eventuate in cancer of that animal's skin. This is an important concept not only from our own interest in protecting our employees against the effects of radiation but in the whole problem of the cause of cancer, and suggests there are multiple causes in many, many cases, not just single causes. There may be additive effects of this

sort.

Again, as pointed out, our interests overlap with those of others working in cancer. Therefore, we do support the Chemical Coodination Center of the National Research Council, referred to yesterday. Also, we actively support the Bioscience Information Exchange, which was mentioned yesterday, I believe, by Mr. Runyon.

Thus we meet in day-to-day activities our scientists, the scientists from the Cancer Institute, scientists being supported by funds from the Cancer Society and from the Damon Runyon Fund and the like. Now, for our on-site program I have been asked to say a few words about the program in San Francisco. It is 1 of our 4 major AECconstructed and owned but contractor-operated laboratories. We do not operate any of our research laboratories ourselves. They are all operated by contractors, most of the medical ones by university contractors. This one is the Radiological Laboratory at the University of California Medical Center in San Francisco, where we provided a 70 million electron volt synchrotron. That simply means a machine which will put out electrones with energies of about 70 million volts.

From this machine can be produced X-rays at the equivalent energy range, and also electrons can be brought out directly. This is the only machine at this energy range available to medical researchers in this country.

As you know, there is 1 at the Sloan-Kettering or Memorial Center of about 30 million electron volts.

There has been 1 at the University of Illinois of around 10 million electron volts. This is in a different order of magnitude.

If there is any virtue from radiation of this sort in the treatment of cancer we hope to find out in this program what these virtues might be. Dr. Stone, who unfortunately cannot be here, is a pioneer in high energy radiations as applied to the treatment of cancer. He was the first person to use the high speed-the so-called fast neutrons-in the treatment of skin cancer, during the days of the Manhattan District. While he has been waiting for his machine to be installedit is just beginning to operate-he has carried on a very extensive program in the use of radioiodine in the treatment of thyroid diseases-both benign, hyperthyroidism, and cancer of the thyroid. and others have now contributed so much in the field of the use of radioiodine in disease that radioiodine now will probably be the first one of the artificially produced radioactive elements to be recognized and appear in the United States Pharmacopoeia.

He

I want to mention briefly, before closing my statement, the activities in Japan of the Atomic Bomb Casualty Commission, a followup study of the survivors of the atomic bomb at Hiroshima and Nagasaki. Dr. Farber yesterday referred to the increased incidence of leukemia among the survivors there.

This is the sort of activity that we feel pays off in the long run, even though for years some people have criticized this program because nothing turned up. Now we know that ionizing radiation from

an atomic bomb will have the same effect as X-rays if you get enough of them, produce an increased number of cases of leukemia. We must think about that.

The same thing, of course, in this activity has turned up the persons suffering from cataracts, among the survivors.

I think that is all I have to say right now, Mr. Chairman. Thank

you.

The CHAIRMAN. Any questions, gentlemen?

Doctor, I would like to inquire this: Does your division furnish isotopes used in medical research without charge?

Dr. DUNHAM. Our branch, the Medical Branch, provides isotopes used in cancer research at 20 percent of the list price in the AEC catalog.

The CHAIRMAN. What is the English and Canadian practice in this respect?

Dr. DUNHAM. They make no distinction between an isotope used for cancer or for any other purpose.

The CHAIRMAN. Just one other question. The Meharry Medical School to which you made reference is located in Nashville?

Dr. DUNHAM. Yes.

The CHAIRMAN. That is a colored institution?

Dr. DUNHAM. That is right. Dr. Paul Hahn is in charge of that program that I referred to.

The CHAIRMAN. Mr. Dolliver?

Mr. DOLLIVER. These cyclotrons are machines of similar design and similar purpose which developed originally from the research of Dr. Lawrence; is that not true? Or was he the man who originated them?

Dr. DUNHAM. He invented the first cyclotron. There were also Van de Graaf accelerators which were developed before his. His particular type of device was way ahead of the others, at his time. He has continued, as you know, to be several jumps ahead in the development of the machine.

Mr. DOLLIVER. He is one of the leaders in this field; is he not?
Dr. DUNHAM. That is right.

Mr. DOLLIVER. What was the voltage or the electron voltage of his first machine, as you recall?

Dr. DUNHAM. Dr. Hasterlik believes it is about 8 Mev.-8 million electron volts.

