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

[John Jacobus <crispy_bird@YAHOO.COM>]

First of all, I will not get into the arguement of how

much should it cost to save a life.  



But, I will add some comments to what you have

written.  "Diffuse" or non-solid cancers are indeed

difficult to treat.  However, some diffuse cancers

such as Acute Lymphocytic Leukemia (ALL)in children do

respond to chemotherapy very effectively.  Survival

from childhood leukemia has gone from zero to about

80%.  Maybe radiation is not the best treatment for

brain cancers.  Or even gene therapy. 

http://www.mdanderson.org/diseases/braincancer/

Just because we can use radiation does not mean that

that is the best treatment option.



As you note, while 36,000 brain cancers are reported

every year, ". . .an estimated 169,400 new cases of

lung cancer and an estimated 154,900 deaths from lung

cancer will occur in the United States during 2002."

http://www.lungusa.org/diseases/lungcanc.html.  Given

some limits to spending medical dollars, which would

you choose?  



I guess the thing that bothers you is why the US,

Canada and Australia do spend more on BNCT?  Is it

because one success requires more expenditures in

resources?  I think part of the issue is that the

research done in Argentina, the Czech Republic, Italy,

Finland, Sweden, etc., is that it is tied into their

physics programs, and is really not a true medical or

biomedical research program.  That is the way the

proton treatment at Harvard was run for years, and

some medical research programs in the US were

supported by the old Atomic Energy Commission and

Department of Energy.  It allows for money to be

allocated for the highly visible treatment of patients

as well as support other, non-medical programs.





I imagine that if BNCT shows more successes, it will

receive more research funding.  Currently, it is

cheaper to have patients go to research centers doin

BNCT that to build new centers. 



-- "Franta, Jaroslav" <frantaj@aecl.ca> wrote:

> 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.

> 





=====

+++++++++++++++++++

"The care of human life and happiness . . . is the first and only legitimate object of good government."

Thomas Jefferson



-- John

John Jacobus, MS

Certified Health Physicist

e-mail:  crispy_bird@yahoo.com



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