Answer to Question #1376 Submitted to "Ask the Experts"

There are three principal techniques used to treat cancer and other diseases with radiation. In some cases, radiation was used for other diseases and condition, so the treatment of cancers may not have been the first application. In teletherapy, beams of radiation external to the body are used treat cancers on the skin or inside the body. The radiation can be x rays, gamma rays, electrons, or heavy ions, like protons. The first claimed treatment involving x rays occurred on January 29, 1896, which was three months after the announced discovery of x rays by Wilhelm Roentgen (Orton 1986). Emil Grubbé, a medical student in Chicago, began daily one-hour treatments of an advanced breast carcinoma to a Mrs. Rose Lee. Treatment involved placing the x-ray tube against the lesion and treating the patient for as long as it was comfortable to the patient. Grubbé reported a marked regression of the tumor. However, Grubbé's claim has been disputed due to lack of immediate reporting. The first documented treatment was performed by a German physician named Voight who treated a patient on February 3, 1896, for nasopharyngeal cancer (Orton 1995). The first use of gamma rays from radium was first reported by Dr. Danlos in the St. Louis Hospital, Paris, in 1900. Initially, treatment involved lupus-type skin lesions, but radium to treat cancers was begun in 1903 (Early and Landa 1995). In brachytherapy, a radioactive source is placed into the patient to irradiate the tumor site. The source is usually encapsulated and may be removed or left permanently in the patient. The first report on an implanted source occurred about five years after the work of Emil Grubbé at St. Luke's Hospital in New York (Orton 1986). Robert Abbé inserted the first interstitial radium implant into a lobe of a patient suffering from hyperthyroidism. The source, which was a 100-mg glass encapsulated radium tube, was removed after one day, and the patient remained in good health for the next six years. While hyperthyroidism is not a cancer, the technique demonstrated the use of sealed sources of radiation in the treatment of organ diseases. The first medical uses of radionuclides in treating cancers and other diseases are not as clear-cut. This is due to the popular use of radium salts and radon-charged water in the early decades of the 20^th century. Homeopathic physicians first began to prepare radium salts for internal use around 1908. Frederick Soddy, the radiochemist, first suggested in 1905 that radon gas from radium-bearing solutions could be used by people suffering from tuberculosis. Probably the first selective use of an artificial radionuclide to cure cancer was the use of ³²P by John Lawrence in 1938 and 1939 to successfully treat a patient diagnosed with leukemia.

John Jacobus, MS, CHP

References

• Orton CG. Bioeffect dosimetry in radiation therapy. In: Orton CG, eds. Radiation dosimetry: Physical and biological aspects. Plenum Press; 1986.
   
• Orton CG. Uses of therapeutic x rays in medicine. Health Phys 69:662-676; 1995.
   
• Early PJ, Landa ER. Use of therapeutic radionuclides in medicine. Health Phys 69:677-694; 1995.