Clinical oncology. Part 2 (1st section).

London : University of London Audio-Visual Centre, 1974.

1 encoded moving image (47.09 min.) : sound, black and white.

00:47:09

University of London

Restricted

In English

Presented by Dr R L Morgan, Mr J A McKinna and staff of the Royal Marsden Hospital. Participants: Dr McDonald, Mr D Eaton, Dr Levene. Made for British Postgraduate Medical Federation. Made by University of London Audio-Visual Centre.

This video is one of around 310 titles, originally broadcast on Channel 7 of the ILEA closed-circuit television network, given to Wellcome Trust from the University of London Audio-Visual Centre shortly after it closed in the late 1980s. Although some of these programmes might now seem rather out-dated, they probably represent the largest and most diversified body of medical video produced in any British university at this time, and give a comprehensive and fascinating view of the state of medical and surgical research and practice in the 1970s and 1980s, thus constituting a contemporary medical-historical archive of great interest. The lectures mostly take place in a small and intimate studio setting and are often face-to-face. The lecturers use a wide variety of resources to illustrate their points, including film clips, slides, graphs, animated diagrams, charts and tables as well as 3-dimensional models and display boards with movable pieces. Some of the lecturers are telegenic while some are clearly less comfortable about being recorded; all are experts in their field and show great enthusiasm to share both the latest research and the historical context of their specialist areas.

Segment 1 Professor Peckham talks to camera. He introduces the subject of radiography by giving a detailed history of its discovery at the end of the 19th century. He describes the early technical advances and draws a diagram depicting tumour growth patterns following a singe dose of X-rays. Time start: 00:00:00:00 Time end: 00:04:33:00 Length: 00:04:33:00

Segment 2 Peckham describes how the study of the effects of X-rays on normal tissues is as important as that on cancerous tissue. He differentiates between how radiation therapy can be used to treat localised disease and metastatic disease. Although localised tumours are potentially easier to treat with radiation, Peckham gives statistics for how many people die each year due to the failure of radiation therapy to control the growth of a localised tumour. He then draws an illustration depicting what happens during radiotherapy on head and neck cancers. Time start: 00:04:33:00 Time end: 00:10:12:00 Length: 00:05:39:00

Segment 3 Peckham draws an illustration showing how the position of a tumour is affected by oxygen supply; a cancerous cell which is well supplied with oxygen is three times more likely to respond to radiation therapy than one which is starved of oxygen. He goes on to describe methods of re-oxidising tumour cells. Time start: 00:10:12:00 Time end: 00:17:11:00 Length: 00:06:59:00

Segment 4 McElwain talks about drug treatments in general on the control of cancer, in particular he talks about the discovery and introduction of chemotherapy. He refers to a table listing the different drugs available to treat cancer and describes each one briefly. Time start: 00:17:11:00 Time end: 00:20:24:00 Length: 00:03:13:00

Segment 5 McElwain continues to talk about chemotherapy. He shows a table listing different types of tumours that are potentially curable by chemotherapy. Next, he refers to a table showing tumours which are treatable but not usually curable by chemotherapy. Finally, he lists the tumours which may be helped but are never cured by chemotherapy. McElwain shows a table listing statistics for the prolongation of a patient's life if chemotherapy is used, and a table showing tumours for which chemotherapy has produced no prolongation of life. Time start: 00:20:24:00 Time end: 00:25:07:00 Length: 00:04:43:00

Segment 6 McElwain discusses chemotherapy further, this time looking at its role in disseminated (metastasised) disease. Although chemotherapy cannot cure cancer once it has metastasised, it can help people and prolong life. He then discusses, briefly, treatments which combine surgery, chemotherapy and radiotherapy. Time start: 00:25:07:00 Time end: 00:29:36:00 Length: 00:04:29:00

Segment 7 McElwain describes how drugs such as chemotherapy should be used - as single agents in small doses or large doses - or as combinations with other drugs and treatments. He talks about how opinions on which option to take have changed over the years and describes which direction is thought to be the most successful at the present time. Time start: 00:29:36:00 Time end: 00:34:55:20 Length: 00:05:19:20

Segment 8 McElwain draws a diagram depicting the life cycle of a tumour cell. He describes how drugs intervene with a tumour cell's ability to divide and spread. However, these drugs often have a serious affect on the health of the bone marrow, although McElwain believes this is small price to pay when treating an aggressive tumour. Time start: 00:34:55:20 Time end: 00:37:24:00 Length: 00:02:28:05

Segment 9 McElwain shows a graph which details what happens to the blood when chemotherapy drug methotrexate is given over a number of days. He describes how it is important to balance a dose of the drug which leads to tumour destruction without causing too much damage to the patient. He suggests that combination therapies can be more effective and shows a table listing the effects of combination chemotherpay on testicular cancer. Time start: 00:37:24:00 Time end: 00:41:52:00 Length: 00:04:28:00

Segment 10 McElwain discusses lymphatic leukaemia which responds well to chemotherapy. He gives statistics for the successful treatment of the disease and shows a short film of the leukaemia unit of the Royal Marsden Hospital, where children are treated. He discusses how different kinds of chemotherapy affect the child's life after treatment - single dose chemotherapy can leave children as invalids whereas combination therapies have a more positive outcome. McElwain ends the first part of this lecture by describing how important it is for a team approach to the treatment of cancer, involving surgeon, radiotherapist, diagnostician etc. Improvement in drugs can only go hand in hand with developments in the overall management of patients with cancer. Time start: 00:41:52:00 Time end: 00:47:09:14 Length: 00:05:17:14