Med School Professor Describes Method to Relieve Pain of Cancer

WASHINGTON, D.C.--An electrical current, alternating at a frequency of two million cycles per second and flowing through electrodes implanted in the frontal lobe of the brain, has been effectively used to relieve pain and suffering of patients with incurable cancer without causing major psychological damage.

Use of the radio-frequency lesion maker was described last week by Dr. James C. White, Professor of Surgery, Emeritus, at the Medical School and from the neurosurgical laboratories at the Massachusetts General Hospital. Dr. White spoke at the Second International Congress of Neurological Surgery at the Statler Hilton Hotel.

Dr. White's research was carried on in cooperation with Dr. William H. Sweet, Chief of Neurosurgery at the Massachusetts General Hospital and Associate Professor of Surgery at Harvard, and with Dr. Thomas P. Hackett, Assistant Psychiatrist at the Hospital and Instructor in Psychiatry at Harvard.

As described by Dr. White, a tiny electrode is inserted into each frontal lobe of the brain with the patient under general anesthesia. Once in place the electrode tips lie in the "inferior medial" white matter of the lobe, with the thread-thin wires, insulated by lacquer and fine teflon tubing, projecting through the scalp. When the electrodes are attached to the high-frequency electrical current, Dr. White explained, lesions, formed by coagulation of tissue, are created in the area. The process takes from five to 10 seconds. Additional lesions are created at intervals of several days by withdrawing the electrodes a centimeter at a time and reapplying the high-frequency electrical current.

"By making serial lesions at intervals of several days," Dr. White reported, "the reaction of the patient can be observed and the leucotomy carried to the point where concern over pain and need for narcotics cease."

Reporting on 21 cases of malignant disease, Dr. White said that 15 were "effectively relieved of their pain and the suffering that so often develops in the terminal stages of cancer." Five others had incomplete but "worthwhile" relief; one failed to obtain significant benefit. Another's pain was effectively relieved but the patient succumbed to pneumonia spreading from infected cancerous tissue in throat.

Patients suffering non-malignant but painful diseases, such as facial neuralgia, may also be relieved and enabled to continue without resort to narcotics.

The procedure described by Dr. White follows earlier attempts to use electrodes to achieve the same end; but previous methods, he pointed out, necessitated reinsertion of the electrode each time the extent of coagulation was increased. The use of radio-frequency current, which heats brain tissue without charring, permits repeated coagulation over an extended period of observation.

"Attempts to relieve by frontal leucotomy (lobotomy) the nagging persistent pain and dread that cancer may inflict on its victims," Dr. White said, "date back 15 years. Except as a procedure of last resort, bilateral extensive lobotomies have never been popular. The ensuing deterioration in personality and mentation can be appalling, much more so than in the psychotic who has undergone a similar procedure."