The study questionnaire asked in detail about the type and pattern of use of each mobile phone the respondent had used and about other RF exposures and brain tumor risk factors. The questionnaire was administered by an interviewer using a computerized laptop data entry system (except in Finland), with practical advantages but with the disadvantage that no original paper records were available to check the fidelity of data entry for apparently erroneous values. The questionnaire collected information on hands-free phone use, which was excluded from analyses because head exposure would then be negligible. It is unknown, however, how well subjects can recall past use of hands-free devices or whether recall differed between cases and controls.
The standard of care includes surgery to remove as much of the tumor as possible, and then radiation and chemotherapy. In the past, radiation sometimes diminished patients’ brain function, but techniques have improved so that more healthy brain tissue is spared and patients fare better, said Dr. Mitchel S. Berger, a neurosurgeon and glioblastoma expert at the University of California, San Francisco.
The focus of this work was to determine the incidence of long-term (≥2 y) survival for patients with brain metastases from different primary cancers and to identify prognostic variables associated with prolonged survival.
Patients with a single non-SCLC, breast, melanoma, renal cell, and ovarian carcinoma brain metastasis have the best chance for long-term survival if treated with surgical resection and WBRT.
2.0 What is Breast Cancer?
Cells make up many different parts of the body – skin, bones, brain, heart, and breasts. These cells are replaced when they become old or injured by replication at varying rates depending on the part of the body. The replication process is regulated by genes that code for proteins which increases or decreases the rate of division. These genes are proto-oncogenes (when mutated become oncogenes) and TSG’s.
Notwithstanding the inherent unreliability of recalled amount of use, the only cumulative mobile phone exposure measures available in the Interphone study were duration and amount. Neither yielded material evidence of a positive association with brain tumors. Specifically, for the longest-term users (≥ 10 years since first use), no association was found for glioma (OR = 0.98; 95% CI: 0.76, 1.26) or meningioma (OR = 0.83; 95% CI: 0.61, 1.14). Most ORs were ) but in contrast with the raised risks for long-term use reported by , ). For heavy use measured by estimated total number of calls, again, there was no positive association with brain tumors: ORs were
If exposure to RF fields through mobile phone use were tumorigenic, people using mobile phones longest and those who were the heaviest users would be expected to show the highest risks of brain tumors. Reliability of recall of amount of use a decade ago is unknown, and the average amount of use is likely to have shifted over time as phone use has escalated universally. Validation studies of recall of phone use in the previous 6 months, and up to approximately 5 years in the past, have found that even in the short term, subjects on average underestimate the number of calls per month but overestimate duration of calls, with moderate systematic error (underestimation by light users, overestimation by heavy users) and a large amount of random error (). Recall of number of calls was found to be better than recall of their duration. Furthermore, in the Interphone study cases more often than controls gave implausibly high estimates of daily time spent on calls (e.g., 10 cases and no controls reported average use of > 12 hr/day). A validation study that included both cases and controls found that cases overestimated phone use in distant time periods, which could cause positive bias in risk estimates (). It thus appears that recall of amount of use was appreciably erroneous and quite likely different for cases than for controls. It is possible that recall of year of first use, and hence duration of use, may have been more reliable than recall of amount of use.
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The deficiencies of exposure measurement, because of recall misclassification in studies such as Interphone, and because of misidentification of users in records-based studies such as the published cohorts, leave it doubtful that either study type could reliably detect a small effect, if one existed. Both for this reason and because research cannot in principle prove the complete absence of an effect but only place limits on its possible magnitude, there is bound to remain some uncertainty for many years to come. The limited duration of data yet available, which is mainly for up to 10 years of exposure and to a lesser extent for a few years beyond this, also leave uncertainty because of the potential for long lag period effects, especially for meningioma, which is generally slower growing than glioma. The possibility of a small or a longer-term effect thus cannot be ruled out. Nevertheless, although one cannot be certain, the trend in the accumulating evidence is increasingly against the hypothesis that mobile phone use causes brain tumors.