Top Docs: 5 fast facts about radiation

Radiation has come to play a crucial role in medicine, with X-rays and other types of scans giving insight into what's happening in people's bodies. But as doctors look for cancerous tumors and other abnormalities, they and their patients must keep in mind that radiation can be dangerous, too.

Here's what you need to know:

1. BE AWARE OF THE POTENTIAL HARM FROM RADIATION BUILDUP

A variety of medical scans expose the body to radiation, including X-rays and CT (or CAT) scans. Patients should know how to assess the risk.

"Radiation damages cells and internal chemistry of cells," said Dr. Steven Weck, chairman of radiology at Glen Cove Hospital. "The effect increases with increasing radiation dosage." He explained that radiation may damage "the DNA/RNA headquarters of the cell, which can predispose the cell to become cancerous. Radiation exposure can even create mutations that will then carry on to children."

According to Dr. Jonathan A. Haas, chief of radiation oncology at Winthrop-University Hospital in Mineola, medical personnel who administer tests that involve radiation must adhere to federal government guidelines about the proper upper levels of annual radiation exposure, which they track for patients, he said. The policy, known as ALARA (an acronym for "as low as reasonably achievable"), mandates making every reasonable effort to keep radiation exposure as far below the upper limits as practical.

Haas also noted that radiation does not build up in the body. Instead, the problem is that continued exposure to radiation causes more damage to cells. It's the buildup of damage that's the problem, not the buildup of radiation, he said.

2. KEEP TRACK OF THE NUMBER OF SCANS YOU GET

If you're exposed to radiation in multiple ways -- dental X-rays, mammograms, CT scans, bone X-rays -- it's crucial to keep a record of all scans and share this information with your doctors.

"The patient should never assume that the doctors know about all the tests they've had, particularly if they've been performed by another doctor," Haas said. The combined exposure to radiation could be dangerous and unnecessary. "I'd encourage patients to be their own advocate and let their doctors know what tests they've had recently, especially if they're going to different institutes," he said.

3. EXPOSURE LEVELS VARY

Some types of scans, such as chest X-rays and mammograms, expose patients to low levels of radiation. Radiation exposure is higher with CT scans, and several studies have linked their increasing use to a greater risk for cancer. The risk depends on the frequency and level of exposure.

"Diagnostic radiology and CT scans are extremely powerful tools in the diagnostic work-up of virtually all diseases, and the reason for their increasing use is their ability to rule in or rule out various conditions," Weck said. "Their use very often puts the patient's disease in proper perspective, allowing a tailored approach to an individual's condition."

The Alliance for Radiation Safety in Pediatric Imaging has put forth an Image Gently program, designed to stress the importance of low doses of radiation by physicians and dentists. Its guidelines, including information for parents, are available online at imagegently.org. Several radiology associations have created a similar program, called Image Wisely. Information for adult patients can be viewed at imagewisely.org/patients.

4. IT'S OK TO ASK FOR A DIFFERENT KIND OF SCAN

Procedures that expose the body to radiation often are the most appropriate option. But other types of scans -- such as MRIs, which rely on magnetic fields -- can sometimes serve as an alternative, Haas said. If you have a severe headache, for instance, he said you might prefer an MRI instead of a CT scan.

However, be sure to consider the possible downsides of switching to an MRI from a CT. An MRI scan will take more time, Haas said, and it may require patients to enter small spaces with loud, pounding noises. His advice is to simply ask your physician if another type of scan would work. "The answer may be no," Haas said, "but that's a question that a patient can ask."

5. TAKE HOME COPIES OF YOUR SCANS

"Almost all imaging is now digital, and virtually free copies are given to patients on request in DVD form," Weck said. "These prior imaging studies can be very valuable and can often clear up clinical questions without the need for further new imaging."

Radiation oncologists and diagnostic, vascular & interventional radiologists

RADIATION ONCOLOGY

Dr. Jay L. Bosworth

6 Ohio Dr.

Lake Success; 516-394-8100

Dr. Ezriel Diamond

688 Old Country Rd.

Plainview; 516-932-6007

Dr. Richard M. Gewanter

MSKCC Long Island

1000 N. Village Ave.

Rockville Centre; 516-256-3600

Dr. Maged M. Ghaly

300 Community Dr.

Manhasset; 516-470-7190

Dr. Jonathan A. Haas

Winthrop-University Hospital

Radiation Oncology

264 Old Country Rd.

Mineola; 516-663-2501

Dr. Lucille Lee

LIJ Medical Center

Dept. Radiation Oncology

270-05 76th Ave.

