CURE OF CANCER

Otago Witness, Issue 3556, 9 May 1922, Page 8

CURE OF CANCER

RADIUM NOT A FAILURE. REPORTS ON RESEARCH WORK. AN ADJUNCT TO SURGERY. (From Our Qwn Correspondent.) LONDON, March li. In view of the recent statement made by Sir Thomas W. Parkinson regarding tne | failure of radium as a cure for certain j diseases the report of Dr A. E. Hayward i Pinch, medical superintendent of the London ] Radium Institute, is of interest. “Radium ; is not a failure when used intelligently and j ecientifically,’’ he asserts. The criticisms , originated, he says, from well-meaning but ill-informed practitioners. possessing very little personal experience. “These statements are not infrequently alluded to dv patients and their friends, and it is obvious that considerable harm has been done by thsdr dissemination.” It is pointed out in the report that it is in relation to cancer that this substance lias 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 the known resources of medicine and surgery had been exhausted.. . . At the present the institute case sheets comprise the flames cf many patients suffering from recurrent inoperable malignant disease (cancer), who first 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 the radium employed in the experiments discussed 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 Hie temporary charge of three men, the late Mr Cecil Lyster, Professor Lazarus Barlow, and Professor Sydney Russ, 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 made 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 hut national and scientific interest.” The question set the investigators was to determine the curative value in cancer of penetrating rays like that of the gamma ray 3 of radium. They employed the relatively huge mass at their disposal to thia end chiefly. The conclusion is as follows: “ The experience gained during the 29 months that we 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 be 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 infensitv that it will be lethal to the malignant cells and include the whole of the region involved.” HOPE REQUIRES TEMPERING. The position at present is hopeful (says the medical correspondent of Tire Times). But the new work shows that hope requires tempering-. We are not by any means in a

position to dispense- with . surgery; rather, the radium treatment is t-o 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 168 cases. It is pointed out that many of them were “very advanced” and that with few exceptions they were “surgically inoperable.” (All forms of cancer have been lumped together in the table): Apparentlv recovered. No growths detectable 16 Operation considered inadvisable, but subsequently carried out Improved, disease quiescent 24 Disease progressing .. .. 25 Died 91 These results, as can be seen, are chiefly important as showing that something can be done. It was found that certain forms of cancer are much more susceptible to the rays than others, there being, in fact, a scale of resistance. Other experiments on animals showed that the same thing applies to the 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, one animal is more susceptible than another. Warm-blooded animals are 12 to 29 times more easily affected than cold-blooded, such as the frog. The cat 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 been 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. On 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 specific in its action against the malignant coil, killing that without injuring its normal, harmless, necessary neighbours. Had Ehrlich lived he 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 the principle of wha-t- Ehrlich called chemo-the-rapeutios, and his followers are 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 minotaur may he met and slain. Certain German students have followed this clue during recent years with a measure of success more promising than anything yet recorded against cancer. Particular kinds of Rontgen rays may be just such as ore absorbed by a particular type of malignant cell, because of its particular physico-chemical constitution; and the ' soecificallv absorbed ray may kill, just as the specifically fixed drug may kill, the parasite in the chemo-thera-peutic® of syphilis by salvarenn. But there is a- long gamut of X-rays and a large variety of malisn-ant - ceDs. We are only at the beginning, but I 1 do not see how we con doubt that, it is the beginning of the end of the present armallino* i death-rate. j RADIOLOGIST AND SURGEON, i “So much for the future; but already ; definite and confident advice m-av be given t-o the public. No longer can or should the treatment of cancer be entrusted to the ■ surgeon alone. In the present stage of our j knowledge and experience, thanks above all ! to the superb work done at Erlangen, in i Bavaria, we must lay it down that, in every | case, the radiologist, as well as the surgeon - —T did not, do not, cannot, dare not vet, | sav in place, of the surgeon—should be called i in. The very best surgeons, already, are systematically using X-radiation in aid of , the knife, and the surgeons who pooh-pooh I it, as some do. are the representative's in | our day of those who pooh-poohed Lister and who exist in all ages to remind us that the ■ word surceon literally means mnnuali labourer. In any and every case, now and ! hereafter, early treatment is beyond all words the best. Many common forme, of cancer, j which still exact a heavy death-rate, mav j now certainly he called curable if the good i surgeons and the good radiologist (equipped

with the new apparatus for producing 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 mam lines of inquiry were as to the effects on human patients, suffering from cancer and like malignant diseases, of radium treatment, and 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 the majority of tumours to be lethal, would have a direct effect in retarding and possibly overcoming growth.” Summarising the records of several eas-JS 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 aaj with improved methods of technique, particularly if surgical treatment is combined with the use of buried radium and penetrating radiation from the surface, better results will be assured. And our work is at present proceeding on these lines.” COLLABORATION OF 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 thmalignant cells; the possibility of lowering the resistance -of the patient by this radia tion has, however, to be borne in mind and guarded against.” The report continues with observations or the 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 secondary effects, though the two are 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 tliat in the use of radium there may yet be found a remedy for one of mankind’s greatest scourges.