CURE OF CANCER

Otago Daily Times, Issue 18545, 4 May 1922, Page 8

CURE OF CANCER

RADIUM NOT A FAILURE. REPORTS ON RESEARCH WORK. AN ADJUNCT TO SURGERY. (Fbom Oob Own Correspondent.) LONDON, March 14. In view of the recent statement made by Sir Thomas W. Parkinson regarding tne failure of radium as a cure for certain diseases tho report of Dr A. E. Hayward Pinch, medical superintendent of the London Radium Institute, is of interest. “Radium is not a failure when used intelligently and scientifically.” he asserts. Tho criticisms originated, he says, from well-meaning but ill-informed practitioners, possessing .very little personal experience. “These statements are not infrequently alluded to bv patients and their friends, and. it is obvious 1 that considerable harm has been done by their dissemination.” It is pointed out in the report that it r» in relation to cancer that this substance has been judged—that is to say, to the most intractable disease in the world. Further, patients have frequently become extremeiy ill before radium is resorted to. In spite of these facts, “patients whose lives would have speedily terminated, and who would have suffered much intense agony, have been enabled by radium treatment to live for many years in comparative comfort, after all th© known resources of medicine and surgerv had been exhausted.. . . At the present the institute case sheets comprise the names of many patients suffering from recurrent inoperable malignant disease (cancer), who firat presented themselves ' for treatment some seven, eight, nine, or 10 years ago, and ..who are now leading useful and comparatively healthy lives, the disease having been rendered quiescent by the treatment which they have received." RADIUM FROM GUN-SIGHTS. From the Medical Research Council, too, there comes a monograph to which peculiar interest attaches, as tho radium' employed ip the experiments rjjscussed was the largest quantity hitherto made use of. Medical science in this respect profited by the war, for the radium was gathered in 1919 from “innumerable gun-sights, watch dials, and other instruments of war.” In all / five grammes of hydrated radium bromide or about two and! a-half grammes of radium element were obtained, the estimated value . being £72,500. This radium was given into Ifie temporary charge of three men, the late Mr Cecil Lyster, Professor Lazarus Barlow, and Professor Sydney, Ruse, who, by permission of the authorities of the Middlesex Hospital, undertook responsibility for it. Unhappily, one of the three, Dr Lyster, died in 1920. He died a martyr to the dangerous work he was engaged on, and had for long before been engaged on. The monograph states that “his own early and! pioneer work exposed him to great personal danger because of its novelty; to this, in fact, he mad© the sacrifice of his life after a period of long strain during the ■ war, in which he sought, and most bravely sustained, very heavy additional burdens regardless of any but national end scientific interest.” • The question set the investigators was to determine the curative value in cancer of penetrating rays like that of th© gamma rays of radium. They employed the rela--tively huge mass at thedr' disppeal to this end chiefly. Th© conclusion is as follows; “ The experience gained during the 20 months that wo have had the use of this large quantity of radium has convinced us that, in the treatment'of malignant disease (cancer), the Collaborate work of physician,, surgeon, radiologist, and pathologist is very necessary." In other words, the destruction of cancer is unlikely to lie accomplished by this means unless a great number of circumstances are taken into consideration. For the effective treatment of cancer is “largely a question of applying a dose of radiation of such intensity that it will be lethal (o the malignant cells and include th© whole of the region involved.” HOPE REQUIRES TEMPERING. The position at present is hopeful (says the medical correspondent of The Times). But the new work shows that hope requires tempering. We are’notby any means in a position to dispense with surgery; rather, the radium treatment is to be looked on as an adjunct to the , surgical. In some cases, for example, patients thought to be too ill for‘ operation became “operable” after radium was used. The following table gives the result of treating 166 cases. It is, pointed out that many of them were “veryadvanced” and that with few exceptions they “were “surgically inoperable.” (All ’ forms of cancer have been lumped together in the table); Apparently recovered. No growths' detectable .. 16 Operation inadvisable, but '• subsequently carried out 53 Improved, disease quiescent 24 Disease progressing 25 Died .. 