Comment
D-12-02599
S0140-6736(12)60603-5
Embargo: April 18, 2012—00:01 (BST)
Physics and medicine—two tips for a long and happy marriage
tissues, and ion flow tube mass spectrometry (SIFT)
designed to detect cancers from analysis of a patient’s
breath.6 For treatment, one of the most effective ways
to treat malignant tumours remains radiotherapy—
high-energy radiation including not only x-rays but also
beams of particles such as electrons, protons, and other
nuclear particles produced by accelerators originally
developed as “atom smashers” to investigate the
structure of atoms and nuclei. Electron linear accelerators
that generate x-rays are the workhorses of radiotherapy
departments worldwide, while the potential of proton
and other nuclear beams to improve cancer treatment,
especially in children, is reflected in the rapid increase in
the provision of dedicated facilities.6
Understanding, generating, and manipulating radiation
has been made possible by basic physics research into the
structure and evolution of the universe and the building
blocks of matter. I urge the UK Government and other
funders to recognise that continued support for that
research will deliver corresponding advances in medical
technologies in the years to come.
Second, for medical practitioners to make full use
of modern physics-based technologies for diagnosis
and treatment, it would be hugely beneficial to have
a sound understanding of the physics involved. As
Stephen Keevil1 points out in his paper on historical
perspectives, basic physics was once a compulsory
element in undergraduate medical education in the
Published Online
April 18, 2012
DOI:10.1016/S01406736(12)60603-5
See Online/Comment
DOI:10.1016/S01406736(11)60311-5
See Online/Series
DOI:10.1016/S01406736(11)60282-1
DOI:10.1016/S01406736(12)60429-2
DOI:10.1016/S01406736(12)60428-0
DOI:10.1016/S01406736(12)60476-0
DOI:10.1016/S01406736(12)60281-5
Wellcome Library, London
The Lancet’s Physics and Medicine Series1–5 highlights the
many ways in which physics has revolutionised medical
practice, from the development of disciplines such as
electrophysiology, biomechanics, and ophthalmology,
to the techniques made possible by the discovery of
radiation and radioactivity.1
As outlined by Peter Morris and Alan Perkins2
imaging techniques that use the entire breadth of the
electromagnetic spectrum, from x-rays to terahertz
radiation, as well as ultrasound, are increasingly used
not only for diagnosis but for medical screening and as
an integral part of treatment planning. Andreas Melzer
and colleagues3 show how physics-based technologies
used in the treatment of patients include techniques
for minimal access surgery, ultrasound, photonics, and
interventional MRI. With input from physicists and
engineers, Paul O’Shea4 describes how interdisciplinary
“new biology” is opening up possibilities—particularly
through genomics and nanomedicine—for the
development of personalised medicine to increase the
effective deployment of treatments. A more systemic,
quantitative, and predictive approach offers important
potential benefits for medicine and health care, as
Geoffrey West5 highlights.
April 20, 2012, marks the 110th anniversary of the
date on which Marie and Pierre Curie first refined radium
chloride—a good occasion to celebrate the long and
happy marriage between physics and medicine with
the publication of The Lancet’s Series. I would like to use
the occasion to put forward two proposals to keep that
marriage thriving and productive far into the future.
First is the continued need to support physics research.
Most if not all of the physics-based techniques and
technologies described in this Series derive from the
discoveries of basic physics research, undertaken purely
and simply to investigate the nature of our world and to
expand the frontiers of knowledge.
Focusing on cancer alone, physics research plays a
crucial part in improving both diagnosis and treatment
through techniques based on different forms of
radiation.6 For diagnosis, CT based on x-ray imaging (CT
scanning), PET, MRI, and specialised MRI techniques are
all well established,2 while more recent developments
include laser-driven terahertz radiation, optical coherence
tomography (OCT) to map cancerous and precancerous
Marie and Pierre Curie in their laboratory in Paris (c. 1900)
www.thelancet.com Published online April 18, 2012 DOI:10.1016/S0140-6736(12)60603-5
1
Comment
UK, with exemption for students with a GCE A level
pass in physics. This requirement was dropped in the
1980s, although physics remains part of the medical
degree syllabus elsewhere in Europe. In the UK today, we
have reversed the long-term decline in the number of
students taking A level physics or the equivalent, with a
steady year-on-year increase since 2007. Record numbers
of qualified physicists are entering teacher training, with
the prospect—albeit some years in the future—that
all parts of the UK will have enough specialist physics
teachers to ensure that every child has access to a high
quality physics education.
Against this background, I would ask UK medical schools
to consider restoring the requirement for applicants
to hold physics A level or equivalent qualifications.
The Lancet’s Physics and Medicine Series clearly shows
the potential to diagnose and treat increasing numbers
of patients, with increasing effectiveness, using physicsbased techniques. Understanding the physics that
2
underpins these techniques would be a real advantage
to medical practitioners, and to their patients.
Peter Knight
Institute of Physics, London W1B 1NT, UK
[email protected]
I declare that I have no conflicts of interest. I am President of the
Institute of Physics.
1
2
3
4
5
6
Keevil SF. Physics and medicine: a historical perspective. Lancet 2012;
published online April 18. DOI:10.1016/S0140-6736(11)60282-1.
Morris P, Perkins A. Diagnostic imaging. Lancet 2012; published online
April 18. DOI:10.1016/S0140-6736(12)60429-2.
Melzer A, Cochran S, Prentice P, MacDonald MP, Wang Z, Cuschieri A. The
importance of physics to progress in medical treatment. Lancet 2012;
published online April 18. DOI:10.1016/S0140-6736(12)60428-0.
O’Shea P. Future medicine shaped by an interdisciplinary new biology. Lancet
2012; published online April 18. DOI:10.1016/S0140-6736(12)60476-0.
West GB. Quantitative systemic thinking: importance in medicine. Lancet
2012; published online April 18. DOI:10.1016/S0140-6736(12)60281-5.
Institute of Physics. Physics for an advanced world: a look at the vital
contribution that physics research has made to a number of major
technological developments. London: Institute of Physics, 2009. http://www.
iop.org/publications/iop/2009/page_38208.html (accessed April 12, 2012).
www.thelancet.com Published online April 18, 2012 DOI:10.1016/S0140-6736(12)60603-5