Is it really worth it? Is it worth to invest Billions of Swiss Francs in the discovery of a new particle? And does the result really improve people´s lives? What benefit does physics bring to people? Which impact does it have on the medical field? These were some of the questions that the physicist Martina Bucciantonio (35) and medical doctor Franco Cavalli (71) passionately discussed in Locarno on April 4th 2014. The discussion under the headline “Living matter or dead matter” took place in Locarno´s high school in front of 50 pupils attending 13th grade. It was facilitated by journalist Gerhard Lob.
Pupils associate the term “physics” probably foremost with the dynamic of solids, the principle of thermodynamics, of electrical circuits and a lot of mathematics. Only after second thought do x-rays that are used at doctor´s offices perhaps come to mind. However, their discovery by Wilhelm Röntgen on November 8th 1895 was revolutionary. He applied the x-rays for the first time on December 22nd to take an image of his wife´s hand (maybe it was the hand of another person). Martina Bucciantonio started her presentation with this little excursion into Röntgen´s discovery. She is currently working on her PhD thesis at CERN in Geneva. Her dissertation is focused on medical applications of particle physics, especially the hadron therapy.
First the scientist spoke of her personal career. She recounted how she was torn between a major in Physics versus one in Medical studies when she started college. “After I had decided in favor of physics I first fancied going into basic scientific research. But then I decided for the application oriented field of studies.” After completing her degree in Pisa she moved to the USA to work at Fermilab, America´s premier particle physics laboratory, and then joined CERN at Geneva, “this fascinating melting pot of people from over 100 different countries”, as she puts it. And what will be the next career step for the particle scientist? Hard to say. The lives of scientists somehow resemble the lives of mendicants in the middle ages. They are constantly moving from one place to another. Challenges and compromises in their private lives have to go along with this pattern.
15000 particle accelerators
Does scientific research have a benefit? This is one of the ever reemerging questions. The answer is: Of course it does. The Large Hadron Collider (LHC) at CERN is the world´s biggest particle accelerator but by far not the only one. Around 15 000 particle accelerators exist worldwide. They operate in clinics and health resorts as well as in radiotherapy: One field is the traditional radiotherapy that uses electromagnetic waves and foremost x-rays.
Beside that, the new hadron therapy that uses protons and ions has been introduced. Both therapies have completely different characteristics. “While photons impact on the surface, energetic particles like protons penetrate deeper, even dozens of centimeters into the tissue. There the energy discharges at a clearly defined location”, Bucciantonio explains. “This makes proton therapies very useful in hitting a target like a deep lying tumor. Its location has to be determined exactly in advance in order to prevent a damage to the surrounding tissue.”
Next to the physicist sits doctor Franco Cavalli, an internationally renowned oncologist. Originally he dreamed of becoming a journalist, he remembers. But his father demanded of him to learn something “reasonable”. Back then students from the Ticino only had the choice between becoming engineers, lawyers and doctors. He decided for the latter, assuming that he would be able to realize his political and socials ideals in a very innovative field of medicine at that time: psychiatry. “The movement thought that the “insane patients” could be useful to the revolution”, Cavalli remembers the beliefs of that time. But he soon turned away from it and focused on Internal Medicine, especially on Oncology. In this field he thought he would be able to reconcile his thirst for scientific knowledge with his political passion. “Malignant tumors are caused in 50 percent of the cases by the behavior of people suffering from cancer and by environmental influences. There is direct link to society, especially as oncology encompasses many medical aspects from biochemistry and genetics to the patient´s psychology.” Psychology is a very important part of oncology. “Cancer patients evoke the thought of death, that is why we want to avoid them. The patients tend be ostracized. Their oncologist on the contrary makes them feel accepted and well taken care of.”
So far the clinical viewpoint has been presented. But what role does scientific research play in this? Here the oncologist´s and the physicist´s paths cross. “Cancer will always exist because living matter cannot exist without a transformation process”, says Cavalli. But even if you cannot eradicate this illness you can learn to deal with it. The last decades have brought immense and encouraging progress, says the doctor: In the 1970s only 15 percent of cancer patients survived, today the rate has reached 50 percent. “The collaboration of researchers and doctors is essential”, adds Bucciantonio. “This is true for medical physics whose task it to guarantee smoothly functioning medical appliances and to set up a therapy plan, but also for the physicists who work in basic research. Doctors can provide physicists with important suggestions and new ideas.”
How efficient is hadron therapy? Bucciantonio: “We still need time to collect statistic evidence from hadron therapy to compare it with conventional approaches. But we are on a good track. However, statistics have to take into account the time spans in which patients were treated with different methods. Otherwise a comparison is impossible.”
A pupil asks about the best-known causes for cancer. “Asbestos, tobacco, alcohol, infections, toxic substances and radiation. These factors create an initial damage from which a tumor develops”, says the oncologist. Further factors that nourish cancer cells are bad nutrition and obesity. Cavalli is not surprised that the number of tumors in developing countries is exploding as eating habits there resemble, more and more Western habits.
Fight against cancer
“Which types of cancer have the best chance of being cured?“ another student wants to know. “Radiation therapy, especially chemotherapy does not distinguish between healthy and unhealthy cells. But drug therapy tends to kill those cells first that multiply the fastest”, explains Cavalli. “Therefore there is a higher chance to cure a fast growing tumor. 80 percent of cancer types that children suffer from can be cured successfully.” Martina Bucciantonio adds: “Some cancer types are highly resistant. Fighting them with hadron therapy can be more efficient and less damaging than conventional radiation therapy.”
“But does the expensive hadron therapy have a chance to establish itself?” a student wants to know. Bucciantinio is convinced that it does. “There are some companies that produce more compact und more simple machines. These can be easily added to existing structures. And therefore they have a chance to be commercially successful.”
After almost two hours of discussion the pupils return to their classrooms or go home. Their final high school exams are only a few months away. The discussion gave them the chance to contemplate their professional future. Some may strive for a medical degree, others for one in physics. And maybe they will meet again in a couple of years to discuss the latest generation of medical applications for the hadron therapy.
Text Marco Cagnotti (published 6. 4. 2014; translated into English by Petra Krimphove)
The internet diskussion (Google-Hangout) of march 20th 2014 to the same topic (video)