The American College of Surgeons has recently undertaken a movement which has a significant bearing upon the future progress of radiology in its relation to the treatment of cancer. For the first time in our history this subject will be taken up seriously by a group of men whom we may well consider leaders in scientific medicine, and it is not too much to hope that in the very near future they will assist us to place the proper valuation upon the rôle which radiation therapy essays in the field of therapeutic endeavor. Such a move is of tremendous importance, not alone to us radiologists but, most of all, to that vast clientele of human beings who rightfully look to the medical profession for relief from the most terrible and relentless enemy of mankind—cancer. It is a well known fact that the number of hospital treatment centers where radiation therapy is adequately available is extremely small, and consequently reliable radiation statistics are in no manner comparable with those of surgery. Now, however, if the writer's information is reliable, the American College of Surgeons proposes to enhance the opportunity for improvement of the radiological departments of the hospitals by concentration of cancer cases, consultation with special staff groups, stimulation of research, and by making available the methods and results of standard group practices in other institutions. To this end cancer committees or cancer clinics will be encouraged in such institutions, where the radiologist will be given equal opportunity with the surgeon to study out the proper procedure for the diagnosis and treatment plan of the individual patient. The writer feels that this is the most portentous movement inaugurated in recent years, and he believes that every earnest radiologist will gladly seize upon this opportunity and do his utmost to co-operate in this altruistic work. To single out one field where surgery and radiology must soon reach an understanding, cancer of the breast is suggested as the one which offers the most debatable ground. The operative treatment of cancer of the breast has now been practically standardized; that is, it is generally recognized that anything short of total extirpation, with a clean dissection of all accessible lymphatic structures, is useless. Has radiation treatment for the same condition been equally standardized? By no means. Radiologists are not at all in accord as to what constitutes a total sterilization dose or a total cancer dose, neither have they agreed as to what constitutes an ideal X-ray procedure even with the available measurable factors, such as voltage, milliamperage, distance, filter, time, etc., nor has it been possible as yet with radium to accept a standard known to be sufficient, accurate, and ideal.
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