Transcript for:
فهم الإشعاع في علاج السرطان

Wait, sir! Where are you going? -What?! -Pass the bag through the machine sir. No, I can't get my bag covered with radiation, my wife is 3-month pregnant! What radiation, sir? I personally washed this device today in the morning! No matter what you say, I won't get X-ray leftovers into my house! What leftovers? I cleaned it well! Am I here to buy it? Please just let me go, I'm very late! I can't, these are the company's instructions. I don't understand, why are you so worried from the device? This is radiation. Do you understand what radiation means? No, it's not that, you're worried. Fine, I am a coward, I am afraid, let me in! The bag gets passed, then you pass. You coward! Do you know how long have I stayed away from X-rays? Ah man, I miss my ex a lot! Calm down. When you let me in, I'll fix things between you and it'll all be okay. Well now that you said that... I get in? I swear you won't pass until the bag passes through. I will explain to you in a simple way, this device produces some rays, harmful rays, as harmful as cigarettes. I smoke IQOS. Oh my god. You people, someone save me from this person! Fine fine, why the loud voice? Bring the bag, I'll search it manually... then, we pass it into the device! You know what, take the bag, I don't want it. I'm leaving! I won't work here, I will quit! In God's care, sir. Yes, Ahmed. I chased away the last employee. Come on, bring the men so we can go up and open the safe above. Hello my friend viewers, Welcome to a new episode of El-Daheeh. In 1937, Gunda Lawrence had a medical appointment at the Mayo Clinic, the doctor, at that time, informed her that she had uterine cancer and had 3 months to live. Of course, for anyone, this news is a disaster! But fortunately for Gunda, her son was a doctor, John Lawrence. Her second son, Ernest Lawrence, and he was a physicist. The two sons, John and Ernest, agreed they couldn't leave their mother like this. Her only hope for recovery is that John takes her with him from Minnesota to Berkeley. There is a chance that they will put it under a million-volt X-Ray machine! This device, my friend, was very rare, there were only 2 of them in all of America! It was designed by one of the team members led by Ernest Lawrence. I'm telling you my friend, the treatment was difficult and exhausting. John wrote later that his mother was begging him to stop the treatment and leave her. And he felt he was very cruel because he didn't listen to her. According to the words of writer Nuel Pharr Davis, who was one of the Lawrence Brothers colleagues in the laboratory, that the two brothers used a device called the Cyclotron, which was made by Ernest to hit their mother with neutron radiation as part of the treatment. "What is this disobedience, Abo Hmeed?! He hits his mother with radiation, did it go this far?!” Calm down, my friend! Don't make anything irritate you so easily! These are specialized doctors, what do you know?! I'm joking, my friend, you certainly understand. Honestly, my friend, I don't want you to rush to judgment. This neutron beam was the only hope for a cure. Indeed, with time, the tumor faded and the treatment proved successful! And Mrs. Gunda, who we pittied two minutes ago, and the doctor told her, "You have 3 months to live", she lived for 15 years after that! This story is a real proof how children can be useful sometimes. You work hard raising your children, they make you go sick, then they treat you. It does not just stop here, Gunda attended the honoring of her son, Ernest Lawrence, for his Nobel Prize in Physics for the Cyclotron. The device was one of the first particle accelerators. "Particle accelerators" "Abo Hmeed, there is a loophole in what you are saying.” What, my friend? "How come they say that this radiation is what causes cancer? and you just said that it cures cancer, then what happened in Hiroshima and Chernobyl? Photoshop? a hoax created by the West? a great goal, but against us?!” Why are you talking like that? "Nothing Abo Hmeed. I felt like I had a strong argument!" -Sit down. -Okay. This, my friend, is the plot I got for you, that what causes cancers can also cure cancers! I'll make a dramatic exit, then come back to explain. Human medicine, my friend, treats the body as if it is in an ideal state. If any imbalance occurs and the body is far from this ideal state, this appears as a disease. This state of perfect balance, what we call homeostasis, includes many variables at the same time. Starting with how your temperature is 37, or your pressure is 120/80, and even when it comes to the levels of neurotransmitters in the brain. So for contemporary medicine, you're just a bunch of standards. The goal is to maintain this ideal state. This Order does not turn into Disorder. Any change in these numbers means there is a defect and disease. For example, when the doctor tells you, "Don't eat too many salty things.” I would like to assure you that he has no personal enmity with Pickles. But this is because the