Milestone-Proposal:COBALT-60 RADIATION CANCER TREATMENT UNIT
To see comments, or add a comment to this discussion, click here.
Docket #:2023-09
This proposal has been submitted for review.
To the proposer’s knowledge, is this achievement subject to litigation? No
Is the achievement you are proposing more than 25 years old? Yes
Is the achievement you are proposing within IEEE’s designated fields as defined by IEEE Bylaw I-104.11, namely: Engineering, Computer Sciences and Information Technology, Physical Sciences, Biological and Medical Sciences, Mathematics, Technical Communications, Education, Management, and Law and Policy. Yes
Did the achievement provide a meaningful benefit for humanity? Yes
Was it of at least regional importance? Yes
Has an IEEE Organizational Unit agreed to pay for the milestone plaque(s)? Yes
Has the IEEE Section(s) in which the plaque(s) will be located agreed to arrange the dedication ceremony? Yes
Has the IEEE Section in which the milestone is located agreed to take responsibility for the plaque after it is dedicated? Yes
Has the owner of the site agreed to have it designated as an IEEE Milestone? Yes
Year or range of years in which the achievement occurred:
1951
Title of the proposed milestone:
Cobalt-60 Radiation Cancer Treatment Machines, 1951
Plaque citation summarizing the achievement and its significance:
In 1951, two Canadian teams of medical physicists, engineers, and radiation oncologists in London, Ontario and Saskatoon, Saskatchewan independently, yet cooperatively, designed and assembled the first treatment machines that directed gamma radiation produced by radioactive cobalt-60 onto cancerous tumours in patients. First applied at Victoria Hospital, London on 27 October 1951, this revolutionary treatment has since been used to extend the lives of millions of patients around the world.
French: TBD
200-250 word abstract describing the significance of the technical achievement being proposed, the person(s) involved, historical context, humanitarian and social impact, as well as any possible controversies the advocate might need to review.
The development and use of cobalt-60 cancer treatment machines made a significant and positive contribution to health care worldwide. While X rays produced by X-ray tubes had been used for cancer treatment since the 1920s, their energy was not sufficiently high to achieve adequate and focused penetration to deep-seated lesions in the body. Radium sources had been used with some success but was very expensive. Dr. Harold Johns, a Canadian medical physicist, recognized that cobalt-60, which could be produced in a nuclear reactor, had a long enough half-life and emissions of sufficient strength to potentially replace radium. He provided the guiding force that led to development of a suitable source, a machine to contain it, and a methodology and data to control it that were still required before this potential could be realized in a practical setting. Development and calibration of a cobalt-60 radiation therapy machine proved effective for treatment of deep-seated tumours, and in 1951 two teams of medical physicists, engineers, and radiation oncologists in London (Ontario) and Saskatoon (Saskatchewan), independently, yet cooperatively, designed the first cobalt-60 radiation treatment machines or “cobalt bombs”. These machines directed gamma radiation directly on cancerous tumours. The first use of the cobalt treatment was on 27 October 1951 at Victoria Hospital, London. Decades of effective worldwide use and the many millions of lives extended have proven the efficacy of this technology and the benefit to humanity.
IEEE technical societies and technical councils within whose fields of interest the Milestone proposal resides.
Engineering in Medicine and Biology Society (EMBS)
Nuclear and Plasma Sciences Society (NPSS)
In what IEEE section(s) does it reside?
London (R70007) and North Saskatchewan (R70039) (both R7)
IEEE Organizational Unit(s) which have agreed to sponsor the Milestone:
IEEE Organizational Unit(s) paying for milestone plaque(s):
Unit: North Saskatchewan Section
Senior Officer Name: Adam Detillieux
Unit: London Section
Senior Officer Name: Dennis Michaelson
Unit: IEEE Canada
Senior Officer Name: Tom Murad
IEEE Organizational Unit(s) arranging the dedication ceremony:
Unit: North Saskatchewan Section
Senior Officer Name: Cosme Loi
Unit: London Section
Senior Officer Name: Dennis Michaelson
IEEE section(s) monitoring the plaque(s):
IEEE Section: North Saskatchewan
IEEE Section Chair name: Cosme Loi
IEEE Section: London
IEEE Section Chair name: Dennis Michaelson
Milestone proposer(s):
Proposer name: Murray MacDonald
Proposer email: Proposer's email masked to public
Proposer name: Denard Lynch
Proposer email: Proposer's email masked to public
Please note: your email address and contact information will be masked on the website for privacy reasons. Only IEEE History Center Staff will be able to view the email address.