Mr. DOLLIVER. Eight million electron volts. Now, the largest one is the one in San Francisco, with 70 million?

Dr. DUNHAM. No, the largest one of that type is the one at Berkeley. Mr. DOLLIVER. Which is 100 million?

Dr. DUNHAM. There is one at the University of Chicago which is larger right now; 450 million electron volts.

Mr. DOLLIVER. Four hundred and fifty million electron volts?
Dr. DUNHAM. Yes.

Mr. DOLLIVER. Of course they have increased very rapidly in their size and capacity. Now, these are highly technical machines; are they not?

Dr. DUNHAM. Pardon me?

Mr. DOLLIVER. These machines are highly technical?

Dr. DUNHAM. Highly, and very difficult to operate. One machine was not mentioned. Dr. Bugher wanted us to be sure to mention the

cosmotron at Brookhaven, which gets up into the 2 billion and 3 billion electron volt range.

Mr. DOLLIVER. Does it not take a man of very considerable experience and skill to actually operate one of them?

Dr. DUNHAM. It takes more than one man. It takes a whole team to operate one of these newer, more high-powered ones.

Mr. DOLLIVER. The technique of their operation is not widely known or widely dispersed; is that right? I mean, you have to have trained personnel?

Dr. DUNHAM. Yes.

Mr. DOLLIVER. Unless you have trained personnel their operation can be most dangerous?

Dr. DUNHAM. Right.

Mr. DOLLIVER. And quite lethal if they are not properly operated. Would it not follow from that that there should not be so many of these machines until we learn how to operate them a little better?

Dr. DUNHAM. I think our record is pretty good so far. Of course, as you probably know, we have a fellowship training program to train people in radiological physics who can sort of police these machines and see that the longer haired scientists do not hurt themselves.

Mr. DOLLIVER. Did I not see one of these out here at the Bureau of Standards several years ago? I think they had one set up out there. Dr. DUNHAM. They have a betatron and also one of the Van de Graaf machines.

Mr. DOLLIVER. Those two terms do not mean very much.

Dr. DUNHAM. The Van de Graaf is the one you may remember. It stood up very high with some big knobs up at the top.

Mr. DOLLIVER. Yes.

Dr. DUNHAM. The betatron, I guess, has been finished in the last year or two. That is where things go round and round and come out

on the side.

Mr. CARLYLE. Mr. Chairman?

The CHAIRMAN. Mr. Carlyle.

Mr. CARLYLE. Doctor, I was just wondering how you arrived at the price of 20 percent when you sell isotopes.

Dr. DUNHAM. We were charging nothing. We found there was a little reluctance to separate out the use of isotopes on the orders. Therefore, we put this charge of 20 percent on so that there would be no confusion. It has reflected itself in the fact that, though the number of users has gone up under the cancer program, the actual numbers dispensed under cancer as opposed to those that were paid full price for has gone down. It really sort of clarified the atmosphere, as it were, from the standpoint of bookkeeping.

Mr. CARLYLE. Your statement a few minutes ago relating to cataracts was that an increase was found to exist after the bombs had been dropped in Japan?

Dr. DUNHAM. They found over 100 cases of what the scientists call cataracts among the survivors in Hiroshima. Only two of these are severe enough to require operation. They all developed some 4 to 5 years after exposure, but they seem to be very clearly of a type that is seen almost entirely in radiation exposures. There has been some experience with that type of cataract in this country. Mr. CARLYLE. That is all.

This combination of facilities enables us to utilize short half life isotopes and the nuclear reactors in investigative therapeutics.

The aim of the cancer research program at Brookhaven is to investigate the therapeutic application of nuclear energy in the treatment of human neoplasms with particular emphasis on the short half life isotopes.

Dr. Warren, I think, has adequately explained what we mean by the half life isotopes, and to reiterate, we are using half life isotopes with a half life of some 30 minutes, or 2 hours, or 8 days.

Now, radiations which disintegrate over a short period of time produce their effects by destruction. Our aim is to place the proper ionizing radiations in the proper place and to obviate as completely as possible the destructive effects on normal tissues. With some short half life isotopes we can accomplish a part of this in that a large amount of ionizing radiations can be localized to an area for a relatively short period of time with minimum damage to the organism as a whole.

