Letters Sent to Dr. Frederick B. Flinn, November 4, 1925

COPY RADTUM CHEMICAL COMPANY Pittsburgh,Pa. November 4,1925 Dr. Frederick B. Flinn, 437 West 59th St., New York,N.Y. Dear Doctor: Replying to your letter of October 25th, regarding the effect on tisrue of long continued exposures of radiom. I am very sorry to say that I do not have any reprints on this particular subject, but the case quoted by Dr. Pfahler is somewhat as follows: The original lesion was supposed to be an osteosarcoma situated in the left gluteal region. It was operated in an Eastern Clinic and promptly returned; was operated a second time, with a very rapid return. The first operation was about 13 years ago. After the second operation the returned mass was rayed and during the next 12 years, this patient received over this region 135,000 milligram hours of radium. This was delivered at irregular periods and included surface radiation with screened radium, using slight distance, 50 to 300 milligrams at each application. It also included interstitial radiation from steel needles containing 12, milligrans each. As stated, the radiation was given at irregular periods and was used, for the most part, on nodules although the base of the lesion was frequently rayed after the sloughing tissue had been removed by the cautery to prevent absorption. For a long period after radiation it was impossible upon microscopic examination to find other than dense fibrous tissue, but finally the growth was found to be a neurosarcoma, which it had probably been from the beginning. The interesting part of this case was that in spite of this large amount of radiation, the normal surrounding tissue did not seem to be damaged and the spinous processes which were exposed became ebonized instead of necrotic, and no damage whatever seemed to be present in underlying nerves. The patient finally succumbed to deep pelvic involvement, the end coming rather quickly. I have, of course, noticed the local effects on the fingers of radium W orkers and very early in my personal experience I devised methods for handling radium without digital contact, for I am quite sure that long continued short exposures of the fingers to radium applicators will in time produce a radium keratosis, with a subsequent develop- ment of a more virulent lesion - possibly a squamous cell eqptheliome. These lesions, however, must be of extremely low virulence, as I have noted one on my own finger which has been present for some seven or eight years, never disappears, does not extend and only becomes sensitive when radium is brought in contact with the lesion. I trust that this information may be of some value to you, and would ask that the case mentioned above be not quoted until the attending surgeón is ready to make a full report. (signed) William H. Cameron Medical Director.