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Radiotherapy: Missiles and craftiness against tumor

New methods combating cancer sound more artful than modern belligerence and guerrilla policy. The enemy is being shot down with gold- and carbon ammunition.

This mask makes sure that the patient does not move his head while the head tumor is being bombarded with heavy ions
Picture by Department for heavy-Ion Research Darmstadt

The souvenir which Adolf Skopek brought from a trip to the German Society for Heavy Ion Research to his hometown Furth (Lower Austria), looks very perilous. Nearly like the torment airhead from the Leonardo Di Caprio movie "The Man in the Iron Mask". Only that the 26 year old carpenter voluntarily slipped into the nightmarish rock-hard ace resin construction, in order to try a totally new tumor therapy.

Twice Adolf Skopek has been operated eight hours long before. What at first hand was being announced as drunkenness ("I see everything twice") and then as effects of a tick bite regarding the symptoms turned out to be a "half malignant tumor". Surgeons in the Viennese AKH first removed a golf ball-sized piece of proliferating cell from the head of the 26 year old. "During the second time the tumor was already sausage sized", he portrays in an interview. It pushed on the optic nerve of the right eye and was accrued on the brain stem, wherefore not everything could be eliminated. The consequence: The tumor kept on proliferating.

"Those kinds of cancer types can usually not be controlled with common remedies", explains Prof. Dr. Karin Dieckmann from the AKH Department of Radiotherapy. "The traditional treatment with ultra strong x-rays even with the completely new intensity modulated method is not optimal, because it leads to a highly handicapped visual nerve and brain stem."

Through this 70 meters long circular tunnel ions are being accelerated to almost speed of light

Hence Viennese doctors sent Adolf Skopek to the research center in Darmstadt, where the now again two centimeters big tumor has been fired at with so-called heavy ions. During the process in a 70 meters long circular vacuum tunnel tiny electrically loaded carbon particles are being accelerated to almost speed of light and are fired at the proliferating undesired cells with perfect timing. The shot is batched and calculated so precisely that the carbon ion in the tumor grinds to a halt, just shortly before it releases most of its destructive energy amidst the misdemeanant.

The advantage: The surrounding healthy cells (including the optic nerve) are being saved, while a good portion of the demolition hits the tumor in multiple volleys and several directions. Anyway Adolf Skopek experienced the treatment as painfree. The only thing he noticed was a few flashes of light and the taste of chlorine during the half hour treatment at the moment when the ion ray irritated the optic- and taste nerve on the way to the tumor.

Graphics: How the radiation dosage of Schwerions lapses on the edge of the tumor immediately after the peak
Picture by Department for heavy-Ion Research Darmstadt

The disadvantage: The tumor and for this reason also the whole affected body part with all its organs, through which the ion rays speed like remote controlled arms towards their destined goal, should be completely immobilized. Therefore the "casted head", so that the severe shot cannot fail and cause damage. The method is still developable and despite the high costs very promising. In the next years not only in Germany some of these heavy ion and proton radiation centers will spring up like mushrooms. Also in East Austria, in Wiener Neustadt, presumably in 2008 the "MedAustron", a Cancer Therapy Center with this newest method is brought on line. 1200 patients should be treated there per year.

Prof. Dieckmann: "Fortunately we already have very specific set therapies." Unlike with prostate cancer a specific unusual and not very cheap method is being employed for a short time. Under narcosis tiny gold particles filled with radioactive iodine (so-called "Seeds") are being shot into the prostate with a sort of gun, so that the radiation emerging from the iodine at the same time systematically fights the proliferation cell, without doing harm to the vicinical colon. By the way: The gold stays in the prostate after the treatment...

In another department of the Viennese General Hospital oncologists Prof. Christoph Wiltschke and Prof. Christoph Zielinsky currently fiddle about a vaccine against breast cancer in the research laboratory. It should be put to the test in a patients study in the middle of the year.

"The idea is", so Prof. Wiltschke in the interview, "that the body develops antibodies due to the vaccine, which as a result should recognize cancer cells by themselves and start to combat them." The difference between an influenza vaccine and this kind of vaccine is the fact that it cannot be applied prophylactically. In addition the body detects the influenza virus by itself as a foreign object. Regarding tumors the body still has to learn how to combat against itself.

Medicine like medieval times: During the leaguer of a fortress all tricks were allowed
Picture by T. Micke

Whilst this attacks, like during the leaguers of an inimical fortress, all tricks are allowed: If direct attacks do not make enough impact, even against cancer it is correspondingly being tried to destroy the water supply, intercept food supply, turn off electricity or to creep into the fortress as an enemy ally.

"Finally", explains Prof. Wiltschke, "we move towards a development where one employs a combination of different methods." – A medical cocktail, which at the same time pursues several strategies to trick cancer cells.

Soon there will be more drugs like the much-lauded "Avastin", which should extend the average lifespan of patients with severe colon cancer anyway from three up to more than six months. Thereby not so much the capture and the demolition of the "cancer fortress" would be important in the first place. If you can close in on the enemy permanently and hinder its dissemination, like the medicament "Glivec" demonstrates in particular types of leukemia you can stop its fatal mission over several years. It would be desirable to improve this life extension in a way that the patient dies a natural death before cancer strikes.

In the end what is most important despite all the new methods and rays of hope is the patient's attitude towards his illness. 26 year old Adolf Skopek: "I kept on lying on the bed crying endlessly" – lately made a completely new start after the devastating diagnosis in 2000: In the meantime he is happily married to his former girlfriend Brigitte. They build a house together. After the first positive check-up Skopek was all smiles: "I wanna become more than 100 years old."

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© A report by Tobias Micke (20-02-05) – Contact