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from outside, as in the case of infections, viruses, bacteria, and the like; but other ills arise from the fact that the germ plasm itself carries certain potentialities for difficulty, and we know those are called hereditary factors, usually broken up as genetic. For example, color blindness and things of that sort.
So that our concern is very great here. It so happens that radiation may not only damage the tissues of the individual himself, but radiation may also alter the chromosomes of the germ cells of the individual, so that not the individual himself but his children show disturbances and anomalies of an inherited character.
The effect of radiation is to increase the frequency with which such things occur. It generally does not mean something new in the way of disease, but an increase in the frequency of certain diseases of this kind.
Consequently, in Japan a great deal of the program there is concerned with the detection of any evidence of abnormality of the children of people who were in Hiroshima and Nagasaki at the time of those two bombs. It is the largest single effort in the study of human genetics that has ever been attempted. It is part of that program, but it is a very large part of it.
We find that radiation producing such genetic changes may produce changes that are beneficial, particularly in agriculture, so we are working with those things as well.
We prosecute studies of the relationship of the susceptibility to infection and prior or concomitant exposure to radiation. The possible relationship of radiation and the failure of the individual to defend himself against infection constitutes another class of thinking.
So that although I cannot give you numbers of diseases which get involved here, I think we can say that there is no province of human ill in which some work is not going on in this general program, even the area of psychology.
Mr. CARLYLE. Doctor, let me ask you this: Is it generally thought that this new radiation will be of assistance in treating most of the known kinds of cancer?
Dr. BUGHER. Most of the known kinds of cancer? Yes; I think we can anticipate that there are applications of radiation that can be developed to every known kind of cancer, but that does not mean to imply that we have those applications in workable form today.
Mr. CARLYLE. I believe that is all, Mr. Chairman.
Mr. DOLLIVER. I was interested in what you had to say about the effect of radiation on the chromosomes and genetics, Have there been any conclusions drawn from the studies made at Hiroshima and Nagasaki ? • Dr. BUGHER. The genetics data from the Japanese is not yet complete enough to give us a firm basis for conclusion. We have just had the benefit of a study of that data by a panel of geneticists in this country, and a similar study will be done by Japanese geneticists.
Generally speaking, there seem to be some effects on such things as the sex ratio, a little shift in the proportion of males and females, as one type of thing that seems to be there. The effects have not been by any means dramatic. The most precise statistical work is required in order to show that there has been some change at all in the progeny of the exposed parents.
Mr. DOLLIVER. Is there experimental data available with respect to genetics as to changes in the lower animals?
Dr. BUGHER. Yes, we have a very great amount of work that is going on. In fact, I believe it is true that about one-half of the total research in genetics in this country is being supported by this general atomic energy program.
Mr. DOLLIVER. Has there been anything published in that field?
Dr. BUGHER. Yes, there is growing literature. During this spring in the bomb tests at Nevada we had a very large program dealing with bomb effects on lower forms of life in the genetics field, involving plants, bacteria, small animals, and the like. That work is going on actually all over the country at the present time. It is all funneled out from the Nevada tests.
Mr. DOLLIVER. I presume the results of those tests and that information will be available to the public?
Dr. BUGHER. Yes, sir; we plan to declassify all those experimental results and they will be published in just the normal way. The only cause of delay, actually, is the fact that it takes 1 or 2 years for the geneticists to get the results of their experiments.
Mr. DOLLIVER. That would be true, I presume, of both animals and plants?
Dr. BUGHER. Yes.
Mr. DOLLIVER. So we cannot anticipate any conclusions from the geneticists until, say, 1956 ?
Dr. BUGHER. Well, actually some parts of it will be appearing rather soon. Some of the results with fruitflies, for example, can come out rather soon. Final results for animals such as mice require about 2 years; in other words, for the animal to have lived at least a major part of his life span.
Mr. DOLLIVER. They had some swine out there and some sheep and some other animals, as I seem to remember from the press.
Dr. BUGHER. Yes. The genetic experiments, though, did not deal with those. They were used for some other radiation subjects.
Mr. DOLLIVER. Thank you.
