London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1934

[Report of the Medical Officer of Health for London County Council]

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RADIOTHERAPEUTIC CLINIC : LAMBETH HOSPITAL.
Report for the year ending 31st December, 1934.
By George F. Stebbing, M.B., B.S., F.R.C.S.(Eng.), Surgeon Specialist;
P. Berry, M.D., B.S., M.R.C.S., L.R.C.P., Senior Assistant Medical Officer:
and
T. M. Robb, M.R.C.S., L.R.C.P., Assistant Medical Officer, Lambeth Hospital.
During the year ending 31st December, 1934, 550 new patients were placed
on the records of the radiotherapeutic clinic, excluding those who were treated in
the special department for carcinoma of the uterus. Most of these patients were
in the hospital for at least a few weeks and some of them for several months.
During the year, 1,007 patients suffering from malignant tumours were discharged
from, or died in, Lambeth hospital. This number includes all cases in
which the diagnosis of a malignant tumour was made, although many of them
had tumours in such a position or of such a nature that neither surgery nor radiation
could offer them any relief. For some of them the diagnosis was only made at the
post-mortem examination, and in other cases the patient was treated entirely by
surgery. Whenever any member of the staff thought that there was a possibility
of radiotherapy being the treatment of choice for the patient, the patient was sent
to the radiotherapeutic clinic. Some patients for whom it was proposed to undertake
radiotherapy treatment did not in fact receive any treatment, either because the
necessary preparation could not be made owing to the patient's feeble condition,
or because the patient was unwilling to co-operate in the treatment. In previous
reports it has been pointed out that a large number of patients sent to the clinic
are suffering from malignant tumours in an advanced stage, sometimes even with
widely spread metastases, and some are so infirm from constitutional disease that
treatment is extremely difficult, even when there is a prospect of making the patient
more comfortable by it. There are also sent to the clinic a large number of patients
who have already had treatment for a malignant tumour, either by surgery or by
radiotherapy, at some other hospital, and this type of case is increasing in number
as compared with previous years.
The table that has been prepared this year to show the result of treatment has
been very much simplified, as it was found, that with increasing numbers, the clerical
work of preparing a table on the Stockholm principle was too great to be undertaken.
Table II shows the number of patients that have started treatment in each year
since April, 1930, for each disease or stage of disease, and gives their crude survival
number at the end of each year after the commencement of treatment. No attempt
has been made to correct these figures or to produce the survival rate after the
deduction of untreated cases, untraced cases, or patients that have died of an intercurrent
disease, but the number of these has been entered in the end column.
Such a table is published so that comparison may be made with those of other
clinics, but it does not show the value of radiotherapy in the palliation of disease
which has gone beyond the stage of recovery. A very large proportion of those
who have been treated during the year, and many of those treated in previous
years, although not completely recovered from their growth, have been rendered
comfortable, and often even symptom free, for periods of many months on end.
although the disease proved fatal in the end. This palliative action of radiotherapy
needs to be emphasised. There is a growing demand for statistical evidence of the
value of any particular treatment in disease, and this demand has been largely
created by the radiotherapists, who were the first to make compilation of such
statistical records a principal feature of the clinics in which they worked. Given
a very large number of patients, observed over a period of many years, the value of a
treatment as a life-saving measure can be very accurately gauged from carefully
compiled statistics. It is important, however, to remember that there are many
things which are not capable of statistical expression ; and even in the best and
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