04/24/2012
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 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 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.
Marie and Pierre Curie in their laboratory in Paris (c. 1900)
Wellcome Library, London
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 physics-based techniques. Understanding the physics that underpins these techniques would be a real advantage to medical practitioners, and to their patients.
I declare that I have no conflicts of interest. I am President of the Institute of Physics.
Copyright 2012 Elsevier Ltd
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