MSK Radiation Therapy: Timeline of Progress

Timeline Transcript

Timeline of Progress

Memorial Sloan Kettering was one of the first medical institutions to recognize the potential of radiation for cancer treatment. Since then, MSK has continued to pioneer new developments in the field, right up to the present day.

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—First x-ray machines installed

Just six years after German physicist Wilhelm Röntgen announced his discovery of “X-radiation” (x-rays), Memorial Hospital obtains two x-ray machines for use in treating cancer. The machines are acquired with the help of surgeon William Coley, an early supporter of the technique.

—Benefactor provides support for radiation therapy

Scientist and mining engineer James Douglas, whose daughter died of breast cancer, gives the first of several large financial donations to Memorial Hospital. The donations come with the stipulation that the hospital focus solely on cancer and that radiation be used in its treatment.

—Prostate cancer treatment pioneered

Memorial Hospital surgeon Benjamin Barringer pioneers the first brachytherapy treatment of prostate cancer using radon-filled needles inserted into the prostate gland through the perineum.

—Pioneer of medical physics joins Memorial Hospital

Physicist Gioacchino Failla is hired as the first Director of Medical Physics (then the Radium Department) at Memorial Hospital. Dr. Failla, who obtained his PhD with Marie Curie in Paris, would become a giant in the field, pioneering several new techniques in both external- and internal-beam radiation.

—Memorial Hospital acquires large gift of radium

James Douglas donates 3.75 grams of radium to Memorial Hospital for use in radiation therapy. The radium is stored in a vault in the hospital basement. Emanations of radon gas are collected and used in treatment.

—External beam radium device developed

Memorial Hospital medical physicist Gioacchino Failla develops the first external-beam radium therapy device, known as a "radium element pack" or a "radium bomb," to treat cancers located in the chest, brain, and abdomen.

—Standard radiation dosing tables developed

Memorial Hospital physicist Edith Quimby devises many of the dosing tables that will be used in radiation therapy for several decades. She also develops the radiation "film badge" — for many years a standard way to detect accidental exposures. 

—Marie Curie visits Memorial Hospital

Marie Curie — who with her husband, Pierre, discovered radium in 1898 — visits Memorial Hospital on a tour of the US. She is particularly interested in seeing the radium vault, with its semiautomatic radon collection system devised by Gioacchino Failla.

—Memorial Hospital acquires more radium, and a nickname

Through various donations, Memorial Hospital acquires nine grams of radium — more than anywhere else in the world — earning the nickname "Radium Hospital."

—MSK scientists consult on "Radium Girls" court case

MSK scientists James Ewing and Lloyd Craver serve as advisors in a landmark workers' compensation case involving radium. Before its health hazards were widely known, radium was used in many commercial products, including glow-in-the-dark paint for watch dials. Dial painters — most of them women — became sick from radiation exposure, some developing cancer.

—Total body irradiation unit opens

Arthur C. Heublein and Gioacchino Failla install a total body irradiation unit at Memorial Hospital to treat Hodgkin’s disease and lymphoma. Patients lived in the unit for two to three weeks while being administered low-level radiation. This procedure, which destroys cancer cells in the bone marrow, paved the way for bone marrow transplants and is still in use today.

—Powerful x-ray machine obtained

Memorial Hospital acquires a one-million-volt x-ray machine, one of the first of this size in the US. This machine is used to deliver focused beams of radiation to tumors located deep inside the body.

—New radiation facilities open

Memorial Hospital opens in its new location on 66th Street and York Avenue, with modern radiation facilities. Shown here is a treatment control room with a 250-kilovolt x-ray machine.

—Radioactive "seeds" produced

MSK pioneered the collection of radon gas in gold "seeds” for use in internal radiation therapy, or brachytherapy. The gold capsule filters out the beta rays that cause burns and inflammation while permitting gamma rays to pass through.

—Betatron installed

Memorial Hospital acquires a 24-million-volt electron machine, dubbed the betatron — the first to be installed in a cancer center. The betatron delivers high-energy electrons directly and precisely to the site of a tumor. It would be used at MSK for the next 25 years to treat breast, head and neck, cervical, and other cancers.

—Afterloading technique developed

MSK radiation oncologist Ulrich Henschke develops a system for administering internal radiation by sending a radioactive pellet down a catheter that could be removed after use, termed "afterloading." This helps decrease radiation exposure to doctors, nurses, and other healthcare workers.

—I-125 seeds used for prostate cancer

MSK radiation oncologists Basil Hilaris and Ulrich Henschke begin using radioactive iodine (I-125) seeds to treat prostate cancer, an approach that would become standard practice. These seeds are much safer than radium as a source of radiation.

