. Radium . pre-ceding radium treatment. Electro-coagulation or even embedding radiumshould not be done until cell proliferation is checked by surface radia-tion. In all squamous cell epithelioma the adjacent lymphatics should 122 Radium always be irradiated to the point of skin tolerance and if any palpableglands remain each should be speared and radium imbedded. Aftera clinical cure the site of the lesion and adjacent glands should be in-spected at frequent intervals for a period of three years. Careful ob-servation regardless of the method employed would often be the meansof avoiding a destr
. Radium . pre-ceding radium treatment. Electro-coagulation or even embedding radiumshould not be done until cell proliferation is checked by surface radia-tion. In all squamous cell epithelioma the adjacent lymphatics should 122 Radium always be irradiated to the point of skin tolerance and if any palpableglands remain each should be speared and radium imbedded. Aftera clinical cure the site of the lesion and adjacent glands should be in-spected at frequent intervals for a period of three years. Careful ob-servation regardless of the method employed would often be the meansof avoiding a destructive recurrence. It is generallv conceded that fractional doses of radium are con-traindicated in the treatment of both basal and scjuamous cell epithe-lioma. It is important in all cases to estimate the physiological doseand give the maximum dose at the first treatment. Radium, when given in full doses covering all the diseased areawith the proper amount of filtration and the correct distance, will cure. Fig. 9. Epithelioma on the nose treatedby implantation of two 10 milligramradium for four as shownin picture. Result was a clinical cure. over 95 per cent, selected and between 80 and 90 per cent, of unselectedcases of basal epithelioma. With our present day technic o\er 90 per cent, of early cases ofepithelioma of the lip can be cured. The farther advanced the disease,the smaller the ratio of cures and if there is extensive glandular in-volvement, the prognosis is grave. For the purpose of description, epi-theliomas of the lower lip, besides the superficial and deep variety, areclassified into three different stages. First, where the lesion is clinicallylimited to the lip, that is, there is no palpable glandular involvement;second, where there is only one chain involved, that is, the submentalor the submaxillary, and third, where more than one chain of lymphaticshas metastasized. In treating the first class, where there are no clin-ical metastases, it has be
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