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Some preliminary studies have been done at the University of California on the biological effectiveness of protons. We hope to extend these studies. The early studies look very promising. It appears that one can put a very large dose of radiation into a deep portion of the body with high-energy protons.
Another aspect of our studies is an extension of the use of hitherto unused radioisotopes in cancer therapy. This aspect of our program is just getting under way, and it parallels the Brookhaven and the Oak Ridge programs.
One interesting use of radioisotopes that is being developed by our group-and it is only possible by the use of some of our very high flux reactors in this country-is the development of a very powerful source of lower energy radiation for the taking of X-ray radiographs. At the present time we are developing a very high specific activity thulium 170 source. This gives off rays that are much like the rays from an ordinary X-ray machine. We hope to develop a unit that is very small, does not depend on electric connections for use, and we hope that it will be possible to develop a practical radiography source. This means many people can do radiography for the detection of cancer under rather adverse conditions.
Yesterday Dr. Mider mentioned the work Dr. Leon Jacobson had been doing and the demonstration he had made that the shielding of the spleen during a radiation protects an animal to an extent from the lethal effects of radiation. This observation is of fundamental importance, not only because of the obvious aspects of protecting individuals from radiation but also because it seems that it may be possible in the future to develop and to demonstrate certain substances present in the blood stream which both protect the bone marrow from damage and will make possible the administration of larger doses of radiation to people in the treatment of cancer, and also because it seems that this not as yet isolated growth factor might in some way be related to the growth of tumors.
Dr. Jacobson's group is carrying on this very interesting approach to the study of cancer and formation of blood.
Another group at our institution is studying the effects of radiation on cells, tissues, and on total organisms. As Dr. Bugher mentioned, in this country there is a rather large group of individuals who were administered radium many years ago as a therapeutic procedure. One of our groups at our hospital is studying the effect of this radium on the bones of these individuals, and the production of tumors in these individuals.
The placing of the Argonne Cancer Research Hospital as part of the University of Chicago Clinic is, I feel, rather fortunate. We have extended some of the studies alluded to yesterday of the relationships of hormones to the growth of cancer. One of our groups at our hospital is studying the relationship of the endocrine glands, specifically the adrenal glands, to the growth of tumor cells, and they are doing this by feeding to the individual safe amounts of tritium, which is radioactive hydrogen and radioactive carbon, labeled precusors of certain hormones, and studying the synthesis of these hormones both in normal and cancerous people. This is a very fundamental study and is being used to elucidate some of the relationships between hormones and growth of cancer.
At this point I would like to mention that this study is made possible because the entire facilities of the Atomic Energy Commission are available to us. These tests, in order to do them safely, require small amounts of these radioactive substances, and we are fortunate in that we can have developed for us very fine and very sensitive detection apparatuses which in general have not been available up to the present, outside the National Laboratories of the Atomic Energy Commission.
Now, we have 58 beds in our hospital, and patients are admitted through our University of Chicago clinics, of which we are a formal part, and are also referred by the 19 medical schools of the Middle West who are affiliated with our hospitals through their relationship to the Argonne National Laboratory. We are accepting only research patients. We hope to evaluate these various radiation factors in these patients.
Another important part of our program which is just getting under way is the training of radiologists from our 19 medical schools. I might mention that others from other parts of the country can certainly come to our institution, but we are concentrating this program in the Middle West at present. This is the training of radiologists in the use of these improved techniques; rotational therapy, the use of radiocobalt therapy, and so forth. We feel it is important for us to disseminate the information on these newer techniques as widely as possible.
I think this sums up in general some of the things we hope to accomplish at our new institution.
The CHAIRMAN. Any questions, gentlemen?
Mr. ROBERTS. Just one question, Mr. Chairman.
The CHAIRMAN. Mr. Roberts.
Mr. ROBERTS. Doctor, is it true that as far as any research program is concerned it could not proceed any faster than the trained manpower and the facilities available to do the job? That would be generally true, would it not?
Dr. HASTERLIK. Yes, I would agree heartily with Dr. Bugher that this is one of the most important parts of our program; stimulating and training scientists in these specific fields.