sodium level affects blood pressure. Or, as we explained, it affects the balance levels in the body. -"Abo Hmeed, don't worry about me." -Why, my friend? "Abo Hmeed, I am a someone who takes care of his health. I wake up and run, eat honey, and eat raw garlic.” my friend, let me surprise you and say that this balance is not just a lifestyle. For example, what should we do if, God forbid, you have a stroke? Or the immune system, that protects the body, attacks the body itself, like immune diseases? In immune diseases, the infection does not come to you from the ones closest to you, it comes from you! The imbalance isn't just something does not work, or something changes its course. But it is possible that one of the glands in your body is working excessively, or you work actively but not enough. Then the body's organs, which control this balance, are not working well, and that's when we intervene with our treatment from the outside of the body. The treatment that can be violent sometimes while restoring this balance. For example, in the case of clots, the body needs a substance to prevent blood clotting. and increases its fluidity violently, in order to equalize and balance the clot. We need to continue pumping blood, so we can create fluidity to remove this blockage. Your pressure goes high so you take something to lower it, if low, you take something to raise it. If your temperature is high, you use cold compresses. You are trying to reset to default all the time. Remember, my friend, human life is nothing but continuous attempts at factory reset! Let me surprise you and tell you that treat some clots we resort to snake poison! Snakes like the Saw Scaled Viper release what are called hemotoxins. These are toxins that prevent the blood from clotting. And it causes its fluidity to the point of death! It kills you by making your blood flow more. But this same poison in an appropriate dose, can be turned into a thinner for a blood clot patient! Again, my friend, what can kill you in some cases can treat you in other cases! We want to get the body back to homeostasis. Imagine, my friend, snakes kill 100,000 people every year with their bites, but with medicines that come out of their toxins, you know how many they save? 40 million patients! "I love snakes so much, Abo Hmeed!” Let me tell you, my friend, that the problem of diseases like cancer, is in what a study in the journal Trends In Neurosciences called, in the year 2021, with the Homeostatic Challenge. This means that it challenges the state of homeostasis, which we are striving for. Cancer is crazy cell division, that can happen in any organ and spread to the whole body. An opponent that is difficult to besiege and target. This needs violent and aggressive treatment with the same madness as cancer! just as crazy as it is, in order to get the body back to a state of ideal balance. One of these treatments may be much more violent than snake poison. It is, as we talked about, radiotherapy. To understand, my friend, radiation therapy, let us learn about the history of its discovery. The story begins with the German physicist and engineer Wilhelm Röntgen, and his discovery of a new type of rays in December 1895. These new rays, which he called X-rays, given the name of the mathematical variable X, this discovery made a breakthrough in many scientific fields at the same time. He won the first Nobel Prize in Physics in 1901. Among Röntgen's discoveries are two are very important things to us today: The first that he discovered it by chance when he put his hand in front of the rays, that it shows a picture of his hand bone! This led people to conduct many experiments to use these rays to diagnose patients. By coincidence also, -this is all for their good intentions- doctors noticed that patients who they try to diagnose them with these x-rays, when they are exposed to it for a long period of time, burns appear on the areas exposed to the rays. This made people think, if this radiation can cause burns or even death of these tissues, then instead of just using it in imaging, why don't we use it to burn wounds, tumors, and ulcers to get rid of them? This is the principle with which some initial experiments that succeeded in treating some skin diseases, such as lupus vulgaris and lupus erythematosus. In 1899, Thor Steinbeck succeeded in the treatment of Basal Cell Carcinoma. Anyway, all that was some of the medical results that Röntgen discovered. As for the second result, which is equally important, or maybe more important, is that many people depended on Röntgen's invention, and made subsequent discoveries that may be just as important. Sometimes they were more important. For example, the French scientist Henri Becquerel discovered radiation of a different type at frequency. Becquerel was studying one of the uranium salts, he had a theory that it absorbs sunlight and emits X-rays. Although these rays are invisible, we can see them on film, in order to study its results and provide treatment for patients. But, my