RE: " new reactor will make certain Australia remains at the forefron t of cancer treatments "

["Franta, Jaroslav" <frantaj@AECL.CA>]

Thanks John.

Please see reply below.



Jaro 





-----Original Message-----

From: John Jacobus [mailto:crispy_bird@yahoo.com]

Sent: Tuesday February 17, 2004 11:05 AM



The usefulness of BCNT for all but a limited number or cancers has to still

be established.  There are two

things to remember. 



(1) Cost verses benefit is always a factor.  If cancers can be treated with

known, accepted protocols

involving surgery, radiation, chemotherapy or some combination, the

physicians will use them.  The

introduction of new modalities in treatment have to prove a significant

benefit, as the PRIMARY goal of

medicine is to improve the quality of patients' lives, not push forward

research. <snip>



JF reply:

As I understand it, diffuse-type cancers are considered inoperable and

therefore untreatable. The prime example being brain cancers like GBM.

Not having a treatment option for such cancers effectively condemns patients

to death -- a painful death at that, when ineffective treatments are used in

vein.

About 36,000 primary brain tumours are reported in the U.S. each year; of

these, more than 17,000 are diagnosed with high-grade gliomas.  About half

of these patients die within the first year, according to the American

Cancer Society.

According to another (earlier) estimate, here are about 7,000 deaths per

year in the USA resulting from (GBM) brain tumours. The total incidence in

the USA, Japan and Europe combined is approximately 50,000 per year. 

According to http://www.bnct.net/ :

Every year, approximately 500 patients in Sweden and 7,000 patients in the

US are diagnosed with glioblastoma multiforme, a highly malignant form of

brain tumour. In spite of aggressive treatment, including surgery, which is

often followed by radio- and chemotherapy, the mean survival of these

patients is less than a year. 



You tell me whether so many lives are not worth trying to save.



Of course there is always the issue of cost.

On the one hand we have the western economies of countries like Australia,

Canada and the US (to some extent) who say they can't afford it and have

therefore - so the story goes - abstained from BNCT work (and perhaps other

so-called leading-edge medical research). Then there are the economic

powerhouses of countries like Argentina, the Czech Republic, Italy, Finland,

Sweden, etc. who have somehow found a way forward.

The contrast is pretty remarkable, IMO.



Jaro

=================





Another consideration is that the some of the reported treatments involve

only

specific, rare cancers.  The main cancer types remain

lung, prostate, breast and colon-rectal.  Improved

treatments of these cancers will provide the most good

for the most people.  Developing treatment for a rare

pancreatic cancer that only affects 1% of patients may

increase our understanding of cancer treatment, but

will do little for the vast majority with "common" cancers.



(2) Just because a medical treatment makes a

"breakthough" does not really mean it does.  Companies

and institutions have a motive in reporting their

findings.  In the early-1980s, a number of medical

research centers were buying accelerators for fast

neutron therapy treatment.  Except for the Trevatron

(I love that name), I do not think any are still doing

that type of therapy in a clinical setting.  All work

with fast neutrons remain a research. See 

http://www.radonc.uchicago.edu/lionel/linktest.html. 

That being said, there is ongoing work in proton

therapy in both the Loma Linda, CA, and the

Massachusetts General Hospital which has shown great

promise in heavy ion therapy.  Does Austrailian or

Canada have proton treatment facilities?



--- "Franta, Jaroslav" <frantaj@AECL.CA> wrote:

> > I thought it interesting how "cancer treatment"

> leads the way in public

> > relations campaigns like the article below, but

> when it actually comes

> > down to "remaining at the forefront" of medicine,

> ANSTO balked at

> > including a BNCT facility at the new Lucas Heights

> reactor in Sydney,

> > leaving Australia's group of BNCT researchers high

> & dry.

> > Regrettably, this hypocritical approach is also

> taken in Canada's proposal

> > for the new CNF reactor.

> > One bit of good news in all this is that at least

> the Koreans modified the

> > HANARO Maple reactor which Canada built for them,

> to include a BNCT

> > facility.

> > Guess who's going to "remain at the forefront" of

> medicine.