RADIUM AND CANCER.

Manawatu Standard, Volume XLI, Issue 9766, 3 April 1914, Page 2

RADIUM AND CANCER.

(British Medical Journal, January 3rd,' i 1913.) 1 A REVIEW. | The cancer problem is still unsolved. All the known forces anil elements in nature*are being pressed into the ser- ' vice, and the search tor and cure goes on. Radium, the most recent discovery in physics, is one of the rarest and most mysterious of substances, and it is in a sense fitting that it should be capable of effecting cures in cancer, one of the strangest, though commonest, of diseases. Cancer has always possessed a dread fascination tor the public, and our profession is in a measure under reproach that the cure is still uncertain. Radium, too. appeals to the non-scientific imagination in the romance of its discovery, in its peculiar and wonderful attributes, 1 and in its ultra-commercial value. The fact that radium has in certain cases apparently cured cancer brings i into conjunction two extraordinary forces, the full extent and power and , variability of which are unknown. In • the remarkably candid and temperate address, published in this issue, which Sir Alfred Pearce Gould delivered last month before the West Somerset Branch of the British Medical Association he shows himself, anxious that the . profession should reah'se on the one hand I how inconstant the disease cancer is, i how erratic its behaviour, how though 1 generally painful it may be painless ; how though commonly tending to ! rapidly increase in 6izc it may actually shrink as it grows; how it may even very rarely undergo spontaneous cure; ami, on the other hand, how little we really know of the new therapeutic J ' agent—radium. Proof of the earlier of these propositions is unnecessary; the mutability and variability of cancer ( manifest themselves in the practice of every man. As to the last, it has to be confessed that we are not in utter ignorance. It is acknowledged that radium can both stimulate and check cell i growth apparently of all kinds. Its ]K)\ver of cheeking cell multipulation and growth appears to bo greater when exercised ujxm cells of malignant growths than upon normal tissue cells, and Sir Alfred Pearce Gould seems roadv to admit that radium can inhibit or check the growth of cancer cells—i that it has, in fact, a selective affinity for cancer cells, and can destroy them. It is upon this fart that its use as a curative agent depends; but. if pushed i too far, it destroys normal tissue, no, that its power of resistance to the growth and propagation of cancer ie iesscinxl. In other words, the immunity reaction of the tissue is lost. Vpon this latter may depend the explanation of those cases which appear to be worsened by radium treatment. But radium has a still further power. T)r Abbe, of the New York Cancer j Hospital, speaking in the discussion on i thus subject at the Brighton meeting of | the Association, pointed out that radium has also a stimulating effect on cell | growth. Ho had experimented by exj]K)sing seeds of oats in layers to radium emanations at varied distances. The oats were afterwards planted in rown I corresponding to the distance at which each of the layers had been exposed to radium. He found that the two row* which had been nearest to the radium were killed, the third row was devitalised, the fourth to the seventh ro\v.< i were mo6t i>orfect in growth, being actually larger, thicker, and richer in [colour than the central rows which had . not been irradiated at all—that is to , say. growth had been stimulated. Th<' rows beyond these again were poor in [quality—in point of tact, devitalised. j Time exposures had similar results. ' After ten to fourteen hours' irradiation j the effect was overgrowth ; beyond that period there was depression. Whether ' the action of radium on animal tissues lis identical with that on vegetable [structures is noi yet known; a close similarity may be presumed. I The technique of radium—thereapv I has not yet been fixed. Sir Alfred • Pearce Gould is convinced that the cm- ■ bedding of radium within the tumour ■ mass is more efficacious than external I application of radium plates. In this jhe is in agreement with Dr. Dominici land Dr. A. A. Warden, of Paris, who j recently published the reports of the 'later condition of patients shown at the | London meeting of the British Medical I Association; he is in agreement also with Bumm and Doderlein in Germany. Of course, where embedding is impracticable, the plate method should be adopted though embedding may be done in unlikely situations. For example, to reach an epithelioma at the base of the tongue the small glass, platinum or silver tube covered with rubber may be inserted by the submental route and re- ' moved by the attached threads after twenty-four hours. By the embedding method more rapid results seem to be obtained, since one or two applications have proved in certain cases sufficient to cause the disappearance of malignant tumours with rapidity little short of miraculous. The next technical point in that dosage should not be too great. Sir Alfred Pearce Gould has employed tubes of radium emanations from 50mg. to lOOmg., and finds on the whole that these (lows suffice to kill the canjoer cells without damaging the healthy 'tissue. Professor Bumm, to whose demonstrations on radio-thereapy of cancer of the womb we have already referred, says that it is a serious mistake , to imagine that the greater the dosage l the letter the result. Ho found himself constantly diminishing the weight! of the radium employed, and ho was j now in the habit of using not more than j 50 to 60 mg. at a time, and said that he had no doubt that it was best from every point of view to use weak deses ; and increase the time of application, as ! a rule to twenty-four hours at a time. The Munich operators were of the same opinion. Another fairly definite view held by radium workers is that sarcoJ matous tumours are more readily ini flnenced by radium than cancers. It is ■ true that only one of Sir Alfred Pearce i Gould's striking first series of five is an ■ example of sarcoma, but all of the last (three cases are sarcomata, though they jhave not yet been long enough under 'observation to be classed amongst the , cures. .THE RADIUM TREATMENT OF ! CARCINOMA UTERI. i . (British Medical Journal, December I 27th, 1913.) The wide interest aroused by Bumm's recent lecture has in no eense abated,' and Dr. V. Seuffort Dodorlein's first' assistant made the journey from Munich with the 6ole object of recounting his chief's further experience with the remedy since his pronouncement in the summer at the Gynaecological Congress at Halle. He reported that 152 cases of carcinoma of the uterus and cervix had received the treatment. One-third of these were also treated with X Rays, and none of them were • treated by radium only. The clinic in Munich also used only small doses (50 to 100 mg.) which were inserted for twenty-four hours at a time. They were ,in complete agreement with Bumm's warning on the dangers of lead filtraItion. Of the 152 eases 103 were in- , !>e dated from the time of publication operable, and the increased admission i of inoperable cases was undoubtedly to ' be dater from the time of publication of the radium treatment. The beneficial results of the rays were demonstrable in every single owse, for since , February of this year there had not i been a single case of uterine or cervical cancer operated on in Dojlerlein's

I clinic. A large proportion of the 152! j cases were still under treatment, but! for the present 31 of these had beenj regarded as successfully treated, ami j had been discharged. These results' were truly remarkable when it was remembered that 10 of these 31 cases had | l)cen labelled mopcrahlo on admission, j Dr. Seuffort informed his hearers that at a recent meeting of the heads | of the Bavarian Gynaecological clinics I at Munich Professor Doderlein had de- [ monstrated 2-1 of th(*c 31 apparently! , cured cases to the satisfaction of all! : present; in none of them eon Id a recur- j i rence be established. In one remark-! . able case in which the primary growth had deeply involved the vaginal mucous membrane, and in which the pelvis was | filled with secondary tumours, the . whole mass and the vaginal ulcer had i seemingly disappeared completely four weeks after the radium had been . applied.