Yesterday I went to the mailbox and pulled out the Discover magazine issue for September 2006. We've subscribed to it for years now, but in glancing at the cover headlines "Strange Therapies: Forgotten Photos From The First War On Cancer"

Actually the article is by Susan Kruglinski, but it had some fascinating photos and history on radiation (p. 44, From the Burns Archive: The Deadly Rays That Cured Cancer")

The old photo archive accompanying the article included a photo from 1939 of a woman wearing a lead shield mask with a lead mouthpiece for cancer treatment on her upper lip.

Thought I would mention the article, in case someone else would find this of interest. Seeing the history of radiation, makes me feel a tad better that there's been some improvement in treatment.

They also included a photo of a doctor that lost both his hands from overexposure to radiation. According to the article, "Scores of pioneering doctors died after months or years of treating patients."

Jen

The first succesful tratement of a head and neck patient, with radiation, was actually done in the late 1800's at the Madame Curie Institute in France. Up until the 60's radiation was performed in much the same way, typically using a radiative source, such as cobalt 60, in a lead box. Eventually, they would move several bricks of lead sitting on top of the box to give them the correct radiation field (they call it primary collimation). In the 1960's the Medical Linear Accelerator (LINAC) replaced cobalt 60 as the radioactive source and was electronic, ionizing radiation that is generated when intense (4-MeV to 20 MeV) microwave energy is directed into a water cooled target made of tungsten and converted into ionizing radiation. The old cobalt machines (which are still used in some parts of the world), had to have the treatment times increased as the radioactive source decayed. This would result in sometimes, horrific and irreparable skin damage. The LINAC all but eliminated that, they also discovered that by bending the beam, they could further eliminate much of the "dark radiation" responsible for skin damage, and many patients, like myself, suffer only a mere sunburn. Many elements haven't changed since the beginning. They still use the bricks for primary collimation (automated and under computer control of course and made of pure tungsten) and they still use beam blockers and shadow trays to protect radiation sensitive areas (mainly for XRT patients) much as you described in the 1939 article. They also developed a number of "applicators" which also act as secondary collimation to further define the radiation field. They now typically use a tray and the devices are not physically placed on the patient. They moved away from lead and have this material that's eutectic (melting) point is so low that is becomes liquid in hot water, so they can reuse it over and over. The latest advance in RT is PBT (AKA photon beam therapy) which uses a "charged particle" concept). Less than 1/2 dozen facilities in the US have access to this technology. MD Anderson stated last year that they were investing 200 million dollars in a dedicated facility for it. It is quite different from ionizing radiation in that the charged particle doesn't develop it's full potential until it reachs the actual target, making collateral damage virtually zero. I believe that the treatment is done in one shot as well, fractionalization is not required. I have also read that it is so accurate that they supplement it with IMRT to guarantee clean margins (although probably not the same amout as used as the primary treament) . PBT is a huge investment. The typical LINAC is probably 1 or 2 million dollars and weighs in around 9 tons. PBT has 35 tons of just the gantry in each treatment suite. The PB generator can be "piped" to multiple treatment rooms, cutting the cost somewhat, perhaps the higher patient throughput is a cost factor as well. It requires an entire custom, dedicated building as well.

In the early 1900's people were encouraged to drink radium laced water as as a "health booster" and cure all. An unshielded x-ray machine for measuring your foot size, for use in shoe stores, exposing the sales people to phenomenal amounts of radiation, hence the Food, Drug and Cosmetic Act was enacted in 1938. The CDRH was once called Radiological Health Unit. For an FDA timeline see: http://www.fda.gov/cdrh/centennial/milestones.html

Understand also that radiation doesn't "fry" or "burn" the tumor, rather it alters the DNA and cancer can't reproduce itself and dies off (literally shrivels and melts - at least that's what supposed to happen anyway). Normal cell tisses will regenerate to a large degree but they they found that they have to allow time for healthy tissues to heal so that's why the dose is split up into fractions. The first big technological leap was going from Cobalt to Ionizong radiation and I believe the next one will be once PBT once it is more accessible.

Gary....We're sure glad you're on our team
JaneP

I remember playing with the foot x-ray machine in the shoe store when I was a kid. It was used to see if the shoes fit, but it was a real kick. I was truly fascinated and used to run to the shoe store to play with it when my parents were shopping nearby. Who knew?

Gary,

You constantly amaze me! Holy moley!

More about shoe fitting machines (I was flabbergasted that they actually found an operating one in a shoe store in 1981!!!!):

http://www.mtn.org/quack/devices/shoexray.htm

Here's a nifty site for radium water and other quackery scams concerning water - It is a large Power Point document(.ppt) so if you are on "dial up" you may wish to skip it.

http://www.aces.edu/waterquality/DrinkingWaterScams-Regional%20PPT-web.ppt

Thank you for the compliments - I have worked in the medical device industry since the 70's.

Gary, I'm also glad to have you sharing this stuff. It interests me a lot these days. I often think about the poor breast cancer patients who went through the old Cobalt 60 form of radiation and got horribly burnt and damaged (I guess it never occured to me it would be possible for it to be used on oral cancer without totally destroying someone's mouth). I'm grateful for their bravery, which eventually allowed the technology to develop further.

Nelie

Gary, can you cook? Amy

Amy,
I have to - my wife doesn't. I also do my own laundry & the windows (did I mention I am also the maid). Don't forget landscape maintenance & garbage. After I recovered most of the container plants were dead and it took a lot of hard work to reclaim the landscaping. This year I finally had a decent garden. I constantly tell her that if I die, sell the house within three months or it will look like sh*t.

She was a good caregiver when I needed it the most however. But I am paying for it now.

Nelie,
when you think about it, we are all lab rats and each one us us contributes to furthering the scientific part of medicine (whether we want to or not).

Gary, would you consider moving to the Ozarks? Your wife and I could have a glorious time doing "whatever" and you could stay busy[I promise}. The living is easier AND much cheaper here Imagine- just 2 stoplights within a 20 mile radius, major traffic hazzards are blue haired old ladies, deer, possums, and armadillos [thank you, Texas]. And wonder of wonders- we have the internet and seem to be a major meth lab too. Any Interest? Amy