friend, while he was working on the experiment, the weather remained cloudy for two days. There was no sun at all in Paris. Becquerel discovered -while researching X-rays- other different rays that are affected by the magnetic field. He also discovered materials in nature that without another energy source produce different radiations. The phenomenon of strange radiation that is affected by this magnetic field, Pierre Curie and Marie Curie after him named it radioactivity. While studying this phenomenon in uranium ore, they discovered two new elements: Radium and Polonium. Nobel prizes were definitely handed out! Let me tell you, my friend, that this series of discoveries, opened the way for the use of radiation in treating many diseases. But, my friend, people found out the hard way, the door that opens is not easy, it is scary and aggressive. Madame Marie Curie, whom we talked about in an episode before, the discoverer of radium, and one of 4 people in the world to receive the Nobel Prize twice, and one of two people who received two Nobels in science. Most likely, this woman died due to her exposure to radiation. Due to being exposed to radiation numerous times, her personal needs, such as clothes, books, and her notebook, are still radiant until today! Even, my friend, her very body is buried in a lead-lined coffin, to isolate the radiation! During the same period when she and her husband discovered radium and polonium, and Henri Becquerel discovered radiation, people, my friend, were using it in everything so madly, like the ketchup bags in the orders unnecessarily abundant! I want to tell you, my friend, sometimes radioactive materials were sold to people under the public eye. Radiant toothpaste, as if this radioactive toothpaste will make your teeth shine more and kill bacteria! "What an idea, Abo Hmeed!” What, my friend?! I'm telling you, the woman died and we buried her in a lead coffin! -"Fine". -There were bottles to radioactivate water! Things went out of hand to the point where radioactive distilled water, was sold under the name Radithor. Doctors used to write it to patients for things that had nothing to do with radiation at all, such as bone injuries, for example, If your leg is broken, instead of being put in a cast, it is exposed to radiation! Medicine suddenly began to realize that radiation, that took countless Nobel Prizes, and was being used in products like a quality seal, was a double-edged weapon. Just as it treats on the one hand, it can also be a tool that kills on the other hand! "I'm confused, Abo Hmeed, now I don't know how to have an emotional attitude towards radiation." Look, my friend, this is not required of you. What is required of you is to understand it, and watch the previous episodes and the upcoming ones, that's all. Let me tell you, my friend, that radiation is divided into two types: first, particle radiation, this happens when a subatomic particle travels very quickly. It can reach 99% of the speed of light. These particles can be neutrons or electrons. And then its name becomes either beta radiation or alpha particle. The second type is electromagnetic radiation, this includes X-rays and gamma rays. The important thing is that these two types of radiation have very high energy. To the point that if they hit an atom or molecule, they can knock an electron out of it and turn it into ions. The atom would be sitting in peace, with its protons, neutrons, and electrons family, then rays come and break up families in the atom! -Imagine, my friend, a disintegrated atom! -"Oh God forbid!" No, my friend, they don't break like this, it just removes an electron from it, making it an ion. In other cases, the atom may absorb the molecule that struck it, -in some types of radiation-, and then this atom turns into another atom. When this process of ionization occurs in the cells inside the body, the atom struck by radiation and becomes an ion. Here, the DNA may change or becomes damaged. "Oh, I know this damage, Abo Hmeed." Or maybe important parts in the cell lose their ability to perform functions. If the damage to the cells was high, this could cause the cell to commit suicide. A process called apoptosis occurs, or simply die in a process known as necrosis. Of course, cells can repair themselves, but no one can repair them easily. Not every cell can correct the problem correctly. It is possible, my friend, that genetic mutations occur because of this damage that make the cell unable to commit suicide! Our cell, my friend, when it goes bad, it is good for us that it commits suicide. Because if it is bad and still alive, it will take resources from other cells. It may harm the cells around it, so it gets rid of itself. But when you hit with radiation changing the DNA of the cell, it is possible to change something related to the process of cell suicide. This would create a zombie cell that I don't know how to control it! Thus, the issue may develop until we have a cancerous cell. This is why exposure to small doses of radiation