Cancer, Antidepressants and CT Scans

Is the cure worse than the disease?  A couple of recent studies have raised questions about the antidepressant paroxetine, and about CT scans (particularly for children).

Taking Paxil or Seroxat with tamoxifen

The first study investigated those who were taking tamoxifen (ie Nolvadex, Istubal, Valodex) for breast cancer, along with various antidepressants.  Many antidepressants are taken for migraine, and one of these is paroxetine (Paxil,Seroxat), a selective serotonin reuptake inhibitor (SSRI) antidepressant.

In most cases, there was no problem (although the study may have been too small to detect problems in all antidepressants that were tested).  However, paroxetine did interfere with the breast cancer treatment tamoxifen.  At least, that’s what it looks like.

What the study actually told us was that taking the two together increased the chances of the women dying from breast cancer.  If you’re taking tamoxifen with any SSRI, this may be a study to talk to your doctor about.  Read more in Antidepressants may block breast cancer drug.

CT Scans – are they worth it?

Another one in the cure-worse-than-the-disease category.  Researchers in Canada have noted that CT scans are becoming increasingly common for children with minor head injuries.  However, there is also concern about the risk of cancer related to these scans.

Many people don’t realize that a single CT scan emits between 300 and 600 times the radiation of a common chest x-ray!  So the decision should not be taken lightly.

The Canadian Assessment of Tomography for Childhood Injury organization is suggesting new rules, based on the study of 4000 children who had head injuries between 2000 and 2005.

So how do you know if a CT scan is needed?  Some of the rules include:  there’s an open or depressed skull fracture, there’s a headache that continues to get worse, irritability, or failure to reach score of 15 on the Glasgow coma scale within 2 hours.  Other factors (medium-risk) included the injury comes from a dangerous source (ie falling off a bicycle with no helmet), signs of basal skull fracture, and major swelling of the scalp (due to bleeding).  If none of these are present, it’s likely safer to forgo the CT scan.

Read more at CT scan rules developed to cut kids’ exposure to unnecessary radiation.  More about concussion and brain injury here.

Remember, it’s not always a clear-cut decision when it comes to taking medication, or even having a test done.  It goes beyond factors of time and money, to factors such as the ones above.  Know the facts, weigh the risk with your doctor.