Mr. ROBERTS. How would you feel about a strong fellowship program to train young scientists?
Dr. HASTERLIK. As a generalization I am very much in favor of it. In what area do you mean, sir? In cancer therapy or in fundamental research in cancer therapy?
Mr. ROBERTS. Well, I would say in fundamental research.
Dr. HASTERLIK. I am very heartily in favor of such a program of training scientists.
Mr. ROBERTS. I believe that is all, Mr. Chairman.
The CHAIRMAN. Any further questions, gentlemen?
I just had 1 or 2 questions to ask Dr. Brucer. What is the approximate size of the cobalt machine?
Dr. BRUCER. The small cobalt machine that we have just developed contains about 350 to 600 curies of cobalt 60. This is the type of cobalt we can readily make available. The size of the machine is about 15 inches in diameter. About that large [indicating].
The machine is supported on the same type of a commercial X-ray stand that is now available for the larger X-ray machines, the 400kilovolt type. It weighs about 1,250 pounds.
The CHAIRMAN. It has been brought to my attention, Doctor, that you have just recently returned from studying radiation in Europe. Can you tell us about your findings and how we in the United States compare with European research? I think our committee would be very much interested in having your brief statement with reference to it.
Dr. BRUCER. When I refer to this trip with my boss present, I always say we are way behind. Actually we are not completely behind. The outstanding things I noticed in going through many of the laboratories, especially in England but also in some of the other countries, is the fact that they are making very good use of the two things that they do have available. One is the mechanical engineering that goes into the manufacture of X-ray machines. he other is they do have, through the English reactors, small amounts available of very low intensity cobalt and other isotopes.
In the field of the large sources the X-ray machines, since they cannot get, except through the Canadian reactors, the very large isotope sources, are such that they have specialized on the X-ray machines. One of the things that is outstanding is the fact that they have gone into this moving field, or these extensions of rotational therapy. Actually, I think they are in this field way ahead of us.
Almost all of the research radiotherapists have either developed or are developing or are looking forward to developing some form of a rotational therapy or moving field therapy device.
In the development of the use of very low intensity sources, which they do have available, they have done some very clever things, some of which we are going to copy and some of which I think we can do better than they are doing.
The group at Heidelberg, for example, has taken very small millicurie amounts of cobalt and has made them into seeds, beads, plastic materials, disks, and wafers. None of these are of general use in the treatment of cancer, but each one has a specific use in a very specific type of cancer.
For example, one of the types of seeds that has been developed is only good for treatment of cancer of the maxillary sinus. Another type is only good for treatment of cancer of the bladder.
This is a type of thing we should be doing much more of, and is a type of thing that we will be doing much more of.
The CHAIRMAN. We will now hear from Dr. Charles Doan, dean of the college of medicine of Ohio State University.
STATEMENT OF DR. CHARLES DOAN, DEAN, COLLEGE OF MEDICINE, OHIO STATE UNIVERSITY, COLUMBUS, OHIO
Dr. DOAN. Thank you, Mr. Chairman.
Mr. CROSSER. Doctor, before you undertake your special job, I may say-and I believe I am correct in saying-that you have in Ohio in your own town of Columbus a chapter of the Arthritis and Rheumatism Foundation, have you not?
Dr. DOAN. Yes, sir; that is correct.
Mr. CROSSER. So, as usual, we are leading the way in Ohio.
Dr. DOAN. Yes; we are very happy to support what has been said already this afternoon from our area, as to this work in metabolism and especially rheumatism.
We have a chapter there that is headed up medically by the members of our faculty, who are concerned in that area. We have a very active clinic, a very active division of the department of medicine, devoted to research and the application of treatment to these diseases. Therefore, everything that has been said this afternoon with reference to this specialty we would certainly support, and we would say we are very grateful to have a part in the organized movement and to have at Ohio State University the leadership in our own faculty.
(Discussion off the record.)
The CHAIRMAN. Proceed, Doctor.
Dr. DOAN. Mr. Chairman and gentlemen, I am very appreciative of speaking from the point of view of Ohio State University as a landgrant university, with reference to this attempt to meet the problems of health, especially as they appertain to cancer and other subjects which you are having your hearings about this week and last week.