—Isotopes developed for treatment and research

A cyclotron, nicknamed "Betsy," is installed at the Sloan Kettering Institute and begins producing radioactive isotopes for treatment and research. These isotopes are useful for detecting and treating cancer in the body.

—Linear accelerator acquired

The Therac-20, a 20-million-electron-volt linear accelerator, is acquired by MSK. It can deliver high-energy electrons or x-rays to a patient's tumor in a highly focused manner. Future iterations would become popularly known by their trade names, such as CyberKnife and TrueBeam.

—Hellman becomes Physician-in-Chief

As MSK's Physician-in-Chief, Samuel Hellman pioneers the use of external-beam radiation in combination with lumpectomy for women with early-stage breast cancer, lessening the need for more-extensive breast surgeries.

—Fuks named chair

MSK radiation oncologist Zvi Fuks becomes chair of the department. Dr. Fuks is one of the principal developers of three-dimensional conformal radiation therapy and intensity-modulated radiation therapy (IMRT), two sophisticated computer-guided techniques that deliver radiation to tumors with minimal exposure to surrounding healthy tissue.

—Dose painting and dose sculpting developed

MSK medical physicist Clifton Ling and radiation oncologists Steven Leibel and Zvi Fuks develop dose painting and dose sculpting. These methods allow more-targeted delivery of radiation to the precise three-dimensional shape of a tumor.

—Computer-aided brachytherapy pioneered

MSK radiation oncologists and medical physicists pioneer real-time computer-aided visualization and dose calculations to improve brachytherapy for prostate cancer.

—IMRT used in treatment of breast cancer

MSK radiation oncologist Beryl McCormick and colleagues publish results on intensity-modulated radiation therapy (IMRT) for breast cancer. This represents a novel way of delivering radiation therapy, with fewer side effects.

—Radiation plus chemotherapy shown to benefit lymphoma

MSK radiation oncologist Joachim Yahalom publishes results showing benefits of combined chemotherapy and radiation in refractory Hodgkin’s lymphoma.

—IMRT for prostate cancer shown to improve outcomes

MSK radiation oncologist Michael Zelefsky and colleagues publish results of larger study showing that high-dose intensity-modulated radiation therapy (IMRT) is safer and more effective than previous methods such as three-dimensional conformal radiation therapy.

—3-DCRT for lung cancer advanced

MSK radiation oncologist Kenneth Rosenzweig and colleagues report results of three-dimensional conformal radiation therapy (3-DCRT) for non-small cell lung cancer showing that it is safe and effective.

—Expert in DNA repair genes named chair

Simon Powell is named Chair of Radiation Oncology at MSK. Dr. Powell is an expert in understanding how DNA-repair genes such as BRCA1 and BRCA2 work to fix DNA damage from radiation, and how a patient's genetics may influence his or her response to radiation therapy.

—IMRT for spine metastases shown effective in spine metastases

MSK radiation oncologist Josh Yamada publishes results on high-dose single-fraction intensity-modulated radiation therapy (IMRT) for spine metastases. This is a radical and new approach to spinal radiotherapy that has dramatically changed how this disease is treated.

—High-dose stereotactic radiosurgery developed

MSK radiation oncologists develop a stereotactic radiosurgery technique to allow single-day, high-dose treatment of metastatic brain tumors. In comparison, conventional therapies can take up to six weeks.

—SHARP introduced to treat prostate cancer

MSK pioneers the use of stereotactic hypofractionated accelerated radiation therapy to the prostate (SHARP). SHARP can deliver ultrahigh doses of radiation in only five treatment sessions, compared with close to 50 sessions over ten weeks using the conventional approach.

—Radiation and immunotherapy synergy explored

MSK radiation oncologists Christopher Barker and Josh Yamada, along with cancer immunologists Jedd Wolchok and Michael Postow, publish an article in the New England Journal of Medicine showing how radiation may work with immunotherapy to help patients. This combination of radiation therapy and immunotherapy is now being tested in clinical trials at MSK.

—Proton therapy used for delicate tissues

The unique physical properties of protons allow them to deliver the dose of radiation at a specific depth in the body, lowering the damage to normal tissues. Currently, this technology is used most often for head and neck tumors and for pediatric cancers.

—New approach to breast cancer treatment pioneered

MSK radiation oncologist Alice Ho, in collaboration with Radiation Oncology Chair Simon Powell, develops a new radiation treatment plan that spreads the radiation dose over a larger number of beams. This makes it possible to cover the area more thoroughly without endangering the patient.

—IMRT for mesothelioma shown to be safe and effective

Andreas Rimner, Abraham Wu, and colleagues publish results from a phase II clinical trial showing that hemithoracic intensity-modulated radiation therapy (IMRT) for mesothelioma is safe and effective. This approach represents a new lung-sparing treatment option for patients.