Spoils of War

Among the few chemicals which give some relief in some forms of cancer, one of the best is nitrogen mustard, developed as a poison gas for World War II but never used (TIME, Oct. 21, 1946). Among its disadvantages: it has to be injected, and is sometimes almost as poisonous to the patient as to his cancer cells. Last week, Dr. Cornelius P. Rhoads told the Association of American Physicians in Atlantic City that a new chemical had been found with most of nitrogen mustard's virtues and fewer faults.

Produced in Germany to improve the finish of fabrics, triethylene melamine (T.E.M.) is structurally similar to nitrogen mustard and, like it, reacts freely with organic molecules, especially in fast-growing cancer cells. It is given by mouth, so that patients can go to a clinic for regular doses instead of being hospitalized. The dose must be figured carefully, because T.E.M., like nitrogen mustard, can cause severe stomach upsets.

Dr. Rhoads's colleagues at Manhattan's Memorial Center for Cancer and Allied Diseases (TIME, June 27) treated 37 patients with oral T.E.M. In 20 victims of Hodgkin's disease and leukemia the progress of the disease was slowed, and the patients felt better.

Last week nitrogen mustard also got a boost. Doctors had thought that the site of injection must be a vein. In 1945, a victim of Hodgkin's disease in a Washington hospital got a blistered, ulcerated arm from an accidental injection into an artery. But George Washington University's Dr. Calvin T. Klopp wondered whether the accident had been a bad thing after all: it indicated that nitrogen mustard when shot into an artery, was localized so that it might be more effective in a smaller area.

Careful experiments beginning with animals have proved Dr. Klopp right. In ten cases (mostly cancers of the mouth and nose cavity) where cancers were too far advanced for surgery or X-ray treatment, nitrogen mustard has been injected into the artery supplying blood to the cancerous area. One patient had a brain tumor which had so damaged his sight that he could only distinguish light from dark; after treatment he could read large newspaper type.

Because arterial injection concentrates almost the full force of the drug against the cancer area, as little as one-tenth of the previously required dose is effective. Still, it is no cure. Of Dr. Klopp's ten patients (deliberately picked as hopeless cases), seven have since died. The encouraging thing was, they had been relieved of pain, and in nearly every case their tumors had been partly withered.

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