy for Enlarged Thymus,||p.83|
|12.||Reaching into the Womb: Pre-Birth Breast Irradiation,||p.87|
|13.||Treatment of Acute Postpartum Mastitis with X-Rays,||p.91|
|14.||A Physician's Dilemma: What to Do about Chronic Mastitis,||p.97|
|15.||Management of Tuberculosis: An Eminently Sensible Program,||p.105|
|16.||Mass Screening for Tuberculosis,||p.111|
|17.||Treatment of Bronchial Asthma with X-Rays,||p.113|
|18.||Treatment of Pneumococcal Pneumonia with X-Rays,||p.117|
|19.||Treatment of Pertussis (Whooping Cough) with X-Rays,||p.121|
|20.||Treatment of Hyper-Thyroidism and Breast Irradiation,||p.125|
|21.||Management of Adolescent Scoliosis (Curvature of the Spine),||p.133|
|22.||Chiropractic Examinations and Breast Irradiation,||p.139|
|23.||Major Diagnostic Radiological Contributions to Breast Dose,||p.143|
|24.||Occupational Sources of Breast Irradiation,||p.155|
|25.||Weapons-Test Fallout, Pre-1960, and Breast Dose,||p.161|
Section Three - Stories of Exposures Not in Our Master Table
|26.||The Beauty Shop as a Source of Breast Irradiation,||p.163|
|27.||Yes, We Do Have Your Size: Shoe-Fitters and Breast Irradiation,||p.165|
|28.||Mammography: Past and Present,||p.161|
|29.||Major Surgical Advances and Irradiation of the Breast,||p.183|
|30.||Pre-Employment Fluoroscopic Exams for Pulmonary Tuberculosis,||p.189|
|31.||Fluoroscopy: Source of a Big Underestimate in Our Breast-Dose Finding,||p.193|
|32.||Hard-to-Find Doses from Fluoroscopy and Other Sources,||p.207|
|33.||Dermatology: More Underestimation in Our Finding,||p.219|
|34.||Treatment of Skin Disorders: Overview by Dr. MacKee,||p.227|
|35.||Breast-Exposure by Radium: More Underestimation in Our Finding,||p.235|
|36.||Radiotherapy of Benign Diseases: Overview by Dr. Dewing,||p.243|
|37.||Recent Concerns: Intensive Care Units, Insurance Cases,||p.255|
|38.||Summary on Underestimation of Dose in Our Study,||p.261|