RADIUM IN THE TREATMENT OF MALIGNANT DISEASE
J. R. Riddell
May 9, 1914
Citations
2
Citations
Journal
British Medical Journal
Full text
Semantic Scholar
Key Takeaway Key Takeaway: Radium treatment of malignant disease should be confined to those cases for which modern-surgery cannot offer a fair prospect by operation.
Abstract
length of exposure, nature and thickness of screen-necessary to produce the ideal result must vary infinitely witl thte infinite variety of growtlhs presenting tlhemselves for treatmnent. It is a hardI saying, but the surgeon usitng radium must steer between the Scylla of (a) extensive dlestruction of normiial and malignant tissue, witlh (b) no production of auto6genous an-tibody, and the Charybdis of (c) inssufficiently modified mialignaint cells, -wlich are injured jtust enougli to beconme " latent," anid to lead to local recurrence at some later date, and of (d) malignant cells actuallys stimulated to -an increased rapidity of growth. It is not very probablethat everypractitioner will .be able tocarry otut radium treatment of malignant disease successfullv. (vi) Whatever mttay be the case i future, for th7e present radiuml treatment of 2nalianant disease should be confined to those cases for wvhich modern -surgery cannot offer a fair prospect by operation. In the oase of frankly inoperable mialignant disease it is unnecessasy to urge at the present day that radium should be tried. Inspite of disasters, disappointments, recurrences, pain: from fibrosis so severe that the last state of the patient is worse than the first, a number of cases remain on record in which tlle result lhas been remarkably good. Without doubt the profession holds in radiuit an agent for the treatment of inoperable cancer such as it has never held before. But if this be truie for inoperable cases, should not radium be givena clhance in preference to operation for cases in *which surgery is notoriously unsatisfactory, thougll not impossible? .-Are the prospects of a patient witli malign:ant,disease of the.tonsil or periosteal sarcoina any worse if he be treated with radium: than if he be treated by operation ? Does the small procedure entailed by the intsroduction of a tube of radium into the mass of growtb, as against the large.procedure of an -extensiveoperation, count for nothing in the well-beingof the patient? At the very least, slhould not the patient under such circumstances be presented with the two alternatives and allowed to make his choice ? But this is the furthest that one can go. At present, -where modern surgical operation can offer a fair prospect of satisfactory result, the knife must be recommended in preference to every other agent, and this is as true for recurrences as for the primary disease. It must be remembered, however, that radium has only been known for sixteen years, and has been used in medicine for a far shorter period, whereas tlle surgeon's skill with tlle knife is the product of centuries. My task is finished. With feet sometimes on sure grounid, sonmetimes on less certain ground, I lhave tried to bring to youir eyes visions wlhich eight years' radio-biological work have brought to my own. I see cancer as a protean manifestation of purposelessdisorderly cell growtth brought into existence by the. long-continued action of a cell stimulant, and I see,in radium and radiations an agenev sufficient to produce cancer. But just as in the case of diphltheria the agent which produces the disease is also the agent wllhereby the specific cure for the disease is elaborated, so I am prepared to see cancer caused by radium and cancer cured by radium. Probably it matters little wlhether I foreshadow -the true solution of the " cause of 'cancer " problem, but no man -could wish for a greater hionour than to lhave had a share in foreshadowing the true solution of, the "cure of cancer" problem. For the sake of humanity it is.to be hoped that those who believe in the essential capability of radium to "cure" cancer