RADIUM AND CANCER.

Press, Volume LXVI, Issue 20087, 17 November 1930, Page 4

RADIUM AND CANCER.

I | COMMISSION'S REPORT. PROPOSED SCHOOL OF RADIO-THERAPY. I [.an ccs. o'tx j LONDON, October y. i The National Radium Trust and the j Radium Commission issued their iirst i annua! reports yesterday. The Trust, | an March 31st last, had in hand 9.2X5 ! grammes of radium, which cost j £94,770. Administrative) expenses were £7OO, and a from of £2500 was I advanced to the National Radium ComJ mission for its ospenses. The Trust, on i March 31st, held Treasury Bondß and i Treasury Bills worth £149,771 and a ! sum in cash of £4174. It is hoped for 1 the present to pay administrative es--1 penses out of income. ; * An agreement was made with tue i Union Miniere du Haut Katanga for j the purchase ol' 10 grammes of radium ' at 50 dollars (U.S.A.) a milligramme, ■ payment to be made at the current rate j of exchange on the day of delivery. This has varied between 4.876 dollars and 4.884 dollars to the £, sud the I price has consequently been approxi- ' mately £.lO 5s a milligramme. The I Trust were able to obtain these prej rorential terms (which were eonsiderI ably below the current market price) in ' consideration of the fact that they were I purchasing radium for the purpose ot : forming a central national stock. Under the same agreement tho Union Miniore placed at tho disposal of the ; Trust a "bomb" of approximately four grammes of radium on loan freo ol : charge for a period of three months, | with the option to purchasa at tho end ' of that period at the rate of 50 dollars ! (U.S.A.) a milligramme. | The four-gramme bomb (actually 40-io milligra-mmes J was purchased in i February for £41,550. A email quantity of Cornish mdium (186.5 niillii grai»mes) was bought from ths British : an»i General Radium Corporation for I ."21920. Towards the end of the linan- , cia! year the Commission recommended | that a supply of radium should bo aci quired for the preparation of radon ■ emanation, and the Trust v.-eio c..'cordl ingly in communication with the Union j Miniere for tho purchase of threa ; grammes of radium for this purposp.

Policy of tlie Trust. The report ot! the Radium Commisdeals first of all v.'ith policy. The vietv was t.aken that tho primary o!>jecSives should be —_(n) ''treatment of the sicV as prescribed by the lloynl Charter: (b> the evaluation of radium iti tho treatment of cancer us determined by results ever ;; v eriod cj yeiirj. To curry oijt th!i task i:i t-lie ni-ost effective, safe, and economic manner it was considered imperative that u policy of concentration cf rr.dium ns Hgainst dissemination should be udopted and pursued. It was therefore decided that the distribution of si.itional radium should be restricted to places pesse.-wing a university with a modkv.l school ;;nd complete clinical courses, and that only one hospital--nominated by the medical faculty of iho loo;:l university, and approved by the Commission —should bo recognised as the national radium centre for tho are.'i concerned. In this way only was it thought practicable for tho Coinmission to retain any effective control over tho distribution and use of the radium c-wnitied to its rh?rge, and experience so has shown that ■those initial and basic decisions have been justified by i"-suits. Proceeding on these lines, the following geographical distribution of radium at the Delected national centres was approved :— England <7 centres). — Birmingham, Bristol, Leeds; Liverpool, Manchester, Newcastle - upon - Tyne, Sheffield. Scotland (4 centres). —Aber deen, Dundee, Edinburgh, Glasgow. Wales (1 centre).—Cardiff. London. It was decided to treat London as a separate and special case and to combine a centra for treatment there •with a rational po«t-graduate school of radio-therapy for the service of the whole country. t Since March 31st additional supplies of radium have been ordered and delivered, and in August, 1930, a total of 18>} grammes had been ordered (or had baen approved to be ordered) by the trust, in accordance with requisitions •ind schedules furnished by the Commission. Of this amount some 18 grammes had been provisionally allrv cated to national centres. School of Sadio-Therapy.

The Commission considers that the n<3ed of a larger number of practitioners, fullj" qualified to practise, radiotherapy, is at least as urgent as an increased stock of radium, and it has been much impressed by the lack of adequate facilities for the teaching of this allimportant subject. One of its first preoccupations, therefore, was the creation i»f a central National Post-Graduate School of Radio-therapy, and it was decided that this could most appropriately be established in London. It soon became apparent, however, that the scale, equipment, and operation of an adequate centre would be beyond the resources of Ltny existing teaching hospital, while, on the other hand, it was felt to be undesirable that the new school should have to wait for the establishment of the projected Empire Post-Graduate Medical College at Wormwood Scrubs, or become - absorbed in it. The Commission cam© to the conclusion that the best solution, if it could be achieved, would be tho co-operation, and if practicable the amalgamation, of two existing institutions, the Mount "Vernon Hospital at Xorthwood, Middlesex, and the Eadium Institute in Portland place, London. As a first step the Commission invited the responsible authorities of the two institutions to attend a joint conference, in February, 1930, and, after two formal meetings, the general scheme drawn up by the Commission was generally accepted, subject to the adjustment of certain details. Under this arrangement, the main elinical and pathological work of the joint institution will l>e carried out at Mount Vernon, while the diagnostic and out-patient department, with a proportion of the surface therapy work, •will be centred at the Radium Institute, which will also become the Commission '3 principal centre for the supply of Radon (radium emanation). The total amount of national radium allocated to the joint centre will be a3 under: —Mount A r ernon Hospital—3 grammes (for elinical work); Eadium Institute—l gramme (for Radon). This will be in addition to the existing supplies of the two institutions. • The postgraduate school will be formally inaugurated at the beginning of the next academic year (October, 1930) and a comprehensive course of instruction lia3 already been approved and published. A Postponed. Verdict. 4 - In conclusion," i: is stated, ''the Commission must again emphasise that great caution is necessary in estimate ing the value and efficacy of radium in the treatment of malignant disease, and it cannot too strongly deprecate the creation of false hopes by means of sensational, or even optimistic, statements. As a result of world experience, extending now oyer many years, th<* best that can l>e Said is that some results, under certain conditions, are very satisfactory; that others, for no clear!y established reasons, are less so, and that in a considerable proportion of cases the results are eitner inconclusive or detiiiitely disappointing. This dof?s not jirstify a, pessimistic- outlook, as many