Mr. ROBERTS. Doctor, I believe you testified that this program in which the Atomic Energy Commission is engaged costs the United States Government about $3 million a year; that is, the research phase of it. Dr. BUGHER. Of the cancer program? Mr. ROBERTS. The cancer program. Dr. BUGHER. Yes.
Mr. ROBERTS. I have some figures here from the Department of Agriculture. In the fiscal year 1952 that Department spent about $32 million for the control and eradication of the foot-and-mouth disease.
I also have some figures that the American people yearly spend about $7 million for dog and pet medicaments. That was in 1951. The information is that we spent $17 million for nail polish and enamel; $231/2 million for playing cards; we spent over $91/2 billion for alcoholic beverages; over $5 billion for tobacco products; almost $4
billion for doctors and dentists; $641 million for taxicab fares and tips; $222 million for athletic and social clubs. Here is a good one: $30 million for hunting-dog purchase and training and sports-guide service.
Does it not strike you as rather odd that we are only spending $3 million for cancer research; that is, in the Atomic Energy Commission; and we know that there are 25 million people living today who will probably die with cancer unless we eradicate it or improve in our techniques of handling it? Does that not strike you as a rather odd situation?
Dr. BUGHER. Yes. One cannot rationalize these behavior patterns of man. It is an astounding thing when you put the figures of what we actually do in line with what we should do.
Mr. ROBERTS. Approximately what did it cost us to split the atom? Was it not about $2 billion?
Dr. BUGHER. You mean the development of the first bomb? Approximately that, yes. It was well over $1 billion in capital investment in the Manhattan district, and about that much more in operations. Part of that was capital investment, which we still have.
Mr. ROBERTS. And about how many years did it take us to do that?
Dr. BUGHER. The first fission was recognized in 1939. The Manhattan program began moving in the early 1940's. The first detonation was in 1945. It took that long to develop the processes, the concepts, and actually produce fissionable material in suflicient quantity to have the release of energy.
Mr. ROBERTS. About how many men and women would you say were involved in that operation as workers?
Dr. BUGHER. I would hate to trust my memory on figures, but something on the order of 120,000.
Mr. ROBERTS. Do you not think that research is the answer to this cancer problem?
Dr. BUGHER. Yes; most emphatically we do. The things that limit us are partly human, partly manpower. The number of people who are interested and competent to do research in this field is not great. We have to build a corps of research people, and that takes time.
Mr. ROBERTS. It takes money, too; does it not?
Mr. ROBERTS. A lot more money than we are appropriating and is being spent by private agencies today:
Dr. BUGHER. Well, my own feeling is that our greatest bottleneck is not financial but rather the problem of education and the development of young scientific talent to carry on the necessary investigative work. That is what I think is the chief limitation at the present
time. Mr. ROBERTS. But even in the spread of information and in the matter of detection of cancer it is going to require a lot more money than we are spending.
Mr. BUGHER. Oh, yes; indeed.
The CHAIRMAN. Doctor, you may proceed. May I inquire how many more witnesses there are? Dr. BUGHER. One more,
you please. The CHAIRMAN. I thought it was just one.
Dr. BUGHER. The third and the most recent of the research cancer hospitals to be discussed is the new Argonne Cancer Research Hospital in Chicago, dedicated last March, so that it has been in service now for only a few months. It is operated for the commission by the University of Chicago Medical School, but it functions also on behalf of all of the medical schools of the Middle West. We have asked Dr. Hasterlik, who is associated in the direction of this new venture, to give you the major outlines of the program as it is developing there. The CHAIRMAN. We would be glad to hear from you, Doctor.
STATEMENT OF DR. ROBERT HASTERLIK, ARGONNE CANCER
HOSPITAL, CHICAGO, ILL. Dr. HASTERLIK. Thank you, Mr. Chairman and members. First, Dr. Jacobson, who is ill, asked me to express his regrets that he could not appear in person, and he asked me to present these data to you.
Essentially, our program is divided into three parts. The first is the development of high-energy apparatus for the treatment of cancer. Another portion of it is the evaluation of the efficiency of these various types of machines. And then we are doing fundamental studies on the biology of cancer and the growth factor, and included in this are studies on the effects of radiations on cells and tissues and organisms as a whole.
