Neutrons Against Cancer

Twice a week Betty S., a 42-year-old artist from Chicago, makes the 30-mile trip between her home and Batavia, Ill. There she enters a large concrete-lined room in the Fermi National Accelerator Laboratory, takes a seat in what resembles nothing so much as an electric chair, and waits while a technologist helps her don a mask that holds her face totally immobile. Just before the platform under the chair is lowered beneath floor level, the growth in her throat is located by X ray and pinpointed by three intersecting low-power laser beams. Then Betty's neck is bombarded by a narrow but powerful beam of invisible nuclear particles. The awesome might of the world's largest atom smasher, usually harnessed to explore the innermost depths of the atom, is being used in the war on cancer.

Billiard Game. Betty S. has an inoperable malignant tumor of the esophagus. She is one of two dozen patients participating in a promising new program for fighting advanced cancer of the mouth, upper respiratory system, cervix, brain, pancreas and other areas that until recently have been virtually untreatable. Fermilab's weapon is a beam of high-energy neutrons produced by its linear accelerator. Directed against certain tumors, the neutrons can be more effective than the X rays normally used in cancer therapy. Their advantage lies in the combination of their mass (they are heavy by subatomic standards) and high energy, which makes them ideal "cue balls" in a kind of atomic billiard game: penetrating deep into large tumors, they knock protons and other particles out of the atoms of the cancerous cells. That creates general biochemical havoc, breaking DNA strands and hampering cell reproduction--thus killing the malignancy.

As far back as the 1930s, Dr. Robert Stone of the University of California at Berkeley used neutron irradiation against cancer. But Stone's tests so severely damaged healthy tissue that the treatment was not revived until the 1960s at London's Hammersmith Hospital. The British physicians not only aimed the neutrons more precisely, but also adjusted the dosage so as to hold down immediate side effects.

Following the British lead, Houston's M.D. Anderson Hospital and Tumor Institute, the U.S. Naval Research Lab, and the University of Washington in Seattle have all started using neutron irradiation. But Fermilab has a special advantage: it delivers neutrons at higher energies and thus can probe deeper into the tumors.

Initial Results. The director of Fermilab's neutron irradiation program, Dr. Lionel Cohen of Chicago's Michael Reese Hospital, is encouraged by the initial results, but emphasizes that the use of the Fermilab accelerator for treating cancer is still highly experimental. No one can tell what, if any, long-term damage may result from the use of high-energy neutrons. Furthermore, neutron treatment is suitable for only a small fraction of cancer patients. Says Cohen: "Only 15% of patients now being treated with conventional radiation could benefit from neutron therapy. There has to be a localized cancer of a specific type." But in these cases, neutron irradiation seems to provide hope where there was little or none before. So, asks Cohen, "why not try?"

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