91‘ These results, as can be seen, are chiefly important as showing that something oan be done. It was found that certain forms of cancer are much more susceptible to the rays than’ others, there beifig, in fact,' a scale of resistance. Other experiments on animals showed that the same thing applies to th© normal tissues and structures of the body. One type of blood corpuscle, for example, is easily killed by radium, while another type is very difficult to kill. Again, on© animal is more susceptible than. another. Warm-blooded animals are 12 to 20 times more easily affected than cold-blooded, such as the frog. Tho oat is very highly, susceptible! Animals can be killed by exposure to radium. This study has afforded most useful information regarding the dangers of the treatment and the methods of preventing them. ' At the end of the mass experiment the Medical Research Council _ obtained permanent possession of the radium. It has now hem split up and sent to various parts of the country for further smaller-scale work. From each of these an annual report is to be received. CHEMO-THERAPEUTICS. Ou the subject of research the medical correspondent of The Observer writes: The object of our search —or one most desirable object—is an agent that shall be 1 specific in its action against the malignant coll, killing that without injuring its normal, harmless, necessary neighbours. Had Ehrlich lived ho would have pursued,, with his unrivalled genius, the task of constructing a specific drug, which the malignant cell,and it alone, should ‘fix’ and be fixed by. That is tho principle of what Ehrlich called chemo-therapeutios, and his followers a rat at work on it in many places. ■ “ But the specific agent, need not necessarily be a drug. Knowing that certain radiations are specific, at least in some degree, against such malignant cells'as' those of a rodent ulcer, we are already in possession of what must be a guiding thread through the labyrinth where the minoiaur may be met and slain. Certain German students have 1 followed this clue during recent years with a measure of success more promising than anything yet recorded against cancer. Parl ticular kinds of Rontgen rays mgy be just | such ns are absorbed by a particular type of malignant cell, because of its particular ! physico-chemical constitution; and the I specifically 1 absorbed ray may kill, just os I the specifically fixed drug may kill, the I parasite jjj. the chemo-therapeutics of syphilis bv salvarsan. But there is a long gamut of [ X-rays and a large variety of malignant i cells. W© are only at the beginning, but X | do not see bow we. can doubt that it is the 1 beginning of the end of the present appalling i death-rate. * - ‘ RADIOLOGIST AND SURGEON. “So much for the future; but already definite and confident advice may be given to the public. No longer can or should the treatment of cancer be entrusted to the surgeon alone. In lb© present stage of our knowledge and experience, thanks above all to the superb work done at Erlangen, in Bavaria, we must Jay it down that, in every case, the radiologist, as well as the surgeon —I did not, do not, cannot, dare not vet say in place of the surgeon—shouldibe called in. The very best surgeons, already, are systematically using X-radiation in aid of the knife,, and the surgeons who pooh-pooh it, as some do. are the representatives in, onr dav of tho=e who poolppdohed Lister and who exist in all ages to remind us that the word surgeon literally means manuallabourer. In any and every case, now and hereafter, early treatment is beyond all words the best. Many common forms of cancer, which still exact a heavy death-rate, mav now certninlv be colled curable if the’good surgeons and the good radiologist (equipped with the new apparatus for produeing intense ‘hard’ rays) are called to them in time.” MIDDLESEX HOSPITAL RESEARCH. The results of research at the Middlesex Hospital have now been published by H.M. Stationery Office in a volume entitled, “Medical Uses of Radium” (price ss). The main lines of inquiry were as to the effects on human patients, suffering from cancer and like malignant diseases, of radium treatment, ami the effects on animals of long periods of exposure to radium irradiation. The results reported on human patients are hopeful They showed that an exposure of four to five hours was the probable limit of toleration and “that such an exposure, though not likely in tho majority of tumours to be lethal, would have a direct effect in retarding and possibly overcoming growth.” Summarising the records of several crsjs the report states: “Notwithstanding some disappointing results, the greater temporary improvement obtained in some of the cases of inoperable breast cancer gives reason for thinking that, with the -more accessible tumours and with improved methods of technique, particularly if surgical treatment is combined with the use of buried, radium

and penetrating radiation from tho surface, bettor results w ill be assured. And our work is at present proceeding on these lines. ’ COLLABORATION OE EXPERTS. It is noted that:- “In the treatment of malignant disease, the collaborate work of physician, surgeon, radiologist, and pathologist is very necessary. . . For extensive deep growth the quantity of radium required for adequate dosage is large in order that sufficient radiation may be given to the malignant cells; the possibility of lowering lire resistance of the patient by this radiation has, however, to be borne in mind and guarded against.” The report continues with observations on tho effect of radium irradiation on human tissue and on the tissues of various animals. In regard to this latter point it is noted: “It is possible to kill an animal by irradiation alone, but it is necessary to recognise primary and pecondary effects, though the two arc not always easy to separate. Extraordinary difference is observed between the cold and the -warm-blooded animals, for the frog will support some 12 to 20 times as much gamma-radiation as the rat, rabbit, or cat.” The report is throughout wisely conservative in its conclusions, but it justifies some hope that in the use of radium there may yet be found a remedy for one of mankind a greatest scourges. ' i ,