I was interested to hear Mr. Dolliver ask before whether these were complex machines. Yes. On the staff of our hospital, which has a total scientific staff of 50 individuals, we have 8 physicists and electrical engineers, planning, who also will be needed to keep such equipment in operation. They are very complex.
That brings up a corollary problem. Our institution is not planned as a prototype of what will be available in general to the average physician. It is a research institution. Our apparatus is of a research type. We hope to get answers on what various energy radiations will do to cells, what they will do to tumors as a whole.
Dr. Warren mentioned before that one of the important aspects of treating cancer in the human was the slight difference in sensitivity of the cancer cells in relationship to normal cells. Cancer cells are slightly more sensitive. They die a little more easily than normal tissue cells.
In the past, with the lower energy radiations, this was the means of killing tumors and killing cancer. However, it was not always possible to put a killing dose of radiation into a tumor without doing extensive destruction to the normal tissue around it. Now, how can one change these effects?
Well, one can hope to find chemicals to develop means of making tumor cells more sensitive to radiations in contrast to normal cells, or one can find mechanical means of putting a higher dose of radiation into the tumor directly and not putting it into the normal tissues around it.
As Dr. Brucer mentioned, this can be done by rotating the radiation around the patient; by placing the tumor, as it were, in the center of the circle, so that from all points the radiation passes through the tumor, and very little of the radiation passes into the normal tissues about the tumor.
Well, to carry out these studies we have essentially four machines at present, either complete or in the process of completion. At the present time we are using a 2 million volt Van de Graaf accelerator. This can be used for rotational therapy, not by rotating the machine but by rotating the patient. This is useful also—and we hope to develop the specific use for the treatment of skin cancers, because electrons can be brought out of this machine very easily, and electrons of 2 million volts are just the proper energy for penetrating a short distance into the skin. This is just another use of such a machine.
We have almost completed an 1,800 Curie cobalt-therapy unit. This is a unique machine. It is not planned, as Dr. Brucer's machines are planned, for general availability, but is planned to carry out fundamental research on rotation therapy with the energies that are possible from radioactive cobalt.
As an expression of the importance of association of our type of research hospital with the Atomic Energy Commission, I would like to mention that the design of this machine was made possible by the availability of a very high flux of neutrons in one of this country's atomic reactors, making it possible to have this source which is equivalent in radioactivity to about 4 pounds of radium.
As Dr. Warren mentioned, before 1940 there was only 1 pound of radium present in the whole world in refined form.
Moreover, it is possible for us to produce this source in a very tiny shape. The entire source will be only a little more than 1 inch long and about one-fourth of an inch in diameter. This means we can shoot a very small pencil of very energetic radiation into the patient.
Moreover, the Atomic Energy Commission has loaned us 900 pounds of uranium to use as a shield. This uranium is not useful for the other purposes of the Commission, but it is extremely valuable to us, because uranium is a very fine shielding material. If we had to use lead to protect us from this cobalt radiation we would need approximately 4,000 pounds. With uranium we can get adequate shielding with only 900. So mechanically we can have a very small unit, which is very easily rotated around the patient.
We also have in the process of development a highly experimental machine, a 50 million volt linear accelerator. This has been developed for physics research, and now we are adapting such a unit for the treatment of cancer.
I will come back to the reasons for the use of these machines in a moment.
The University of Chicago also uses a 450-million-volt synchrocyclotron. Approximately 14 percent of the operating time of this synchrocyclotron is available to our research group for studies. At the present time means are being devised for getting out a 450-millionvolt beam of protons.
A proton is another particle which has a positive charge, and it is also a particle that is very much heavier than an electron.
Now to go back to the reasons for these high-energy machines. I would like to say that this is not done to just build bigger and better machines. The reason for higher energy is that it is possible with these high energies, because of certain physical characteristics, to put a very large dose of radiation within the body and a very small dose into the surface of the body. This means that we will no longer be encumbered by the requirements of doing damage to the surface of the body in treating cancer as we have in the past with low-energy radiations.