History of radiation therapy

Influenced by electrotherapy and escharotics—the medical application of caustic substances—doctors began using radiation to treat growths and lesions produced by diseases such as lupus, basal cell carcinoma, and epithelioma.

[4] The widespread use of radium in medicine ended when it was discovered that physical tolerance was lower than expected and exposure caused long term cell damage that could appear in carcinoma up to 40 years after treatment.

Inventive procedures for different diagnostic purposes were created, such as filling digestive cavities with bismuth, which allowed them to be seen through tissue and bone.

[6] During early practical work and scientific investigation, experimenters noticed that prolonged exposure to x-rays created inflammation and, more rarely, tissue damage on the skin.

The biological effect attracted the interest of Léopold Freund and Eduard Schiff, who, only a month or two after Röntgen's announcement, suggested they be used in the treatment of disease.

[citation needed] The first attempted x-ray treatment was by Victor Despeignes, a French physician who used them on a patient with stomach cancer.

In 1896, he published a paper with the results: a week-long treatment was followed by a diminution of pain and reduction in the size of the tumor, though the case was ultimately fatal.

[9] Freund's first experiment was a tragic failure; he applied x-rays to a naevus in order to induce epilation and a deep ulcer resulted, which resisted further treatment by radiation.

[11] Within a few months, scientific journals were swamped with accounts of the successful treatment of different types of skin tissue malignancies with x-rays.

In Sweden, Thor Stenbeck published results of the first successful treatments of rodent ulcer and epithelioma in 1899, later that year confirmed by Tage Sjögren.

In 1896, he published a paper on his findings, Om Anvendelse i Medicinen af koncentrerede kemiske Lysstraaler ("The use of concentrated chemical light rays in medicine").

It was still unclear how the x-rays acted on the skin; however, it was generally agreed upon that the area affected was killed and either discharged or absorbed.

[18][19] Additionally, x-rays were successfully applied to other appearances of carcinoma, trials were done in treating leukemia, and because of the supposed bactericidal properties, there were suggestions it could be used in diseases such as tuberculosis.

It was found that x-rays were only capable of producing a cure in certain cases of the basal cell type of epithelioma and exceedingly unreliable in malignant cancer, not making it a suitable replacement for surgery.

Aside from the medical profession losing faith in the ability of x-ray therapy, the public increasingly viewed it as a dangerous type of treatment.

[21] Soon after the discovery of radium in 1898 by Pierre and Marie Curie, there was speculation in whether the radiation could be used for therapy in the same way as that from x-rays.

Ernest Besnier, a dermatologist, examined the skin and expressed the opinion that it was due to the radium, leading to experiments by Curie which confirmed it.

It was also a method of applying radium emanation to a specially designed applicator constructed to suit the needs of the patient, who could later take it home.

In metal tubes, the radium could be employed in a number of ways: externally; to the interior of the body in places like the mouth, nose, esophagus, rectum and vagina; and into the substance of a tumor through incisions.

[29] In 1903, the discoverer of the electron, J. J. Thomson, wrote a letter to the journal Nature in which he detailed his discovery of the presence of radioactivity in well water.

[30] Inspired by this, using preparations of radium salts in bath water was suggested as a way for patients to be treated at home, as the radio-activity in the bathwater was permanent.

The most marked effects produced with radium therapy were with lupus, ulcerous growths, and keloid, particularly because they could be applied more specifically to tissues than with x-rays.

In many skin diseases, the ulcers would be treated with radium and the surrounding areas with x-rays so it would positively affect the lymphatic systems.

[40] It was believed that even radiation emanation at higher doses than were useful would cause no harm, because the radioactive deposits were found to have been absorbed and released in urine and waste within a period of three hours.

One item, called "Degnen's Radio-Active Eye Applicator" manufactured by the Radium Appliance Company of Los Angeles, California, was sold as a treatment for myopia, hypermetropia, and presbyopia.

[42] In light of the supposed curative properties of radioactivity, a spa was opened up in Joachimsthal, the place at which Madame Curie gathered some of her original samples of radium from spring waters.

He stressed that radiation had the effect of making many cancers worse, many doctors thought the belief that radium could be used to cure cancers at that stage of the development of therapy was a "delusion"—one doctor quoted cited a failure-to-success rate of 100 to 1—and the effects of radium water were undemonstrated.

[41] Cases sprung up of the development of carcinoma in patients who had used conventional radium therapy up to 40 years after the original treatments.

[44] At the International Congress of Oncology in Paris in 1922, Henri Coutard, a French radiologist working with the Institut Curie, presented evidence that laryngeal cancer could be treated without disastrous side-effects.