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Radioactive Iodine Treatment Increases Risk of Cancer Death

By MedImaging International staff writers
Posted on 16 Jul 2019

Patients with hyperthyroidism treated with I-131 radioactive iodine (RAI) are at an increased risk of death due to solid cancer, according to a new study.

Researchers at the U.S. National Cancer Institute (NCI; Rockville, MD, USA), Vanderbilt University Medical Center (VUMC, Nashville, TN, USA), and other institutions undertook a 24-year extension review of a study that followed US and UK patients who were diagnosed and treated for hyperthyroidism, beginning in 1946. A total of 18,805 patients (78% women), who were treated with RAI and who had no prior history of cancer at the time of first treatment were included in the analysis. The excess relative risks (ERRs) per 100-mGy dose to the organ or tissue were calculated.

The mean total administered activity of the RAI was 375 megabecquerel (MBq) for patients with Graves disease, and 653 MBq for patients with toxic nodular goiter. Mean organ or tissue dose estimates ranged from 20-99 mGy (for colon or rectum, ovary, uterus, prostate, bladder, and brain/central nervous system), to 100-400 mGy (for pancreas, kidney, liver, stomach, female breast, lung, oral mucosa, and marrow), to 1.6 Gy (esophagus), and to 130 Gy (thyroid gland).

The researchers identified positive associations for all solid cancer mortality, including female breast cancer (RR 1.12), and all other solid cancers combined (RR 1.05). In patients with Graves disease, the 100-mGy dose to the stomach and breast corresponded to a mean administered activity of 243 and 266 MBq, respectively. The researchers estimated a lifetime excess of 19-32 solid cancer deaths for every 1,000 patients with hyperthyroidism that received typical doses to the stomach (150-250 mGy). The study was published on July 1, 2019, in JAMA Internal Medicine.

“RAI has been used extensively to treat hyperthyroidism since the 1940s. Although widely considered a safe and effective therapy, RAI has been associated with elevated risks of total and site-specific cancer death among patients with hypothyroidism,” concluded lead author Cari Kitahara, PhD, of the NCI, and colleagues. “Greater organ-absorbed doses appeared to be modestly positively associated with risk of death from solid cancer, including breast cancer. Additional studies are needed of the risks and advantages of all major treatment options available to patients with hyperthyroidism.”

In the United States, the prevalence of hyperthyroidism is 1.2% (0.5% overt and 0.7% subclinical), and most cases are due to Graves disease, an autoimmune disease that affects the thyroid, an endocrine gland located in the neck that produces two hormones secreted into the bloodstream, thyroxine (T4) and triiodothyronine (T3); T4 is converted to T3 in cells and tissues. The hormones regulate metabolism. Thyroid disorders include hypothyroidism, hyperthyroidism, nodules, cancer, Graves disease, and post-partum thyroiditis.

Related Links:
U.S. National Cancer Institute
Vanderbilt University Medical Center

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64 (452.99530029297): SELECT fid FROM jos_deeppockets WHERE id=294778643 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294778643 AND published='1' LIMIT 1

65 (308.03680419922): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=213 ORDER BY `ordering`

66 (46.968460083008): select jos_twitters.link from jos_twitters where cat=10

67 (29.087066650391): select jos_facebook.link from jos_facebook where cat=10

68 (30.994415283203): select jos_google_plus.link from jos_google_plus where cat=10

69 (30.994415283203): select jos_linkedin.link from jos_linkedin where cat=10

70 (51.975250244141): SELECT fid FROM jos_deeppockets WHERE id=294778643 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294778643 AND published='1' LIMIT 1

71 (33.855438232422): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=213 ORDER BY `ordering`

72 (!!!!! 1020.9083557129): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778643 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

73 (357.15103149414): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778643 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (157.11784362793): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

75 (311.13624572754): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (427.9613494873): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (73.909759521484): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (161.17095947266): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (70.095062255859): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (224.11346435547): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (72.956085205078): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (149.01161193848): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (199.0795135498): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (91.791152954102): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (68.187713623047): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (!!!!! 1537.0845794678): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (!!!!! 3685.9512329102): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778643 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

90 (685.9302520752): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778643 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (39.100646972656): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

92 (87.02278137207): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (43.153762817383): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (308.03680419922): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (!!!!! 5789.9951934814): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (231.02760314941): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (452.99530029297): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (139.95170593262): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (102.04315185547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

107 (627.04086303711): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

108 (!!!!! 2213.9549255371): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294778643 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

109 (!!!!! 1800.0602722168): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294778643 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (!!!!! 2597.8088378906): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

111 (172.13821411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

112 (167.1314239502): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294778643 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (!!!!! 1088.1423950195): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294778643 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (783.92028808594): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

115 (437.02125549316): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

116 (147.81951904297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

117 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

118 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

119 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

120 (68.902969360352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

121 (54.121017456055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

122 (150.91896057129): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

123 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

124 (371.93298339844): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

125 (!!!!! 150177.00195312): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

126 (!!!!! 4400.9685516357): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778643 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778643 AND type='deeppockets_item' AND published='1' LIMIT 1

127 (!!!!! 55448.055267334): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

128 (!!!!! 7875.919342041): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

129 (!!!!! 7939.1002655029): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

130 (!!!!! 7920.9804534912): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

131 (!!!!! 5866.0507202148): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

132 (!!!!! 2154.8271179199): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

133 (869.0357208252): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

134 (40.054321289062): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

135 (208.85467529297): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

136 (33.140182495117): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

137 (761.98577880859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (592.94700622559): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (88.930130004883): SELECT name FROM jos_deeppockets WHERE id=213

140 (622.98774719238): SELECT name FROM jos_deeppockets WHERE id=213

141 (929.11720275879): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

142 (!!!!! 1587.8677368164): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

143 (!!!!! 5411.8633270264): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

144 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

145 (!!!!! 17561.197280884): TRUNCATE TABLE jos_trademed_module

146 (!!!!! 4442.9302215576): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294778643 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (865.93627929688): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294778643 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (904.08325195312): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (751.97219848633): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (159.02519226074): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

151 (288.00964355469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

152 (!!!!! 2779.0069580078): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

153 (!!!!! 1106.9774627686): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

154 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

155 (172.85346984863): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778643 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778643 AND type='deeppockets_item' AND published='1' LIMIT 1

156 (581.02607727051): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

157 (35.04753112793): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

158 (117.77877807617): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

159 (!!!!! 1718.9979553223): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

160 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778643 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778643 AND published='1' LIMIT 1

161 (92.983245849609): select jos_twitters.link from jos_twitters where cat=10

162 (!!!!! 3347.1584320068): select jos_facebook.link from jos_facebook where cat=10

163 (37.193298339844): select jos_google_plus.link from jos_google_plus where cat=10

164 (82.015991210938): select jos_linkedin.link from jos_linkedin where cat=10

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