can cause cancer. These doses act like a bad friend. These doses destroy the cell and make it cancerous. Not only that, if you're exposed to radiation today, the cancer will not appear tomorrow. As seen in the episode "Hiroshima", they were exposed to radiation, and the cancer came years later. It may come after months, but it won't come immediately at that time. "Okay, sorry, Abo Hmeed. I have a question for you and the scholars. If the radiation is so bad, why don't we just stay away from it, why are we bothering ourselves?!” I want to ask you Was it my aunt standing here telling you it was a double-edged weapon? I told you! We have now said the harms, let's see the benefits. Let me tell you, that cancer and its treatment are two sides of the same coin! In radiation therapy, we hit cancerous cells with high doses of radiation. So that it stimulates these cells to a large extent, causing them damage. Thus, these cancer cells will die from excessive damage. or at least, we damage it till it loses its ability to reproduce and divide. "Okay, Abo Hmeed, radiation turned out to be nice, why did you harm its reputation?" You may think, my friend, this is good, and that the radiation is good, but when you attack cancerous cells, aren't these cancerous cells among normal cells? When you harm cancer cells, you can harm a normal cell, therefore, it turns into a cancer cell as well? "So Abo Hmeed, when we kill cancer, we can turn good parts into cancerous parts, and destroy the healthy parts?!" Yes, my friend, radiation therapy is like any other medical tool we have. As it has benefits, it also has side effects and risks. But it's not a dead stalemate, and there are ways and solutions to use it. For example, we can control and direct radiation. So that it causes less harm to the rest of the body, and the greatest harm to cancer. In order to understand how to avoid the side effects of radiation, we need to know the 3 main methods of radiation therapy. The first step is external beam radiation therapy. The second thing is sealed source therapy. The third one is radioisotope treatment. In external radiation therapy, as the name says, we get a device that emits radiation like Linacs. This device is a particle accelerator. It uses the magnetic field to emit particles or X-rays with high energy. We use the beam that came out of it and treat the cancerous tumor with it. In order to reduce the damage to the cells around the cancer cells, instead of hitting the tumor with the full dose at once, we can change the dose and hit the tumor from different directions. So that several rays from different angles meet at the tumor, so, the tumor takes the full dose, but the rest of the tissues and organs around it take lower doses, hence, less damage. With the development of diagnostic radiology techniques, and the invention of the CT scan, we can deal with the tumor in three dimensions, such as Tomotherapy technology. In the second method, which is sealed source therapy, Sealed Source Therapy, we get a small device called the Applicator. This is a tube or a small capsule like this, we place it surgically inside the tumor or next to the tumor. After we make sure that it is in the correct place for the tumor, we can put inside the capsule a source of radiation. Normally, we use an unstable element, or a radioactive isotope of a stable element, anything that sends radiation to the inside or side of the tumor, so it kills cancer cells. The advantage of treatment with this method is that you can choose other types of radiation. Like, for example, alpha radiation cannot penetrate tissues and travel far. Here you are ensuring that the tissues surrounding the tumor, will take smaller doses than the tumor would take, may God burn it! May it get a radioactive source that will destroy it. Not only that, my friend, since the radiation source is placed in the tumor itself, LAN connected, if the patient moves, or the tumor itself moves, the source moves with it, so it reduces the radiation that may hit the wrong place due to this movement. Finally, the third method, which is radioisotope therapy, also known as open source therapy. Here, the patient is given radioactive isotopes of certain elements, in the form of an injection into a vein or a pill. "What, Abo Hmeed! Are you injecting the patient with radioactive materials?!” Let me tell you, the cells of the body are not the same. We choose these radioactive isotopes, depending on the tissues we want to treat, and see which tissues work with which elements, so that we can mix and match, and everything has fights , except radiation has agreements! For example, my friend, in cases of thyroid disease, whether cancer, or a gland whose activity increased in a way that threatens health, here, we can give the patient sodium iodide salt, but we will replace regular iodine with radioactive iodine, or isotope iodine 131. Here, the thyroid gland absorbs part of the iodine and collects it inside it. The rest of the iodine is eliminated by the body. So here is no