[CIS PIDD] [cis-pidd] Potential Cancer Risk to CVID Radiation Therapist

Thu Jul 16 15:10:02 EDT 2015

I agree with Joe.

But I do not see that the history of autoimmunity is important here.  Not a particular feature in those with lymphoma or cancer.

Charlotte Cunningham-Rundles, MD, PhD

Departments of Medicine and Pediatrics

The David S Gottesman Professor

The Immunology Institute

Mount Sinai School of Medicine

1425 Madison Avenue

New York, NY 10029

Phone: 212 659 9268

Fax: 212 987 5593

Email: Charlotte.Cunningham-Rundles at mssm.edu

From: <Church>, "jchurch at chla.usc.edu<mailto:jchurch at chla.usc.edu> " <jchurch at chla.usc.edu<mailto:jchurch at chla.usc.edu>>
Reply-To: CIS-PIDD <cis-pidd at lyris.dundee.net<mailto:cis-pidd at lyris.dundee.net>>
Date: Wednesday, July 15, 2015 at 5:38 PM
To: CIS-PIDD <cis-pidd at lyris.dundee.net<mailto:cis-pidd at lyris.dundee.net>>
Subject: RE: [cis-pidd] Potential Cancer Risk to CVID Radiation Therapist

My first question was “Is there an increased risk of cancer in individuals who work as radiation oncology techs?”

The answer from our Chief of Radiology:   “Not since 1910.”  Probably more like 1950, but clearly the risk is low.

It seems that the additive cancer risk to this patient is low enough that I would not counsel him to change occupations unless there is/are

·         A strong family history of cancer

·         Lymphoproliferative or autoimmune complications of CVID

·         Perhaps, a long history of tobacco use or alcohol abuse

·         Other co-morbidities associated with cancer.

Joe Church
Children’s Hospital Los Angeles

From: Michael Blaese [mailto:mblaese at comcast.net]
Sent: Wednesday, July 15, 2015 1:55 PM
To: CIS-PIDD
Subject: Re: [cis-pidd] Potential Cancer Risk to CVID Radiation Therapist

Thanks Richard,

The full content of her message follows.  It’s all I know.

"Since my diagnosis 2 yrs ago, I have learned that I have a higher possibility of developing cancer, particularly lymphoma. As a guideline, I understand that I should limit my exposure to radiation. That is my question.
I am a 50 yr old radiation therapist, delivering high doses of radiation to cancer patients. I take the usual precautions, but I am wondering if I need to continue in this area. My CVID episodes/illnesses have worsened over time, despite IV IgG infusions, as well as other health conditions, such as degenerative joint disease and arthritis. (I cannot take anti-inflammatories due to slow clotting factors.) I am concerned about my 30 yrs of occupational exposure."

Mike

From: Richard Wasserman <drrichwasserman at gmail.com<mailto:drrichwasserman at gmail.com>>
Reply-To: CIS-PIDD <cis-pidd at lyris.dundee.net<mailto:cis-pidd at lyris.dundee.net>>
Date: Wednesday, July 15, 2015 at 4:26 PM
To: CIS-PIDD <cis-pidd at lyris.dundee.net<mailto:cis-pidd at lyris.dundee.net>>
Subject: Re: [cis-pidd] Potential Cancer Risk to CVID Radiation Therapist

Mike,
You don't tell us if she is likely to be an "infection only" or an "autoimmunity/malignancy" CVID patient. That might influence the response.
Richard Wasserman
Dallas

On Wed, Jul 15, 2015 at 3:15 PM, Michael Blaese <mblaese at comcast.net<mailto:mblaese at comcast.net>> wrote:
Hi Colleagues,

The IDF received an inquiry from a 50 y/o female newly diagnosed with CVID.  Her question relates to the potential interaction between her profession of 30 yrs as a radiation oncology therapist and the increased risk of malignancy seen in CVID.  She asks if we have any idea of the potential increased risk that she is taking in her current position and if she should consider a change of professional fields?

I can find no data that is particularly helpful in answering the question and would appreciate learning of your experience and potential recommendations to this individual who now faces a difficult career decision.

Thanks for your help
Mike

R. Michael Blaese, M.D.
Medical Advisor
Immune Deficiency Foundation

Email   mblaese at primaryimmune.org<mailto:mblaese at primaryimmune.org>
Mobile phone   443-220-2067<tel:443-220-2067>

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