Radiological Time Bomb

Mary Miller is 25, bright, attractive and ambitious. She has a husband, an editorial job with a New York publishing company and frequently enjoys her favorite pastimes of skiing and attending the ballet. But Mary (not her real name) also has something that casts a shadow over her otherwise happy life. She is figuratively carrying a time bomb in her neck, never knowing whether--or when--it will go off. As an infant in Milwaukee, she received X-ray treatments to shrink her thymus gland, which doctors suspected was causing breathing problems. As a result of that medical vogue, she must now live with the knowledge that she is at least 20 times more likely than the average person to develop cancer of the thyroid, which is normally among the rarest of malignancies.

Mary's predicament is not unique. From the 1930s into the early 1950s, doctors considered low doses of X ray a safe, effective way to shrink enlarged thymus glands or adenoids and destroy infected tonsils. They used the technique on thousands of small children. But in the early 1950s, after doctors began finding a high correlation between the X-ray treatment and the later development of growths (both benign and malignant) on thyroid glands, they hastily abandoned the procedure. In 1958, Dr. C. Lenore Simpson of the Roswell Park Memorial Institute in Buffalo confirmed their growing fears by reporting that children who had received X-ray treatments were far more likely to develop thyroid cancer and leukemia than those who had not.

Research Program. Mary first learned of concern about the X-rayed children last June when she read a newspaper article about the efforts by doctors to locate and examine them. When she visited her parents in Wisconsin a few weeks later, she learned that she, too, had had the X-ray treatments. After seeing her family physician, who assured her that he could detect no thyroid abnormality, she agreed to become part of a research program launched by the Medical College of Wisconsin at Milwaukee County General Hospital.

Doctors at the college have gone out of their way to locate and examine (free of charge) those who, as children, received the X-ray treatment. The doctors examine the necks of all patients for abnormal growths. They also test patient response to agents known to trigger allergic reactions; the tests determine whether the patients' immune systems (which are partly controlled by the thymus) have been affected.

One 25-year-old mother has already died of a thyroid cancer that doctors believe was caused by X-ray treatments administered when she was an infant. But for most, the damage has not been irreparable. Doctors have found thyroid abnormalities in 195 of the first thousand patients examined under the Wisconsin program, but a good many of these growths proved to be benign and were treated successfully. A New York State program that has traced patients since 1955 found only 19 cases of cancer when it studied 3,000 patients in 1963, well above what would normally be expected but considerably below the 20% rate projected by the Wisconsin researchers.

Even those who are given a clean bill of health will worry about sore throats or other symptoms most people ignore. Some are carrying time bombs that continue to tick away. All they can do is hope to discover and disarm them before they explode.

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