Street address(es) and GPS coordinates in decimal form of the intended milestone plaque site(s):
London ON: 42.959725893147514, -81.22562213293283.
Saskatoon SK: 52.136222, -106.630443
Describe briefly the intended site(s) of the milestone plaque(s). The intended site(s) must have a direct connection with the achievement (e.g. where developed, invented, tested, demonstrated, installed, or operated, etc.). A museum where a device or example of the technology is displayed, or the university where the inventor studied, are not, in themselves, sufficient connection for a milestone plaque.
Please give the address(es) of the plaque site(s) (GPS coordinates if you have them). Also please give the details of the mounting, i.e. on the outside of the building, in the ground floor entrance hall, on a plinth on the grounds, etc. If visitors to the plaque site will need to go through security, or make an appointment, please give the contact information visitors will need. London, ON: Victoria Hospital visitors area; adjacent to Historic Sites and Monuments Canada plaque.
Saskatoon SK: Research Centre - Saskatchewan Centre for Cyclotron Sciences
Are the original buildings extant?
No
Details of the plaque mounting:
London ON: in the garden area to the visitors’ right at the main entrance to the Cancer Program.
Saskatoon SK: on outside wall adjacent to main entrance to building.
How is the site protected/secured, and in what ways is it accessible to the public?
In both locations, the plaques will be external and available to the public on a 24-hour basis. The areas are overseen by security personal (Victoria Hospital, University of Saskatchewan) and are generally considered to have a low risk for vandalism.
Who is the present owner of the site(s)?
London ON: London Health Sciences.
Saskatoon SK: University of Saskatchewan
What is the historical significance of the work (its technological, scientific, or social importance)? If personal names are included in citation, include justification here. (see section 6 of Milestone Guidelines)
The pursuit of the “cure” for human ailments has likely been the goal of sentient beings since the Stone Age. While various herbs, potions and prayers prevailed for millennia, modern medical and technological advances within the last 200 years have accelerated at an exponential rate.[1] Modern chemistry (pharmaceuticals) has made a significant contribution to our arsenal of modern weapons against disease, but for ailments such as cancer, more tools were needed.
Röntgen’s discovery of X rays in 1895 and Becquerel’s discovery of radioactivity the next year was followed in 1898 by the isolation of radioactive isotopes suitable for medical applications by Becquerel and the Curries [1][13]. By the 1920s, the use of radiation in treatment of cancer, aka radiotherapy, was well known to be effective at killing cancerous cells, but unfortunately is equally effective at killing normal, healthy cells [2]. To be a practical and effective tool for cancer treatment, it is necessary to focus the radiation, as much as possible, on the cancerous cells. For tumors deep inside the body, it is also necessary for the radiation to penetrate sufficiently to reach its target without killing the healthy cells along its path.
Early radiotherapy had challenges with penetration, focus, intensity control, safety (for both operators and patients) and cost. It would require several subsequent serendipitous events to allow the development of radiotherapy technology that would address these early issues. Cobalt-60 and the “cobalt bomb” radiotherapy developed and first used in London and Saskatoon, Canada, were the foundation of a new era in radiotherapy technology. The development of cobalt-60 radiotherapy represented a momentous breakthrough providing much improved penetration control and reduced complications, along with much lower skin reactions, at a relatively low cost.[1][13]
Prior to the development of artificial radioisotopes, radiotherapy was largely limited to low-energy sources (kilovoltage X-ray tubes) with limited penetration capabilities. Megavoltage machines (such as betatron and Van de Graaff generator) producing megavoltage X rays have already been available during 1940s and 1950s, however, they were very sophisticated as well as costly and therefore not widely available. The significant development of cobalt-60-based treatment machines resulted in a progression from kilovoltage to megavoltage energy and was considered a giant leap forward in the practice of radiotherapy.” [1] The co-development of the “cobalt-bomb” treatment machines solved many outstanding roadblocks to a treatment option that has been credited with saving millions of lives.
The vision and dedication of the scientists involved in the development of a cobalt source led to the design and manufacture of machines that could safely hold and control the cobalt-60 source. This, combined with development of appropriate radiation dosimetry techniques, led to the first “cobalt bomb” treatments at the Victoria Hospital in London, Ontario on 27 October 1951 and at the University of Saskatchewan in Saskatoon on 8 November 1951. Thus began a new era of megavoltage radiation therapy that was cost-effective and has been benefitting millions of patients around the globe for decades [1].
What obstacles (technical, political, geographic) needed to be overcome?
