Clinical oncology. Part 1.

London : University of London Audio-Visual Centre, 1974.

1 encoded moving image (58.06 min.) : sound, black and white.

00:58:06

University of London

In English

Presented by Dr R L Morgan, Mr J A McKinna and staff of the Royal Marsden Hospital. Participants: Dr McDonald, Mr D Eaton, Dr Levene. Made for British Postgraduate Medical Federation. Made by University of London Audio-Visual Centre.

This video is one of around 310 titles, originally broadcast on Channel 7 of the ILEA closed-circuit television network, given to Wellcome Trust from the University of London Audio-Visual Centre shortly after it closed in the late 1980s. Although some of these programmes might now seem rather out-dated, they probably represent the largest and most diversified body of medical video produced in any British university at this time, and give a comprehensive and fascinating view of the state of medical and surgical research and practice in the 1970s and 1980s, thus constituting a contemporary medical-historical archive of great interest. The lectures mostly take place in a small and intimate studio setting and are often face-to-face. The lecturers use a wide variety of resources to illustrate their points, including film clips, slides, graphs, animated diagrams, charts and tables as well as 3-dimensional models and display boards with movable pieces. Some of the lecturers are telegenic while some are clearly less comfortable about being recorded; all are experts in their field and show great enthusiasm to share both the latest research and the historical context of their specialist areas.

Segment 1 Morgan speaks to camera and sums up the content of the previous 8 programmes in the series. He describes how the remaining programmes of the series will focus more on the clinical aspects of cancer. This follows on from firstly, a correct diagnosis of the type of cancer; secondly, an accurate knowledge as to the extent of the disease including both primary tumour and metastases. Time start: 00:00:00:00 Time end: 00:04:44:00 Length: 00:04:44:00

Segment 2 Morgan describes how oncologists dream of discovering a substance that might be completely toxic to malignant cells. He then shows a diagram of the cancer atom bomb as devised by Professor Symington. He differentiates between stage 1 to 3 cancers, with stage 1 being the most likely to respond to treatment. A short film is shown in which a male patient who has had cancer trreatment is interviewed by an unnamed doctor who remains off-screen throughout. He describes his symptoms and the doctor's hand is seen pointing to various incisions on his body from surgical interventions. The patient describes many of his feelings about having cancer and his treatments for it. The film clip ends. Time start: 00:04:44:00 Time end: 00:10:44:11 Length: 00:06:00:11

Segment 3 McKinna talks to camera. He shows X-rays relating to the male patient in the previous film clip, indicating where his oesophageal tumour was first located. He also runs through in detail the patient's chemotherapy treatment plan. He describes how difficult it is to stop the spread of aggressive malignant disease and refers to a diagram showing the spread of cancer in the breast. Time start: 00:10:44:11 Time end: 00:15:34:15 Length: 00:04:50:04

Segment 4 McKinna shows a table detailing the TNM (tumour, node, metastases) method of classifying the extent of a breast tumour. He then shows a graph listing the current known 10-year survival rates for females with breast carcinomas and a further chart showing statistics on the prevalence of breast cancer. These systems of classification, he explains, help the surgeon to lay out the correct treatment plan to help the patient. He gives a brief history of the kind of surgery, over time, that has been used to treat malignant disease. Time start: 00:15:34:15 Time end: 00:20:31:11 Length: 00:04:57:21

Segment 5 McKinna continues to discuss surgical options in the treatment of breast cancer, drawing into his discussion an overview of mastectomy surgery. Particularly difficult to assess, he says, is the extent of spread to lymph nodes - he draws a diagram to illustrate this. Depending on metastases, a surgeon would opt for a radical or a simple mastectomy; McKinna shows a table comparing the two forms of mastectomy. Time start: 00:20:31:11 Time end: 00:25:35:20 Length: 00:05:04:09

Segment 6 McKinna talks about some clinical trials that are attempting to save breast cancer patients from having a mastectomy of any kind. Other new tests such as soft tissue X-ray of the breast are covered by McKinna; this includes, for instance mammography. In other cancers, the development of the oesophagoscope and the gastroscope are allowing for earlier diagnosis of cancer of the oesophagus and stomach. Time start: 00:25:35:20 Time end: 00:29:43:00 Length: 00:04:07:23

Segment 7 McKinna continues to discuss some of the newer means of diagnosing and assessing tumours such as ultrasound scanning and isotopes. Some new surgical treatments, such as the application of heat to destroy tumours, is covered. McKinna introduces a short film in which cold, produced by liquid nitrogen, is used to destroy cancerous cells on a piece of steak. McKinna is then seen in a pathology laboratory where he interviews surgical pathologist Dr Levene. Levene shows a biopsy specimen taken from a cryostat chamber which keeps samples frozen. He describes how frozen tissue can be sliced very finely, allowing for a detailed analysis. Time start: 00:29:43:00 Time end: 00:35:53:10 Length: 00:06:10:10

Segment 8 McKinna continues to talk to Levene in the pathology labortatory. He describes further how frozen tissue can be used to diagnose specific cancerous conditions and to differentiate them from various other conditions, such as those causing inflammatory responses which might appear as tumours. Levene explains how frozen sections of tissue can aid in both diagnosis of initial cancer and in assessing its stage and rate of spread. Time start: 00:35:53:10 Time end: 00:40:18:00 Length: 00:04:24:15

Segment 9 McKinna continues to talk to Levene in the pathology laboratory. Levene tells McKinna that studying frozen sections of lymphoid tissue is a good way of assessing the extent of malignant disease elsewhere in the body. We now see an unnamed doctor, possibly Dr McDonald, seated, examining the foot of a patient lying supine on a hospital bed. The patient is undergoing a lymphogram procedure. The doctor describes the procedure as he performs it. Time start: 00:40:18:00 Time end: 00:44:35:14 Length: 00:04:17:14

Segment 10 Morgan talks to camera. An X-ray of an abdomen is on the wall behind him which the camera pans into while Morgan describes that they show lymph nodes which have been injected with intravenous dye of a patient with carcinoma of the cervix. He shows a further X-ray after the patient had undergone treatment with radiotherapy and the lymph nodes appear normal again. Morgan then talks, in general, about the value of lymphectomy to assess cancer and plan treatment strategies. Time start: 00:44:35:14 Time end: 00:49:53:00 Length: 00:05:19:11

Segment 11 Morgan introduces Dr Jordan Baker and Dr David Eaton who then describe and demonstrate a radioactive source store and dispenser. They run through its applications in detail. Morgan returns and makes various enquiries about the machine then Eaton and Baker leave and Morgan refers to a chart showing how treatments utilising this machine have altered the survival rates of cancer patients within the Royal Marsden Hospital. Morgan concludes the lecture by saying how radiotherapeutic techniques will be talked about further in part 2. Time start: 00:49:53:00 Time end: 00:58:06:17 Length: 00:08:13:17