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The CHAIRMAN. Mr. Carlyle?
Mr. CARLYLE. Doctor, the investigation in which you and your associates are now engaged is really pioneer work; is it not?
Dr. BUGHER. Yes, sir.
Mr. CARLYLE. Is there any part of this particular study in which you are now engaged that has received any consideration at all prior to the atomic age?
Dr. BUGHER. Yes, indeed so. If we think back, radium itself has been available medically for many years now. Much of the knowledge of our problems of toxicity is really derived from this long experience with radium. But until the atomic period, you might say, did arise we had no other source of radiation except radium, X-ray tubes, and for a short period of time things produced by cyclotrons. I am lumping those in with the atomic period, you might say. Mr. CARLYLE. So then this particular study extends only over a very few years?
Dr. BUGHER. Yes, sir.
Mr. CARLYLE. Now, during that length of time do you feel encouraged as to the progress that is being made?
Dr. BUGHER. Yes; very much so. I think that as these other gentlemen will describe their programs one will see that in a comparatively few years we have made very substantial strides. The problem always is not to be so entranced with the progression and advancement of the present that we forget to realize that most of the road lies ahead nonetheless.
The CHAIRMAN. Any further questions, gentlemen?
Doctor, I would like to ask just one or two questions. In everyday practice X-rays are used for many purposes; examination of our teeth and throughout the body down to our feet, for that matter. Is it possible that too much of this X-ray may be of more damage than value?
Dr. BUGHER. It is quite possible. We do not think of radiation as being beneficial to normal tissue, and particularly if there are unnecessary exposures or prolonged exposures the effect may be very detrimental. Although it is not particularly within the province of this program, such applications as examination of feet for the fitting of shoes and things of that sort seem to be quite unnecessary exposure of parts of the body.
On the other hand, the X-ray examination of the chest, which usually means less exposure, actually, is a necessary diagnostic procedure. While the X-ray itself is not going to benefit the man's lungs, the knowledge which is derived from the examination by the roentgenologist is very valuable to him. I think all radiologists tend to be conservative in the application of radiation and to avoid any unnecessary exposure whenever possible.
The CHAIRMAN. Doctor, you mentioned the fact that the cancer effort of the Division of Biology and Medicine was about one-fourth, or a little over 10 percent of the Division's effort. What does that represent in dollars and cents?
Dr. BUGHER. This year the cancer research dealing with research and therapy amounts to approximately $3 million. And some other projects dealing with the causation of cancer will add a few hundred thousand to that. That is, the AEC contribution to this general effort is on the order of $3 million this year.
The CHAIRMAN. What is the total appropriation budget for your Division?
Dr. BUGHER. For this year it is approximately $26 million.
The CHAIRMAN. What is the total budget of the Atomic Energy Commission, if you happen to know?
Dr. BUGHER. It is well over $1 billion for this year, for operations. The CHAIRMAN. Any further questions, gentlemen? If not, proceed with your panel in the way you wish.
Dr. BUGHER. Thank you. I will call on Dr. Dunham for the discussion of the program of the Medical Branch.
STATEMENT OF DR. CHARLES L. DUNHAM, CHIEF, MEDICAL BRANCH, DIVISION OF BIOLOGY AND MEDICINE, ATOMIC ENERGY COMMISSION
Dr. DUNHAM. As Dr. Bugher has just indicated to you, our cancer program stems from our active interest in cancer as an important hazard associated with the atomic-energy industry.
Now, cancer as a hazard in the atomic-energy industry is not entirely related to ionizing radiation as the cause of cancer. We also deal with toxic chemicals such as beryllium, which we are finding in experimental work can produce cancer; so it is not strictly limited to the radiation side of the picture.
As you know, over and above our main-line interest in the problem of cancer as an industrial hazard we in the Division of Biology and Medicine wish to apply for the welfare of the country, atomic-energy tools available to us in any way possible.