While X-rays had been used for cancer treatment since the 1920s, the energy of kilovoltage X rays was not high enough to allow the treatment of cancerous growths deep inside the body. The radioactive isotope radium-226 was used to provide a higher energy source, but its high cost, limited penetration, and safety issues severely limited its use for widespread cancer treatments. Nuclear work in the 1930s and 1940s resulted in the capability to produce artificial nuclear isotopes, one of which was cobalt-60, with a long enough half-life and sufficiently energetic to potentially be useful as a treatment radiation source. The development of a suitable source, a machine to contain it, and a methodology and data to control it were still required before this potential could be realized in a practical setting.
What features set this work apart from similar achievements?
A comprehensive review of the chain of events that led to the introduction of cobalt-60 radiotherapy was presented by Van Dyk in 2020 [1]. The essential aspects of cobalt-60 radiotherapy are described in a Wikipedia article [2]. Professional guidance concerning external beam radiotherapy, including cobalt-60 radiotherapy, are presented in [3]-[5]. Contemporary accounts of the introduction of cobalt-60 radiotherapy include [6]-[8]. Retrospective accounts of the development of cobalt-60 radiotherapy that have appeared in various professional journals include [9]-[12]. Accounts of the 60th anniversary celebrations of the first treatment are given in [13] and [14]. In 2020, the contributions of Sylvia Fedoruk to the initial work at the University of Saskatchewan were highlighted in a biography and associated news releases [15], [16].
At the time of its development, the main “competitors” to a cobalt-60-sourced radiation tool were kilovoltage X rays and radium-226-based radiation treatment (teleradium machines). All were ineffective for treatment of deep-seated tumours, were relatively expensive and had safety concerns. As described above and in the references, effective high-energy x-ray treatment involved intimidating, massive machines to achieve the high voltages required but yet were still limited in depth of penetration and were therefore ineffective for deep-seated cancerous growths. The high voltages required to be even reasonably useful made this option expensive and the output was also inconsistent, resulting in complicated dosage control. Radium-226 radiation was also plagued by only shallow penetration limitations and radium sources were relatively expensive. Moreover, the radium-226 decaying process also resulted in a radioactive gas and associated safety concerns for operators.
Cobalt radiation treatment grew out of a collaboration and coincidence of events that addressed the limitations and shortcomings of previous cancer treatment options. Nuclear reactor developments in the 1930s and 1940s allowed the transformation of naturally-occurring cobalt-59 into a relatively long-lived isotope cobalt-60, which allowed medical physicists to envision and propose the use of artificial radioactive isotopes in cancer treatment. The capability and willingness of Chalk River scientists to develop cobalt-60 sources and the enthusiastic uptake of the opportunity by researchers and medical personnel to design and build working therapy machines resulted in practical radiation therapy being introduced to the oncological community in very short order after the necessary pieces were in place.
Supporting texts and citations to establish the dates, location, and importance of the achievement: Minimum of five (5), but as many as needed to support the milestone, such as patents, contemporary newspaper articles, journal articles, or chapters in scholarly books. 'Scholarly' is defined as peer-reviewed, with references, and published. You must supply the texts or excerpts themselves, not just the references. At least one of the references must be from a scholarly book or journal article. All supporting materials must be in English, or accompanied by an English translation.
References
Reviews
[1] J. Van Dyk, J. J. Battista and P. R. Almond, "A Retrospective of Cobalt-60 Radiation Therapy: "The Atom Bomb that Saves Lives"," Medical Physics International, Special Issue on the History of Medical Physics, vol. 4, pp. 327-350, 2020.
[2] "Cobalt Therapy," Wikipedia, 4 May 2020. [Online]. Available: https://en.wikipedia.org/wiki/Cobalt_therapy [Accessed 25 September 2020].
Professional Guidance
[3] E. B. Podgorsak, "Treatment Machines For External Beam Radiotherapy," in Radiation Oncology Physics: A Handbook for Teachers and Students, Vienna, International Atomic Energy Agency, ch. 5, 2005.
[4] B. R. Page et al., "Cobalt, Linac, or Other: What Is the Best Solution for Radiation Therapy in Developing Countries?," International Journal of Radiation Oncology Biology Physics, vol. 89, no. 3, pp. 476-480, 2014.
[5] L. J. Schreiner, C. P. Joshi, J. Darko, A. Kerr, G. Salomons, S. Dhanesar, "The role of Cobalt-60 in modern radiation therapy: Dose delivery and image guidance," Journal of Medical Physics, vol. 34, no. 3, (ICMP 2008 Special Issue), pp. 133-136, 2009.