iodine left in other organs or tissues in the body. Thus, iodine becomes concentrated in the gland. It did not last long in the rest of the body and the body got rid of it. Here we did marked the thyroid gland, and the radiation that radioactive iodine releases, will go to the place where there are cancers or active cells, and beats them to death. That's a smart move, my friend. It is as if, my friend, we struck the cancer in its own headquarters. In other cases, when the cancer grows and spreads, and occupies other tissues other than the main organ from which it emerges. Like, God forbid, for example, if the cancer reaches the bone, here, we can give the patient salts containing radium 223, or strontium 89. These two elements, my dear, imitate calcium in the body. Therefore, they are concentrated in the bone, So, when the tumor invaded the bones, there will be radiation coming out of it that will attack this tumor. Not only that, my friend, this radiation has not yet finished. "Oh! This radiation came out in a very deep sea!" There's more. Among the new methods that combine two methods of treatment, is treatment by capturing the neutrons. Let me tell you that some elements that exist in nature and are not radioactive, have the ability to catch and capture a neutron if it hits them! And then the atom changes from a stable atom to an unstable isotope atom. For example, boron 10, if you hit boron with a neutron with a low energy, the boron 10 atom, which is stable and in peace alone, will turn into a radioactive boron atom, boron 11. In this treatment method, we inject the cancerous tumor with boron 10. The kind and stable one, who resembles Rashwan Tawfiq! Then, we get a neutron tap, and these atoms are radiated from an external source. Look, my friend, in the past they used a nuclear reactor, but thank God we are now calmer as humanity! You don't have to go to a reactor now, you can do it in a regular particle accelerator! Bam, boron 10 gets those neutrons, it goes crazy on the inside and turns into an unstable radioactive isotope. Boron 11 is crazy and manic! Then Boron 11 is activated and all mad, "Come here, cancer, come you idiot tumor!" It begins emitting radiation that confronts the tumor. This way, you didn't need to expose any other tissue to radiation along the way. "I went to the cancer in its headquarters and bombed it!" "It's a head shot with an AWM sniper equipped with a Scope 8, in the heart of the tumor!" "Sorry, Abo Hmeed, why don't we open it and put the capsule in, guaranteed, go back to the old ways!" my friend, we can't use the scalpel anywhere, not all parts of the human body are accessible. Your body has parts that need a password to get in! For example, in the case of brain tumors, it is not easy to perform an operation and insert a capsule. In the same way as the families I told you about, I don't need to use scalpels, and get inside of the brain. I deal radiation as if it's my scalpel. But it is a very precise scalpel, a scalpel smaller than the atom itself that attacks the tumor and destroys it from within. "Sorry, Abo Hmeed, but is there no risk of leakage? is it not possible for other tissues to be exposed to radiation in this way as well, as a result of these leaking isotopes? we reduced the dose and everything, but this leak can cause another cancer, which will appear later, and I can't take it!" Let me tell you that first, my friend, leakage is an unscientific term. And I tell you now that this is part of the equation, an important part that doctors should consider when choosing radiation treatment. For example, in the case of Hodgkin's lymphoma, women who suffered from this disease and were treated with radiation, or with a mix of radiation or chemotherapy, were at risk of developing breast cancer in the future. In fact, the case of Hodgkin's disease in particular, second cancer is the leading cause of death for patients who have overcome this disease in the long term! Radiation, my friend, is not black and white with cancer. What I want to say, my friend, is that radiation can indeed escape. It may cause damage, but the world is not black and white, mot because it can leak and cause damage, that we stop it. Because in the end, sometimes it cures, and sometimes it works fine. It is effective in more than half of the cases. In a study conducted in 2005, it was estimated that more than 52% of cancer patients, radiation therapy was in their favour. It is true that radiation therapy is an important medical tool in combating cancer. However, it creates new challenges, not only for doctors or patients, but for the entire society. Such as, for example, the island of Goionia in Brazil, in 1985, when a clinic specialized in radiation therapy, moved its place without informing the authorities, and left an old device. Two young men entered the abandoned clinic and tried to steal parts from it, to sell it to a scrap dealer. This, my friend, is an evil I hate, an evil whose taste is bad! Why would you steal a device that treats radiation?! You