RADIU

Hokitika Guardian, 2 January 1930, Page 2

RADIU

A SURVEY E^BpTISH COMMISsHnV ENCOURAGING RESULTS IN CANCER GASES. A statement on “The Radium Problem” was' recently issued by the British Radium Commission as follows: The interest of the world of medicine and of the public at large has been stirred by the advances made in the last few years in the treatment of malignant disease by radium. The subject is of such pressing national importance that in March (A last year the Radium Sub-Committee of the Committee of Civil Research issued a report which led to the creation of the National Radium Fund, which now amounts to nearly £300,000, of which £IOO,OOO was contributed by the Government. Subsequently two bodies were founded to deal with this problem—namely, the National Radium Trust and the Radium Commission. As a. result a largely increased supply of radium will be forthcoming for the use of the medical profession in its campaign against cancer. It is well, therefore, that a preliminary survey should be made of the present position of radium in the treatment of malignant disease, in order to assess its proper value, without either taking an exaggerated view of its healing properties or underrating them. In this connection the Commission would strongly deprecate such extravagant claims as were attributed to a member of the medical profession, addressing a recent meeting of an English medical society, to the effect that on a five years’ average they had cures by radium in 60 per cent o>l operable cases of cancer, 37 per cent in border-line cases, and 28 per cent in inoperable cases. In the opiniuii of the Commission, figures such as these can only be described as cruelly misleading.

THE TRUE POSITION

The true facts of the position, as known to, the Commission, may be summarised as follows: —It has been proved /for many years that radium has a. powerful effect on various affections of the skin, and tiiat rodent ulcer and cancer of the skin can usually be completely cured by its use. During the last few years the technique of radium therapy lias been elaborated and greatly improved by the use of radium needles, or of “seeds” containing radium emanation (radon), which are buried in the tissues in or around the growth. Most of the work done in this country so far lias been directed towards the treatment of cancer of the womb, the lower bowel, the breast, and the tongue and mouth cavity. It can he stated definitely that in the abovementioned regions, as the result of Jong and hard work, of many trials and many errors, a big step forward has been made.

Encouraging as are the results already obtained, it must not be assumed that radium can cure all cancers, for this is not yet - the case and many problems remain to be solved. The attack on the primary growth is, in a sense, the easiest part of the task, for if the growth is accessible and radio-sensitive, if the radium is implanted in the right place, if the whole of the tumour is irradiated, if the dose is correct, and if the exposure is rightly timed—then one may expect the shrinkage and disappearance of the tumour. Radium therapy, howevet, if it is to be successful, must aim at destroying not only the primary growth, also any extensions which may have formed in the neighbouring glands. In the course of the work one point that has come out quite clearly is that destruction of a primary growth, followed by its complete disappearance, does not generally affect the development of secondary growths,- if these are already formed, any more than excision of a cancer of the breast by the knife will cuve a patient, if there are secondary deposits in the interior organs. We must again emphasise the fact that treatment of cancer, if it is to be successful, whether it takes the form of surgical excision, the cautery, radium, or X-rays, must be undertaken early, or before dissemination has occurred; and it must be reiterated that an essential part of the campaign against cancer consists in the education and intelligent co-op-eration of the public, so that early diagnosis and prompt treatment may be secured.

RADIUM AND SURGERY. The relative value of radium therapy in the treatment of cancer, as compared with surgical excision, is a difficult point to assess, for the reason that sufficient facts are not vet. available. In the first place most of the available data- concern cancer only in the regions of the body above mentioned, and. secondly, wo have not yet a sufficient number of cases, nor lias sufficient time elapsed, to enable us to prepare statistics which will show a true and complete picture. One great point in favour of radium is that its use does not involve the risks and suffering associated with extensive and mutilating operations, which are so distressing to all concerned. The operation of introducing radium is in itself a comparatively slight one, and, while the radium is in position, the patient suffers little if any discomfort. Under these conditions, all with good prospects ol

patients be consult et > n sr ega r it is too late of ieffective treatment. , /rtt j It is perhaps dfesirable at this point to deal witli two prevalent misconceptions. First, there is no proof whatever that cancer is either infectious or contagious. Secondly, there is no evidence that cancer is hereditary, except in one rare form of cancer ol the eye. These fears, therefore, can both he dismissed. > RADIUM “BOMB” TREATMENT. So far the successes achieved have mostly been by means of superficial applications, by buried needles, by radon “seeds” or by the combination of these three methods. Little lias boon done, in this country, in the radiation of tumours from a distance by large quantities of radium—that is, by several grammes at a time. This method is known as “distance radium therapy,” or more commonly as the “bomb” treatment, because a large quantity of radium is placed in a container (the “bomb”) and applied in such a way r that the radium rays may penetrate the-affected area. W“ Invo not lmd, hitherto, sufficient radium to do much in this way, although in some other countries it has been under trial. It is however, a method which urgently requires investigation, and a tour-gi ammo “bomb’’ has just been secured by the Commission and installed at the Westminster Hospital, where patients are now being treated with it. To sum up, a good case has been made out for the increased employment of radium. A new weapon, and a powerful on?, has been placed in the hands of the medical profession, though how effective it may be it is impossible, as vet. to say. Txor is it yet established whether patients with malignant disease should be treated with radium alone, or with radium combined with surgery or X-rays. It is probable that a judicious use of all three methods may be required: but in nnv case clinicians must be familiar with them all. SKILLED PERSONNEL NEEDED. . What is required at the moment is work, intensive work, on the many problems which present them selves, combined with careful documentation of the methods used, and registration of the results obtained. This calls for the close co-operation of physicists, clinicians, radiologists, and pathologists. Some brilliant* worklias already been done, but much more requires to be accomplished before the efficiency of radium can be finally established. Meanwhile good and effective use can ho made of a considerably larger quantity of radium, and this will shortlv be available, as a result of the National Radium Fund. Ap even greater and more pressing need, however, is for more Vadium workers, trained in the highest standards of technique’ and one of the first efforts of the Commission will be devoted to augmenting the supply of skilled personnel.

It cannot too strongly be emphasised that, in unskilled hands (i.e., in the hp"ds of persons not fully trained in the best standards of technique') radium may be highly dangerous, both to the patients and to the operate!’.

On the other hand, in radium, properly used, humanity possesses the best means at pr'ese'nt available for combatting certain forms’ of cancer. As to its future, no one can prophesy with certainty. It may, some day, be displaced by other remedies. But at present, with the exception of surgery, there is little else available, and it affords more promise than any other form of treatment.