For specific application of short half life isotopes I will briefly discuss the use of chlorine 38 with a half life of 38 minutes, which we have employed in several patients with ovarian carcinoma which has spread over the abdomen. This is a cancer that originates in the ovaries of the female and as it progresses spreads over the surface of the abdominal cavity. Ordinary ammonium chloride is irradiated in the nuclear reactor and is thereby made radioactive. Ordinary ammonium chloride looks very much like common table salt. This is then placed in the abdomen of the patient. This form of therapy caused a decrease in the fluid accumulations and size of tumor in these cases.

We have also used a gas designated as krypton 87, which has a half life of 78 minutes. We have done that in similar fashion.

I have a photograph which I would like to show that will show the effects of this radioactive chlorine in a case of metastatic cancer to the lining of the thoracic cavity, and if you are interested, I will be happy to pass this out.

I might point out that this [indicating] is the lung and this [indicating] is the area in which the radiation was applied.

Now another project is the use of radioactive iodine in the treatment of thyroid carcinoma. A large number of patients have been treated and at present the study is directed toward ways of concentrating the radioactive iodine in the tumor, optimal doses, and following the chemical course of those patients until death in some cases, with thorough autopsy observations.

Radioactive phosphorus, which has a half life of 14 days is being employed in the treatment of patients with polycythemia and leukemia.

I am sure that you are all thoroughly familiar with the term "leukemia" after yesterday's discussions, and I might point out for Congressman Dolliver that polycythemia is an increase in the number of red blood cells as opposed to anemia, as you mentioned yesterday.

It may be significant that in the treatment of these patients many physicians are being trained in the handling and application of radioactive materials. This gives us a reservoir of physicians trained in handling radioactive materials for the future national needs, such as in warfare.

I think I am speaking for the majority of users in feeling that this nominal charge has been a worthwhile thing and has prevented overordering and wastage of these relatively short-lived materials. The CHAIRMAN. You speak of a nominal charge?

Dr. WARREN. Yes, sir.

The CHAIRMAN. What do you have in mind?

Dr. WARREN. As I recall it in the treatment of a patient with radioactive phosphorus, which is one of the short-lived materials which we use, it amounts to approximately $1.25 or thereabouts.

The CHAIRMAN. Does that cover the shipping charges?

Dr. WARREN. No. That does not cover the shipping charges. The user bears the cost of the shipping charges.

The CHAIRMAN. I assume that is more expensive than the charge made for the isotopes.

Dr. WARREN. That is quite true, sir.

The CHAIRMAN. How much does that usually run?

Dr. WARREN. That varies with the weight of the shipment. The amount of shielding required for each isotope varies, so sometimes our container will weigh only thirty-odd pounds. Sometimes it may go well over 100 or more pounds. Also, it varies with the destination.

We obtain some materials-most of our materials-from Oak Ridge, and some come from Brookhaven. The charge, as I recall it, runs about $20 per shipment for us on the average in the New England

area.

The CHAIRMAN. Any further questions, gentlemen? It seems to me that as we progress the hearing continues to increase in interest, so we will proceed in whatever way Dr. Bugher suggests. Whom would you like to have as your next witness?

Dr. BUGHER. I would like to continue with a discussion of the special program at the Brookhaven National Laboratory located on Long Island at the site of the old Camp Upton, operated for us by Associated Universities, Inc., which in turn is the operating agency for nine northeastern universities.

The Brookhaven Laboratory has a very vigorous and imaginative medical program, and the laboratory has been the pioneer in the utilization of neutron radiation from the reactor in the treatment of brain tumors. I would like to present Dr. Godwin to present the discussion of the Brookhaven program.

The CHAIRMAN. Dr. Godwin, we would be pleased to hear from

you.

STATEMENT OF DR. JOHN T. GODWIN, PATHOLOGIST, MEDICAL DEPARTMENT, BROOKHAVEN NATIONAL LABORATORY, UPTON, LONG ISLAND, N. Y.

Dr. GODWIN. Mr. Chairman and members of the committee, I am happy that Mr. Roberts has identified himself and the recorder as being from Alabama, since at least I think they will be able to understand my Georgia accent.

At the Brookhaven National Laboratory we have a 35-bed hospital associated with a nuclear reactor, or atomic pile. All patients admitted are subjects for investigation of various diseases. The staff numbers around 15 scientists, composed principally of physicians, with a few doctors of philosophy of various training.