[Speaker 1] I'm sorry about that.
[Speaker 2] I'm sorry you want to say that again? (laughing).
[Speaker 1] I'll say that again for the record. (laughing).
[Speaker 2] Say that exactly.
[Speaker 1] Of course, it seems to me
that in cancer therapy,
nothing so sure thing when you go into it,
I think one is cancer is a complex disease,
and it's always very difficult to know
whether the theories that you put forth to treat it,
whether they're right or not.
[Speaker 3] Well, among you Physicists that are
there inside jokes about
this it may go the same way the cyclotron did.
[Speaker 1] Well, no, but there are camps.
Obviously there are camps.
There are people who will
say protons are the way
to go because we can now really put very high doses,
where we want to put them very low dose elsewhere
in the body and so this is the way to go.
Though it's expensive if we can set it up,
so we treat a lot of patients on an average
the cost added may not be
as expensive as we think it is.
There are others who say, well,
the modern techniques now with
a computer-controlled linear accelerator and
intensity-modulated radiation therapy emoting leaf
collimators and the device is
called a tomotherapy,
which is another device which uses low-energy x-rays.
There are people that say with the x-rays
and with these modern approaches,
we can almost approach
the same (crosstalk) thing the protons.
There are people that already
know at least different camps.
The cost of the protons is very
expensive but if it does prove that,
they can be one or two national centers for some size,
maybe it's worth it.
Yeah, I think it just has to be tried,
I don't think it needs to be tried everywhere.
Loma Linda is a good place,
and I've known that group for
many years I think they're doing a good job,
but you wouldn't want to go to a much smaller place,
you don't want to put it in,
you got to go to the MD Anderson,
and that's this general, and say let's
see what we can get with proton therapy.
I will say this,
for example, on the neutrons,
which was an expensive program,
took a lot of time to do,
but we learned as much about
conventional radiation therapy from
that project as we did read almost anything else.
We learned a lot which help what we're doing today,
and we learned some radiation biology,
we learned some physics we learned things about
fractionation and other stuff
which are still important today.
My program stopped,
and neutron therapy didn't work out.
The knowledge that we got out of it
is certainly been very helpful today,
and that'll come out of the proton project
whether it's really successful or not,
we'll learn a lot that will be applied in
the future that's just the way one does things.
But it is a big project,
it's certainly on paper,
and you never start at any of
these projects without at least theoretically
seeing a good advantage that's why you do
it and hope that
your theories and your ideas and things are right.
[Speaker 3] Do you remember when they dismantled a cyclotron?
[Speaker 1] No, I wasn't here. (inaudible)
[Speaker 2] Because you said something about it
as you unfold to
us to this finale as long-term competence got too high,
what period time is this?
[Speaker 1] Well, it's certainly at 5,10,15 years,
so we started neutron therapy in
the late 60s I think here with A&M, for example.
We've now got a very long experience and cross
the cyclotron went bad in
the late 1980s that program was stopped,
maybe in the 1990s,
but anyhow it's been over 10 years.
Now we got those follow-ups,
but we treated for a long time,
but certainly even after
two or three years on certain patients,
you could tell the complications
that they would be most severe.
I will say this, they were no more severe than some of
the complications some 40 years ago of X-rays treatments,
which at times could be very severe.
[Speaker 3] Or an untreated tumor.
[Speaker 1] That's the problem. (laughing) What's the alternative?
Or of surgery.
Surgery can result in a lot of
complications or difficulties and well,
Fletcher was used to say about radiation therapy,
very often the unknown complications.
He would very often know that there would
be not a way out,
but at least you could deal with
the complication either with
surgery or some other form of treatment.
For him, it was
let's try this and if you get a complication,
then we can deal with it surgically
rather than go ahead surgically and do it like that.
(crosstalk) your quality of life must be better.
I think you always have to look at that and say,
"Well, let's try this."
The complications, I think
equality of life is going to be
better if you get complications.
For example, he would,
with the head and neck people in one of
his big arguments that you get
a larynx tumor and
the surgeons always wanted to take the larynx out,
Fletcher knew he could treat it and save his voice box.
[Speaker 3] Then they can speak the rest of their life.
[Speaker 1] They can speak for the rest of their life,
and they could swallow for the rest of
their life and all the rest of it and that's why
he used to get that some of
the cases so upset because it was
the complications of the surgery sure they were cured of
their cancer quality of life was just terrible,
and then he said, I can treat them,
I'll have a cure rates that are
90 something to percent and
for the 10 percent
that we can go back do the surgery. (crosstalk)
[Speaker 3] Take it out that's right, yeah.
[Speaker 1] Do the surgery whereas
the surgeons and pull that was way back,
wanted to just go ahead and do the operation and was in
those areas that can really
have some tried to discussions (laughing).
[Speaker 3] I've seen some letters (laughing)
[Speaker 1] I've seen his staff in tears,
literally in tears, it was interesting.
[Speaker 2] (inaudible) You mean screaming at them or?
[Speaker 1] Yeah, I was just so upset so
the animosity in the fights
that would go on into clinics,
not in front of the patients.
(laughing) But he wouldn't
mind stating what he thought if real.
[Speaker 3] He always seemed worried too real often
that some of them
didn't refer enough patients to him to
apprehend to sustain his studies.
[Speaker 1] That was the other thing
and I don't know what it's like that,
but way back then,
you would put in and enter into
a national trial on the subtle promise that she would get
so many patients to treat
and when that didn't happen then he would get
very upset and that happened on a lot of
cases and to some extent on the neutrons
also because patients had to be entered
into the traps and there
was a national neutron trial going on,
and we need to submit patients,
but hadn't breast was always a problem
with he used the get sick because he
couldn't get patient and do his studies.
That was the fight between
the surgeons and then when the chemotherapies
came along one was just I'm
a three-way fight for the patients.
[Speaker 3] How about Philip Rutledge study
in gynecology did he get along better with Fletcher?
[Speaker 1] Oh yeah he and Fle were very good friends
(crosstalk) and he and become the next order,
there were people that Fletcher got along very
well with and there
were people who he didn't get along very well,
and the people who'd want
to get along with him even though he was difficult.
Felix was a very good friend of his yeah,
who would work very closely with him.
[Speaker 2] He's stumbling a lot is he?
[Speaker 3] Rutledge, I don't think so I think he did.
[Speaker 1] I don't know.
[Speaker 3] I think I get it. (inaudible)
[Speaker 2] Rahm's still here
[Speaker 3] Oh, Rahm style love.
[Speaker 2] I sit in the library here.
Yeah. (crosstalk)
[Speaker 3] We're getting close to three o'clock for
your wife there. (crosstalk).
[Speaker 2] Almost.
[Speaker 3] Perfect. Thank you very much.
[Speaker 1] Give me a call if you need anything else.
[Speaker 3] I'm trying to think of something so. (laughing)
[Speaker 1] Well, I'm in,
in and out like you are (crosstalk) and
I don't have any set duties,
so it's not (crosstalk)
[Speaker 2] You're doing a lot of work in your history.
[Speaker 1] Yeah, but I'm just doing that and writing some things.
I will have some teaching responsibilities in the fall,
but that's not going to take too much time.