take bad deeds and no one is happy, it's like a hypocritical person, who has no interest in himself! Or the one who steals a bad movie or who steals a bad idea! "There is no benefit from what I do, but I want to be evil!" The important thing is that among the parts they stole was a container that looked like a tea thermos. It contains 93 grams of cesium 137 powder. -"Oh My God, Abo Hmeed!" -Do you even know cesium?! "No, Abo Hmeed, but I felt it was dangerous since there was powder." That's right, my friend, there is something dangerous indeed. This cesium, my friend, is so radioactive that it shines! And the man was amazed when he saw it, and distributed it on his family! "Take some radioactive powder and cheer up your friends.” Of course, this crisis ended with the death of 4 people and the injury of many who exchanged radioactive materials as if they were snacks! Not only that, my friend, there are more than 100 thousand human beings who needed to undergo tests to find out who had been exposed to radiation. Entire houses with all their possessions were destroyed, even their soils were swept away, we needed to bury all of this in the form of radioactive waste! Let me tell you about the real disaster. Before the exact source of radiation was identified, the fire brigade was going to throw him into the river! CTRL A, Die. "Oh My God, Abo Hmeed, are you saying that in what's Brazil, would be thrown in the Amazon?!” Radiation will enter every house, from the faucet! You come to meet someone in Brazil, and you say to him, "You're glowing!” then he replied, "I showered this morning.” Fortunately, my friend, the physicist intervened before this disaster happened! Also in 1982, the Therac-25 device, which was considered the most advanced thing of its time, to the point that it is controlled by computer, not manually, there was an error in his software. Radiation therapy, despite creating scientific or technical problems, it also creates ethical problems, simply because, a lot of information that we know now, regarding radiation, we got it because of unethical experiments that occurred on humans during the Cold War. When doctors were giving patients high doses of radioisotopes, while the patients did not have cancer at all! Or give handicapped children food contaminated with radioactive elements, to study the results! This may sound like science fiction or conspiracy theories. But after a journalistic investigation, conducted by journalist Eileen Welsome, for which, in 1994, she won the Pulitzer Prize. President Bill Clinton formed a presidential commission to investigate these experiments. This information has already been confirmed. Unfortunately, my friend, continuing to develop radiation therapy, even if it offers better ways to treat something like cancer, and treating other non-cancerous diseases, it still requires a high degree of commitment from us to strict standards, in order to be able to deal with radioactive materials, and also deal with important ethical dilemmas. In 1907, the scientist who won the Nobel Prize would say: the godfather of Chemotherapy, Paul Ehrlich, that he dreams of a new medicine that can find the Magic Bullet! This is the name he gave to a treatment he wishes and dreams of. A treatment that eliminates the disease, without destroying the patient. This is a vision that will form a framework for the entire twentieth century and for all the chemotherapy and radiotherapy research, as they are the two most important ways to deal with cancer. In a study in the magazine Molecular Oncology, in 2020, it talked about the future of medicine in 30 years, the study confirmed that radiation therapy, which we are afraid of, will continue to be just as important, because, sometimes, it's the only soldier who can face cancer. Its strength is equal to its peak ferocity and violence. Although it's not magic bullet yet that kills the disease without harming the patient, radiation therapy has come a long way, to turns from a deadly weapon that kills the disease and the patient altogether, into a sensitive balance able to intervene into a highly accurate weapon capable of killing the disease without killing the patient, and can return our beautiful, sweet body to the state of hemostasis, the state of balance that cancer disrupts. The challenge here, my friend, is that science removes the magic aura from the term, and provided in the future a real treatment with the accuracy of a magic bullet, with the same efficiency, without its devastating effects. That's all, my friend. Last but not least, Don't forget to watch the old episodes, and the new ones, check the sources below, and subscribe if you're on YouTube. That's all, my friend. May God protect you and protect us all. And may you never need a magic bullet or a mercy bullet, or even a pinch. God, let us pass and leave it, just as the neutron leaves. Do you know, my friend, why the people of uranium disavowed him? -"Why, Abo Hmeed?" -Because they found him fertilized. "Maybe it's in Halal, Abo Hmeed."