Fast Neutrons for Cancer Therapy: A Case Study of Failure

Time: 4:30 p.m.

Place: 210 Dickinson Hall, Princeton University

Note: There is no pre-circulated paper for this talk.

Abstract. In the 1930s, Ernest Lawrence claimed that the unique properties of neutrons produced by his cyclotron preferentially killed cancer cells. In collaboration with his brother John and the Radiologist Robert Stone, human trials were initiated at Lawrence Livermore and showed promising early results. Nevertheless by the early 1940s patients were suffering from such severe toxicity that Stone publicly announced in 1947 that neutrons were unsuitable for cancer therapy. Yet, shortly following World War II, the Medical Research Council of the UK agreed to provide financial support for the development of a cyclotron at the Hammersmith Hospital in London. Although the primary purpose of the unit was to support experiments in radiobiology, by the late 1960s, after a number of bitter internal battles, the cyclotron was committed primarily to cancer therapy with neutrons. Following a series of clinical trials, the clinical leader of the project, Mary Catterall, reported that neutrons provided significant advantages over conventional x-rays, particularly for cancers of the head and neck. During the same period, the MRC built a second cyclotron in Edinburgh, and in a series of papers the Edinburgh team reported that neutrons had little or no advantage over x-rays in controlling tumors while they continued to produce troubling late complications. A major controversy ensued – the so called battle of the dueling cyclotrons – that rapidly escalated from exchanges in the medical literature to bitter and personal attacks in the popular press, and to a widening range of protagonists including the office of Prime Minister Thatcher. Neutron therapy was badly discredited in the UK, and funding for neutron programs suffered worldwide, especially in the US. The story of the failure of neutron therapy is more than a tale of operatic proportions. Its failure opens out for us some of the characteristics of medical research practices. For example, the neutron story tells us much about the important role of the social in clinical trials. It also shows us not only how neutron technologies were taken up and transformed by its users, but how human cancers were reconfigured, constructed so to speak, as suitable candidates for therapy with the evolving neutron machines.