We have tried to make our contribution with reference to the shortage of doctors which has been mentioned here this afternoon. Since 1945 the State legislature in Ohio has appropriated and we have expended in new facilities some $172 million. That has trebled our hospital facilities.
We have this fall accepted our fourth class of 150 medical students each, which is just double the number we had prior to World War II, so that we now have in our medical school in the undergraduate years 600 medical students as of this year. We will graduate our first class of 150 next fall.
More than that, we have rejuvenated our nursing school and there have been in the last 2 years 150 each in our freshmen nursery classes. This is leading to the bachelor of arts degree in nursing.
Both from the standpoint of increased nursing supply and from the standpoint of increased physicians the university at Columbus has really taken seriously the challenge of the modern postwar medical
When it came to the research activities, these funds have been primarily given for the facilities for basic teaching of medical education, and we have, incidentally, 175 interns in residence; a fifth class, if you please, which is training in our expanded hospital facilities at Ohio State University.
When it came to having this good fuselage, basically to provide more medical and nursing care, the research activities, of course, came in. My first interest personally is research, since I was at the Rockefeller Institute for 5 years in a laboratory right next to Dr. Rhoads when he at that time was beginning his work in research which led to the basic study of cells and cancer. So that the research activities in the college of medicine at the university are the first responsibility of such a faculty, because if we do not have the facts we neither can apply them to the patients who come to us nor can we teach them to our students. Therefore, every member of our faculty is an active investigator.
We asked the Federal Government after this expenditure of funds by the State government for $12 million for a cancer research unit, through the National Advisory Cancer Council. We also asked for
funds from the National Advisory Heart Council, as they also were concerned with the extension of cardiac research, cardiological research. We were told that with the demands that were made from other worthwhile institutions across the country our allocation would be $300,000 out of the $12 million we requested. We thanked them very heartily for that and said, "That will be our nest egg.
We went to the legislature which was in session at that time-the Ohio State Legislature-and told them we had to have $300,000 against a program that we felt was of tremendous importance. They said, "We will raise this." And they passed within a month's time this legislation and this fund was granted in the amount of $300,000 for construction: $180,000 for research in cancer from the State legislature for the university for the equipment of this unit for specific research.
Well, in the meantime, the Korean war started and the money just halved when we got our plans in construction value. Therefore, when the contracts-even revised contracts and bids were given, we were $67,000 short of the amount to build the first unit of what we had hoped to be an important research unit, and it was irreducible in its size.
At a State university all the money must be available before the contract can be let-there is no escalator clause which can be used. So, the Kettering Foundation-Mr. C. E. Kettering-being a member of the board of trustees, gave the $67,000 necessary to let this contract. Therefore, our cancer research unit, dedicated May 9, this year, represents Federal funds, State funds, and private funds, which I think is the way our approach to the answer to these problems should be made these days. There should be at each level responsibilities met from the State, the Federal Government, and from private foundations and private individuals.
We are having an increased number of private gifts donated, market for cancer research at Ohio State University because, I think, we have a good educational institution supported by the State. We have had from the National Institutes of Health in the various areas very important subsidies, both at the teaching level and at the research level. Having been honored with the service as chairman of the anatomological study section, when it was carried on under Dr. Dyer some 7 years ago and for 5 years having served on that from the standpoint of the requests coming in for worthy research projects, I certainly want to testify to the extreme value that it has been to us, both from the standpoint of the receiving end and from the standpoint of the advisory end in those diseases which have to do with the diseases in terms of the allocation of these funds, specifically that you grant. I want to say that I think it is a most magnificent program. This program gives us the kind of unity which is really going to bring answers to these questions.
In terms of cancer, I am extremely optimistic. My own field is leukemia, which is one phase of the cancer problem.
When I began 30 years ago in this field, all of the acute leukemia cases were fatal within 2 to 4 weeks. Everyone I saw in 1930 of the acute leukemia cases were fatal within a very short time. Now, we expect to get remissions lasting from 6 months to 2 years, and it would seem reasonable that if one can prolong life and restore one to a normal