Contemporary Accounts
[6] University of Saskatchewan, "cobalt60.usask.ca," University of Saskatchewan Archives, 01 January 1952. [Online]. Available: https://cobalt60.usask.ca/timeline.php#1951. [Accessed 16 June 2023].
[7] E. Hutton, "The Atom Bomb That Saves Lives," Maclean's Magazine, pp. 7-9, 49-53, 15 February 1952.
[8] L. M. Miller and J. Monahan, "Cobalt 60 - "Poor Man's Radium,"" Reader's Digest, pp. 42-46, October 1952.
Retrospective Accounts in Professional Journals
[9] M. D. Schultz, "The Supervoltage Story," The American Journal of Roentgenology, vol. 124, no. 4, pp. 541-559, 1975.
[10] C. S. Houston and S. O. Fedoruk, "Saskatchewan's role in radiotherapy research," Canadian Medical Association, vol. 132, pp. 854-864, 1 April 1985.
[11] R. F. Robison, "The race for megavoltage - X-rays versus telegamma," Acta Oncologica, vol. 34, no. 8, pp. 1055-1074, 1995.
[12] S. Gibson, "Beaming with confidence," The Ontario Technologist, pp. 16-18, Mar./Apr. 2016.
60th Anniversary Celebrations
[13] London Health Sciences Centre, "Celebrating the 60th anniversary of the world's first cancer treatment with cobalt-60," 27 October 2011. [Online]. Available: https://www.lhsc.on.ca/about-lhsc/celebrating-the-60th-anniversary-of-the-worlds-first-cancer-treatment-with-cobalt-60. [Accessed 25 September 2020].
[14] CBC News, "Cobalt bomb officially unveiled at Saskatoon museum," 4 December 2011. [Online]. Available: https://www.cbc.ca/news/canada/saskatchewan/cobalt-bomb-officially-unveiled-at-saskatoon-museum-1.1102354. [Accessed 16 June 2023].
Biography - Sylvia Fedoruk
[15] "New Biography Sheds Light on Fedoruk's Radiant Life," USask Research Profile and Impact, 11 September 2020. [Online]. Available: https://news.usask.ca/articles/people/2020/new-biography-sheds-light-on-fedoruks-radiant-life.php. [Accessed 17 July 2023].
[16] J. Shewaga, "University of Saskatchewan," 13 November 2020. [Online]. Available: https://news.usask.ca/articles/research/2020/uniquely-usask-cobalt-60-treatment-at-usask-made-medical-history.php. [Accessed 16 June 2023].
Supporting materials (supported formats: GIF, JPEG, PNG, PDF, DOC): All supporting materials must be in English, or if not in English, accompanied by an English translation. You must supply the texts or excerpts themselves, not just the references. For documents that are copyright-encumbered, or which you do not have rights to post, email the documents themselves to ieee-history@ieee.org. Please see the Milestone Program Guidelines for more information.
Compiled by the proposers
[1] Media:A_Retrospective_of_Cobalt-60_Rediation_Therapy.pdf
[2] Media:Beaming_with_Confidence_fromOACETT.pdf
[3 ]Media:60th_anniversary_of_first_cancer_treatment_with_Cobalt-60_LHSC.pdf
[4] Media:Cobalt_therapy_Wikipedia.pdf
[5] Media:Cobalt_timeline_UofS_1951.pdf
[6] Media:canmedaj00258-0132.pdf
[7] Media:Cobalt_bomb_officially_unveiled_at_Saskatoon_museum_CBCNews.pdf
[8] Media:Fedoruk_radiant_life.pdf
[9] Media:The_Race_For_Megavoltage_X-Rays_Versus_Telegamma.pdf
[10] Media:The_Cancer_Bomb_Nov-2020_Shewaga.pdf
[11] Media:The_Atom_Bomb_That_Saves_Lives_Macleans_FEBRUARY-15-952.pdf
[13] Media:Cobalt_Linac_or_Other_What_Is_the_Best_S.pdf
[14] Media:Western_News_Battista_Cobalt-60_celebrates_60_years.pdf
Please email a jpeg or PDF a letter in English, or with English translation, from the site owner(s) giving permission to place IEEE milestone plaque on the property, and a letter (or forwarded email) from the appropriate Section Chair supporting the Milestone application to ieee-history@ieee.org with the subject line "Attention: Milestone Administrator." Note that there are multiple texts of the letter depending on whether an IEEE organizational unit other than the section will be paying for the plaque(s).
Please recommend reviewers by emailing their names and email addresses to ieee-history@ieee.org. Please include the docket number and brief title of your proposal in the subject line of all emails.
