CHAPTER VRADIUM IN THE TREATMENT OF CANCER
The action of radium on human tissues was unknown until 1896, when Prof. Henri Becquerel of Paris, having incautiously carried a lump of pitchblende in his pocket, discovered on his skin, within two weeks, a severe inflammation, or ulcer, which was known as the famous “Becquerel burn.” As physicians of the nineteenth century were accustomed to burn out cancers with caustics, the idea occurred to them that the application of radium might prove to be an improvement on the older method.
It has proved to be so, affording in many cases not only relief, but in some instances, even a cure, not only for cancer, but for many other ailments—as we shall see presently. Since that time active investigation into the action of radium on diseased tissues has been carried on, resulting in the establishment in Paris of the “Laboratoire biologique du Radium,” and also of the Radium Institute of Vienna, followed by the establishment of somewhat similar institutions in various other countries, notably in England and the United States.
One of the most famous institutions for radiotherapy is the recently established Radium Institute of Paris, under the management of Mme. Curie and Professor Debierne. This is composed of two distinct compartments. In onethe scientific properties of radium are studied, while the other is devoted to its therapeutic applications. Dr. Regaud, who is in charge of the latter department (a branch of the widely known Pasteur Institute), endeavors to cure cancer and tumors by application of radium and X-rays.
New York City boasts a magnificently equipped Radium Institute, under the directorship of Dr. C. Everett Field. And an even more famous institution is that founded by the Mayo brothers, in Rochester, Minnesota, where these eminent surgeons had accumulated an entire gram of radium as early, at least, as 1920—the largest amount owned by private individuals. This great institution—now known as the Mayo Foundation—is no longer privately owned, but it is still under the direction of the Mayos.
Radiotherapy (or, in France,curietherapy, in honor of the discoverer of radium) or the treatment of various diseases by radioactive substances, has not been applied so extensively as has treatment by X-rays (Roentgen rays), produced in vacuum tubes. On the other hand, the X-rays are not so effective (as usually applied) in the treatment of certain morbid conditions as are the more penetrating Gamma rays from radioactive substances; though the latter are essentially identical with X-rays—swift Beta particles, or negative electrons—of very short wave-length. To produce X-rays as penetrating as the Gamma rays, about two million volts would have to be “cut” on the discharge tube.
The Alpha rays are not often used in medicalpractice, and have little penetrating power. They are stopped by 3½ cm. of air, or by a thin sheet of paper. They are employed only in the way of radium “emanation” (a gas) dissolved in saline solution, or by the use of needles upon which active deposit from radium emanation has been collected. “In either case the emanation water or the active deposit needles must be introduced into the system—whether intravenously or into the solid tissues,—otherwise the Alpha rays would have no power to act. In either case, too, they act along with the Beta and Gamma rays produced by the active deposit” (Lozarus-Barlow).
Beta radiation is used only for superficial conditions and always in conjunction with Gamma radiation. “Instead of a radium salt, one of its products, viz., radium emanation, is often employed chemically. No essential difference is introduced by the use of this emanation excepting that its intensity undergoes a progressive diminution with time, since it falls to half value in 3.85 days. Early rodent cancer, certain conditions of the eyelids, some cutaneous non-malignant tumors and birth-marks, are treated successfully in this way.”
Physicians of the Memorial Hospital, New York City, announced in October, 1925, that by filtering out 90% of the caustic Beta rays emanating from radium and the high voltage X-ray tube, and using principally the healing and stimulating Gamma rays, radiation treatment of cancer of the tongue, lips, nose, ears or other part of the head has been greatly improved.
In the first six months after the new method was begun, more than 100 cases had been treated with what were considered very satisfactory results. Owing to the elimination of the caustic rays, much stronger applications of the beneficial rays can be used, and painful effects are largely obviated.
If experience and special research lead eventually to successful treatment of cancer, it will be a great boon to the human race. The United States leads the world in deaths from this dread disease, with its average of 90 per 100,000 of the population. The mean average of cancer deaths in Europe is 76, in Asia 54, in Africa 33, in Oceania 73. Several races, including the American Indians, are stated to be entirely free from cancer, and others are partially immune. The Japanese, for example, are subject to all forms except cancer of the breast. Eighty-five percent of Americans afflicted with this malady are persons over 40 years of age.
Science Service states that a careful analysis of cancer statistics gathered by the United States Census Bureau over a period of about 20 years in ten Eastern states reveals definitely that cancer mortality is from 25 to 30% higher than it was about 20 years ago. This is the claim of Dr. J. W. Schereschewsky, of the United States Public Health Service, who made the statistical analysis and reported it to the American Medical Association. “There has been a pronounced increase in the observed death rate from cancer in persons 40 years old and over in the ten states comprising the originaldeath registration area,” Dr. Schereschewsky said. “Part of this increase is due to greater precision and accuracy in the filling out of death returns, but the remainder is an actual increase in the mortality of the disease.”
The only way to stop the ravages of cancer, says the Paris Academy of Medicine, is to diagnose it early—in time for operation. For this to be practicable, physicians must be specially instructed. Family doctors are often ignorant of all but a few forms of cancer and do not recognize it in its first manifestations. Women of 40 to 50 are apt to consider little irregularities of bleeding to be associated with the menopause and therefore harmless. Often this is right, but unfortunately the bleeding from an early cancer may not differ in the slightest degree from such harmless irregularities and by the time other symptoms have developed, the cancer has perhaps grown through the wall of the uterus and has spread to regions where no treatment can hope to reach it. The only safe rule to go by is to seek expert investigation for any unusual or irregular bleeding or discharge, however slight, especially if these occur at or near the “change of life.”
One phase of this subject of special interest is that of the use of radium in the treatment of cancer, especially of the neck or lower end of the uterus. There is already sufficient evidence to warrant the statement that some cancers of this region have been permanently cured by radium alone. And as a relief measure in the late and hopeless stages of the disease, radiumprolongs life, relieves pain and adds much to the comfort of the victim.
It has been amply demonstrated that radium treatment increases the permanency of the results obtained by surgery, and often converts inoperable into operable cases.