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R a d i u m 111
died of a secondary growth in the urethra, with metastases to the inguinal
glands.
Radium dose, infiltrating carcinoma
Cases well -g
Bare tubes alone g*
Screened radium alone
4V
Bare tubes and screened radium 4
Unscreened radium held against tumor and screened
radium
ij
Bare tubes and unscreened radium 1
*One case multiple treatment through cystoscope.
IGne case 2 treatments: one case 3 treatments.
(Three treatments.
There were 8 cases in which bare tubes alone were used. In these
8 cases the strength of the bare tubes varied between 0.2 and 3.0 millicuries.
and 1 to 2 tubes to each cubic centimeter were used. In 5 of
the 8 cases bare tube treatment alone succeeded in removing the carcinoma.
In 3 cases, subsequent treatments were necessary to destroy
the growth.
SQUAMOUS CARCINOMA
In 61 cases of infiltrating carcinoma there were 3 cases of squamous
carcinoma. As far as I could *ce there was no way in which the
diagnosis could be made prior to sectioning. They resembled any other
flat infiltrating carcinoma. I believe they are more malignant than most
carcinomas, and are somewhat more resistant to radium treatment. Of
these 3 cases. 1 is well, and 2 are dead or dying.
REASONS FOR FAILURE OF RADIUM IN* SOME CASKS
In 2 cases we tried to implant radium in the base of the tumor without
firstsnaring the tumor off. Boih of ihese cases were pretty extensive,
and one especially very malignant. I am convinced we would have
done better in these cases had we snared the tops of the tumors off,
because wc should have been able to more accurately implant the base
with radium, and the good results we have had are due to this very accurate
implantation. All cases that have had a definite submucous extension
is covered with normal mucous membrane. It is, as a rule, difficult
to see. but can easily be felt. Notwithstanding we have had several
cases in which the tumors have been removed by implanting bare tubes
of the strength of 0.2 millicuries. such cases are rare, and the strength
most useful is 0.6 to 0.7. There have been several cases in which it has
seemed that we ought to have removed the tumor, and the reason that
we have not done so was that we did not reinforce the bare tubes by
the addition of screened radium to the surface of the tumor base.
PRESENT ESTIMATE OK PROPER RADIATION
Dr. Adair has suggested that various parts of the body be dividec'
into sensitive and insensitive areas, and the method of radiation be
varied according to the relative sensitiveness of the parts treated. This
condition applies very well to the bladder, all parts of which are fairly