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Radiation - friend or foe? Presidential address to Ulster Medical Society 4th October 2012.

Spence R - Ulster Med J (2014)

View Article: PubMed Central - PubMed

Affiliation: Professor of Surgery and Consultant Surgeon, Belfast Trust, Centre for Medical Education, Queen's University Belfast, Mulhouse Building Grosvenor Road, Belfast BT12 6BA.

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In Ulster - the importance of X-rays was quickly realised on 9 July 1896 (only 6 months after Roentgen's announcement) at a medical staff meeting in the Old Belfast Royal Hospital in Frederick Street... He did many X-rays in his home in Mount Charles and in 1911 had a formal darkroom and new X-ray equipment in the hospital... The therapeutic use of X-rays followed quickly from the discovery and a lady with cancer of the breast was treated in 1896. (fig 5) Advances followed rapidly - Marie and Pierre Curie identified radium - discovered in 1896 and published in 1898... Radium paint, which fluoresced, was everywhere! However, the same workers who painted radium paint developed a mysterious and profound anaemia and osteonecrosis... Marie Curie, herself died from radiation induced aplastic anaemia... The American physicist, Thorson, first found the direct relationship between exposure to X-rays and side effects – he deliberately exposed his left index finger to an X-ray tube for 30 minutes per day, for 3 days, developing swelling, erythema and pain... With these, and other advances in radiation therapy it is now estimated that two-thirds of the 1.5 million new cancer cases diagnosed annually in USA - will undergo some form of radiation therapy... Despite careful planning, including the use of radio-sensitisers, radio-protectants, non-cancerous cells are affected resulting in many clinical side effects - from fatigue, and depression, to secondary malignancy such as breast cancer in women who have had mantle radiotherapy for lymphoma when young... While the management of the adverse effects of radiation therapy is not ideal, many treatment strategies are in practice... Therefore, with the huge amount of literature both published and on the internet including the standard oncology text books such as DeVita, there is great awareness in the public, the press and medical profession of the benefits and side effects of radiation therapy in the 21 century... The comprehensive Lancet paper of De Gonzalez from a decade ago looking at 15 countries (including UK) estimated cumulative cancer risk due to diagnostic X-rays... The dose of radiation during EVAR procedures may be close to that during coronary angiography which is highest of all (16.0mSv - equivalent to 800 chest X-rays. (fig 14) Similar data have been shown in USA and Europe... Recent debate centres around - ‘what should patients be told’,... Informed consent is not required in the UK for routine imaging, outwith interventional radiology, but should patients be told of the potential benefits of a particular scan (versus adverse effects).

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Acute radiation burn - during radiotherapy for breast cancer
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fig05: Acute radiation burn - during radiotherapy for breast cancer

Mentions: Later in 1896 the great Sir Joseph Lister postulated ‘the transmission of the rays through humans today may not be altogether a matter of indifference to internal organs’31. Cancer of the hands was a common adverse effect to the early pioneers11. The therapeutic use of X-rays followed quickly from the discovery and a lady with cancer of the breast was treated in 189632. (fig 5) Advances followed rapidly - Marie and Pierre Curie identified radium - discovered in 1896 and published in 1898. Eventually Marie was to die from a radiation - induced cancer and yet radiation for cancer was to become a cornerstone of cancer therapies over the ensuing decades. (fig 6)


Radiation - friend or foe? Presidential address to Ulster Medical Society 4th October 2012.

Spence R - Ulster Med J (2014)

Acute radiation burn - during radiotherapy for breast cancer
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4255836&req=5

fig05: Acute radiation burn - during radiotherapy for breast cancer
Mentions: Later in 1896 the great Sir Joseph Lister postulated ‘the transmission of the rays through humans today may not be altogether a matter of indifference to internal organs’31. Cancer of the hands was a common adverse effect to the early pioneers11. The therapeutic use of X-rays followed quickly from the discovery and a lady with cancer of the breast was treated in 189632. (fig 5) Advances followed rapidly - Marie and Pierre Curie identified radium - discovered in 1896 and published in 1898. Eventually Marie was to die from a radiation - induced cancer and yet radiation for cancer was to become a cornerstone of cancer therapies over the ensuing decades. (fig 6)

View Article: PubMed Central - PubMed

Affiliation: Professor of Surgery and Consultant Surgeon, Belfast Trust, Centre for Medical Education, Queen's University Belfast, Mulhouse Building Grosvenor Road, Belfast BT12 6BA.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

In Ulster - the importance of X-rays was quickly realised on 9 July 1896 (only 6 months after Roentgen's announcement) at a medical staff meeting in the Old Belfast Royal Hospital in Frederick Street... He did many X-rays in his home in Mount Charles and in 1911 had a formal darkroom and new X-ray equipment in the hospital... The therapeutic use of X-rays followed quickly from the discovery and a lady with cancer of the breast was treated in 1896. (fig 5) Advances followed rapidly - Marie and Pierre Curie identified radium - discovered in 1896 and published in 1898... Radium paint, which fluoresced, was everywhere! However, the same workers who painted radium paint developed a mysterious and profound anaemia and osteonecrosis... Marie Curie, herself died from radiation induced aplastic anaemia... The American physicist, Thorson, first found the direct relationship between exposure to X-rays and side effects – he deliberately exposed his left index finger to an X-ray tube for 30 minutes per day, for 3 days, developing swelling, erythema and pain... With these, and other advances in radiation therapy it is now estimated that two-thirds of the 1.5 million new cancer cases diagnosed annually in USA - will undergo some form of radiation therapy... Despite careful planning, including the use of radio-sensitisers, radio-protectants, non-cancerous cells are affected resulting in many clinical side effects - from fatigue, and depression, to secondary malignancy such as breast cancer in women who have had mantle radiotherapy for lymphoma when young... While the management of the adverse effects of radiation therapy is not ideal, many treatment strategies are in practice... Therefore, with the huge amount of literature both published and on the internet including the standard oncology text books such as DeVita, there is great awareness in the public, the press and medical profession of the benefits and side effects of radiation therapy in the 21 century... The comprehensive Lancet paper of De Gonzalez from a decade ago looking at 15 countries (including UK) estimated cumulative cancer risk due to diagnostic X-rays... The dose of radiation during EVAR procedures may be close to that during coronary angiography which is highest of all (16.0mSv - equivalent to 800 chest X-rays. (fig 14) Similar data have been shown in USA and Europe... Recent debate centres around - ‘what should patients be told’,... Informed consent is not required in the UK for routine imaging, outwith interventional radiology, but should patients be told of the potential benefits of a particular scan (versus adverse effects).

Show MeSH
Related in: MedlinePlus