As you will recall, the Congress, in appropriating the first moneys for the Atomic Energy Commission, saw fit to see that we did not forget cancer, and actually put wording into the appropriation directing us to exploit in any way possible our abilities in the cancer field.
As Dr. Bugher has said, our activities are limited to research. We have no cancer-control program. We have no special programs of cancer education. We do have a rather sharply defined and limited grant-in-aid type of research contract program with the medical schools aimed at promoting unique and novel applications of atomicenergy products to the study and to the treatment of cancer over and above the activities which we have in our national laboratories, which you will hear about from the doctors here.
As you know, the National Cancer Institute and the American Cancer Society and other agencies have extensive programs of grants for cancer research as such. We have not set up a parallel program of grants simply because isotopes or radiation may be used in a research project. We believe our best competence lies in our ability to pick out, foster, and promote pioneering techniques with these new tools. Thus, in addition to our "on site" cancer-research programs which you will soon hear about, we have several rather interesting programs, four of which I would like to mention to you.
One we have carried on for many years at the Meharry Medical School. A group there has been doing pioneer work with radiogold and radiosilver, particularly the use of these isotopes as injected into the tumor tissue itself.
Also at Washington University in St. Louis we have supported the pioneer work in the use of radiogold in treating cancer of the womb.
And at Ohio State University we have supported for several years the use of radiocobalt, the same type of material that is used in the cobalt treatment bombs of teletherapy sources. They are working with it, developing it as a substitute for radium. It is cheaper. It is easier to handle, placing it in needles and threads and the like, available for the surgeons and therapists, particularly in treating cancer of the female genital organs.
More recently we have been sponsoring a program in Boston at the Massachusetts General Hospital, where they are using arsenic 74, a radioisotope which emits positrons, which are positive electrical charges as opposed to electrons, which are negative electrical charges. They are using this in the diagnosis of brain tumors.
This effort takes advantage of the so-called annihilation-of-matter reaction which is characteristic of the positron. We hope to continue to seek out and to give financial aid to such unique and novel approaches to the cancer problem.
When our advisory committee for biology and medicine had its first meetings back in 1948 and looked about to see what could be done immediately to help in the fight against cancer, they developed a program which has continued to the present day of making radioisotopes more or less freely available to workers in the cancer field. The users have, for the most part, had to pay only shipping charges, if the isotopes were to be used in cancer research, cancer diagnosis,
and cancer treatment.
This contribution they are very proud of, and we hope to continue this program.
I believe Dr. Warren may touch on the use of isotopes in cancer research later in this morning's proceedings.
In addition to these activities specifically pointing toward cancer, we have in our main-line research activity a very extensive program which is comparable to the type of aid program which is given by the Public Health Service and the Cancer Society in medical research. Actually, because of the inseparability of working with cancer and working with ionizing radiation, we are supporting work in practically every cancer research center in the United States. It is not under the name of cancer research, because they are getting us fundamental information on the effects of ionizing radiation on tissues, as well as their cancerogenic properties. Thus we are supporting work at Dr. Rhoads' institution in New York to the extent of $250,000 a year. We are supporting an extensive program at the New England Deaconess Hospital in Boston. We have work under our auspices at the Lankenau Center in Philadelphia and at the Oklahoma Research Institute in Oklahoma City and at the Donner Laboratory for Cancer at the University of California at Berkeley, just to mention some of the more specific programs.
Our interest in the effects of radiation on tissues and its cancerogenic properties has been heightened recently by evidence that certain materials may enhance the cancerogenic effects of other substances. We are supporting a project at the Chicago Medical College in Chicago, where it has been shown that the radiations from radiostrontium-this is a beta radiation, electrons-if given to the skin of an animal in a quantity not sufficient to produce cancer, if later on that animal's skin is rubbed with something like croton oil, which has no carcinogenic properties whatsoever, so far as I know, it will
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
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. He 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.
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?
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?
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