Hodgkin's Hope

Medical researchers are gradually isolating parts of the complex of diseases loosely called cancer, and almost to their own surprise, they find that they are achieving survivals of at least five and ten years for a heartening number of patients. In cancer cases, such remissions are considered tantamount to cure. Last week at Memorial Sloan-Kettering Cancer Center in Manhattan an internation al gathering of radiologists heard that this improvement is now being accomplished for many victims of Hodgkin's disease and related cancers. The higher cure rate, they heard, can be extended not only to greater numbers of Hodgkin's patients, but to others suffering from a variety of cancers.

The improvements and prospects of further gains, said Dr. Myron P. Nobler, result from the use of modern radiation at supervoltage levels. This may come from a linear accelerator, a large cobalt-60 source, or a generator that puts out 2,000,000 electron volts. To protect the patient from radiation sickness and to spare normal tissue, healthy parts of his body must be shielded. At Memorial Hospital, said Dr. Nobler, an X ray with a grid background is made of the body area involved. On this X ray the radiologists mark the vital organs, such as lungs, which must be shielded. A template is made, and then engineers cut out lead shields 21 inches thick to this pattern. The shields, placed in the head of the accelerator, protect the areas on which they cast shadows.

Hodgkin's and three kindred diseases may appear to be distinct entities at certain stages, but in fact they blend into each other. So, Dr. Nobler declared, the thing to do now is to ignore these distinctions and get on with the supervoltage treatment. That way, ten-year survival rates for Hodgkin's patients treated early have been pushed as high as 68% and five-year rates to 80% at some centers.

Radiation should also be used, said Dr. Ralph Phillips, in treating several types of cancer for which it has been little employed because doctors did not expect it to do much good. He suggested that as many as ten types of sarcoma and some other cancers, even far advanced, will yield in some cases to supervoltage radiation.

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