New Hyde Park; 718-470-7190

Dr. Evelyn Marienberg

101 St. Andrews Lane

Glen Cove; 516-470-7190

Dr. Lorraine A. Marin

HealthCare Partners

501 Franklin Ave., Ste. 300

Garden City; 516-515-8820

Dr. Edward E. Mullen

South Nassau Community Hospital

1 Healthy Way

Oceanside; 516-632-3330

Dr. Tae L. Park

Stony Brook Univ. Med. Center

Fl. Level 2, Rm. 664

100 Nicolls Rd.

Stony Brook; 631-444-2210

Dr. Jed Pollack

Long Island Radiation Therapy

6 Ohio Dr., Ste. 103

Lake Success; 516-394-8100

Dr. Louis Potters

LIJ Medical Center

Dept. Radiation Oncology

270-05 76th Ave.

New Hyde Park; 718-470-7190

DIAGNOSTIC RADIOLOGY

Dr. William R. Brancaccio

Radiology Dept.

240 Meeting House Lane

Southampton; 631-726-8411

Dr. Kenneth J. Goodman

St. Francis Hospital-

The Heart Center

Dept. of Radiology

100 Port Washington Blvd.

Roslyn; 516-562-6500

Dr. Jay D. Hammel

4277 Hempstead Tpke., Ste. 200

Bethpage; 516-796-4340

Dr. Janet C. Hoffman

270-05 76th Ave., Rm. C-204

New Hyde Park

718-470-7144

Dr. Arfa Khan

270-05 76th Ave., Rm. C204

New Hyde Park

718-470-7144

Dr. David Kirshy

1333 Roanoke Ave.

Riverhead; 631-727-2755

Dr. Jonathan S. Luchs

224 Seventh St.

Garden City; 516-747-0161

Dr. Seth Mankes

Stony Brook Univ. Med. Center

Radiology Dept.

HSC/Level 4/Rm. 120

Stony Brook; 631-444-5400

Dr. Abraham Port

Complete Women's Imaging

990 Stewart Ave., Ste. 100

Garden City; 516-222-4840

Dr. Dennis R. Rossi

Elmont MRI

545 Elmont Rd.

Elmont

516-328-7200

Dr. Scott J. Sherman

100 Port Washington Blvd.

Roslyn

516-562-6500

Dr. Steven Weck

North Shore/LIJ

at Glen Cove Hospital

Dept. Radiology

101 St Andrew's Lane, Fl. 1

Glen Cove

516-674-7540

Dr. Sydney S. Yoon

Dept. of Radiology

1 Healthy Way

Oceanside

516-632-4660

VASCULAR & INTERVENTIONAL RADIOLOGY

Dr. Kenneth Crystal

100 Port Washington Blvd.

Roslyn; 516-562-6509

How they were picked

Castle Connolly Medical Ltd. is a health-care research and information company founded in 1991 by a former medical college board chairman and president to help guide consumers to America's top doctors and top hospitals. Castle Connolly's established survey and research process, under the direction of a doctor, involves tens of thousands of top doctors and the medical leadership of leading hospitals.

Castle Connolly's physician-led team of researchers follows a rigorous screening process to select top doctors on both the national and regional levels. Its online nominations process -- located at castleconnolly.com/ nominations -- is open to all licensed physicians in America who are able to nominate physicians in any medical specialty and in any part of the country, as well as indicate whether the nominated physician is, in their opinion, among the best in their region in their medical specialty or among the best in the nation in their medical specialty.

Careful screening of doctors' educational and professional experience is essential before final selection is made among those physicians most highly regarded by their peers. The result -- Castle Connolly identifies the top doctors in America and provides the consumer with detailed information about their education, training and special expertise in their paperback guides, national and regional magazine "Top Doctors" features and online directories. Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors. (Newsday is not part of the selection process.)

Physicians selected for inclusion in this "Top Doctors" feature may also appear as Regional Top Doctors online at castleconnolly.com, or in one of Castle Connolly's Top Doctors guides, such as America's Top Doctors® or America's Top Doctors® for Cancer.

To see the whole list . . .

Who else is on the list of Top Doctors? More than 6,000 listings are in the New York Metro Area edition of "Top Doctors," published by Castle Connolly Medical Ltd. The softcover list price is $34.95. For more information, go to castleconnolly.com, or call 800-399-DOCS.