CANCER

Hokitika Guardian, 22 February 1929, Page 2

CANCER

CURABLE IN EARLY STAGES.

ADDRESS BY DISTINGUISHED ' authority. •

WELLINGTON, iFeb. 19

Jii an address to-day to the* New Zealand branch of the British Medical Association, Mr Sampson Handley, the eminent London surgeon and authority on cancer, said that if the public could be induced to seek prompt advice for suspicious symptoms, the cure of cancer would become a very common event.

Mr Sampson Handley, senior surgeon of the Middlesex Hospital, lias come to New Zealand as the representative of the British Medical Association and of the British Empire Cancer Research movement, in opening the discussion on cancer, he expressed his views as to the cane of the disease and indicated the best-known methods of treatment.

“During, the last fifty years,’’ said Mr Sampson Handley, medical “science lias given to the world gifts of incalculable val/ue. difficult to measure either in terms of human happiness or of money value. Lt seems unthinkable nowadays that u pestilence should seize a great city helplessly by the throat and. paralyse it, as London was paralysed by the Great Plague. The Tropics are habitable for‘the European races, and the white man’s grave has become his treasure house and even his home. Surgery and child birth have become relatively safe and painless. The city child, thanks mainly to regular medical inspection and treatment, often compares favourably in physique with the rural one. The measure of these benefits is an increase of ten years on the average span ol human life during the last half-century. “It . cannot be said that the -world at large is particularly , conscious of; these benefits, or particularly grateful for them, ftvils escaped are as if they had never existed,-and in a state of settled happiness lcelings of gratitude soon fade. In the mind of the public the achievements of medicine have only served to throw a sharper light upon ,its failures. lhe mail who is saved in„his. youth from tubercle, malaria,,, or *acute infective disease remembers not these benefits when twenty or>ihi.irby. ’ years..later ho suffers from cancer large part of the increased mortality of cancer occurs in people who, fiiifc for. increased medical knowledge, would have died in youth of diseases now'preventable.

CHANGED ATTITUDE NEEDED.

“It must be confessed that the efforts of medicine to control cancer have not yet been successful, nor can they be expected to succeed while public opinion, with the support of some doctors, maintains that. cancer is incurable and turns from th'e' subject with horror and disgust. Pessimism is the child of ignorance, and the lather of failure, panic, and death. A taboo, as thick as that which in the past guarded Ruapehu, prevented English newspapers, until the last few years, from ever printing the word ‘cancer.’ When the late Mr Child©, of Portsmouth, wrote a work on the control of the disease, lie could not find a publisher until he consented to delete the word ‘cancer’ from the titlo of his hook, and to call it ‘Tfip Control of a Scourge.’ Advertisements inserted in the Portsmouth papers by the health authority to give elementary information about cancer roused a storm of indignation, and had to be withdrawn. What has been the effect of the cancer taboo? The skeleton in the cupboard has become ever more grisly in imagination than in reality. The unmentionable terror has tended to assume the proportions of a nightmare. Worst of all, people who suspect they have the disease conceal their condition, and in very many cases only seek medical advice when their disease has passed the curable stage, and when operation can do no more than ease their sufferings or prolong their' lives. Taking a large nTimber of my private patients, I find that the delay between the time the patient first noticed something wrong, and the time when medical advice was first sought, amounted on the average to six months.

WHAT THE PUBLIC SHOULD

KNOW,

“How is tills situation to "be met? The skeleton must be dragged from tho cupboard, and examined quietly and steadily in the light of day by the profession and the public in cooperation. Under these conditions it •will lose its aura of phosphorescent horror, and will begin to crumble. The menace of cancer to the human family is no more dreadful than others which medicine has faced and finally .overcome.

“The public must be taught a few elementary facts about cancer, must learn to be on the look-out for its early signs, and must be taught that early cancer is painless and that absence of pain does not exclude the possibility of cancer. They must realise above all that early cancer is curable when it occurs in accessible positions, and that tho worst pain connected with most operations for canger under modern conditions is the pain of anticipation. The actual' danger of operation is nowadays small. “If the public could be induced to seek prompt advice for suspicious symptoms, tho cure of cancer would become a very common event. For instance, it is known that the modern operations, which is safe and almost painless, will cure four out of five cases of breast cancor, provided the disease has not already passed the limits of the breast. Cancer specially

affecting women can also be generally cured, if taken early. Unfortunately, in some cases, the disease is so insidious that it is hopeless when first iccognised. There is a good prospect that- withiii the next few years the knife will be largely superseded by an electrical method of removing cancer, perhaps even that radium treatment will in many cases replace operative removal.

PERIODICAL MEDICAL INSPECTION.

“These encouraging facts should be more widely known. To disseminate them, the Middlesex Hospital and the closely affiliated .Middlesex Cancer Hospital, the pioneer cancer institutions in England, have issued a series <>f health leaflets aiming at the instruction of the public in the care of their health. These leaflets are sold at cost to medical officers of health and it be*, public health authorities, and last year about oo.Oi’O of the leaflets were thus distributed. Several of the leaflets deal with cancer. I venture to think that this series of leaflets might prove useful for distribution in New Zealand, and will gladly send specimens to any doctor interested. “In the United States much more intensive, not to say sensational methods of public education about cancer have ben adopted under the netd* of the powerful American Society for the Control of Cancer. ‘Cancel Weeks,’ with preliminary newspaper articles, lectures, addresses, and. clinics, have been held in various cities. Some immediate good has Resulted, but the effect of this intensive publicity has proved to be very transitory. The ruffled public soon sink back n.to their comfortable apathy. “It does not 6eem likely that these intensive’ methods will be found suitable either in England or in New Zealand, but much can be done by medical men in their daily practice to instil in the public mind a few elementary truths. The routine medical inspection of middle-aged persons would in many cases lead to the detection ol early cancer while still curable.' “A similar policy of education of the public and patient research has oecn successful in the case of another skeleton—tubercle. In some respects tubercle is an even more terrible disease than cancer. Whereas cancer usually permits a man to enjoy the best of life and to beget and provide for a family before it intervenes to rob him of his old age, tubercle attacks it victims in youth, and deprives them of their heritage of family joys and blights' the opening prospects of success in hie. Even as regards physical suffering tubercle is perhaps the worse disease. “The effect of dragging tubercle into the daylight of publicity and research has been nothing less than a diminution of the mortality from tuberculosis in England by 50 per cent in the last thirty ■ years. Of tin# people thus saved, of course, a number die later of cancer, and largely for this reason the death rate from cancer has increased in the same period.

EMPIRE CANCER CAMPAIGN.

“I have said that the cancer question is one to be faced by the public, and tile doctors in co-operation. The problem will not be solved without the help and support of an educated public opinion. Without the full support of the laity, doctors are almost powerless in tho contest with cancer —just as powerless as the small professional army of England in 1914 was in the war. The British Empire cancer campaign, started three years ago, aims at organising and co-ordinating lay and professional efforts to solve the cancer problem. It already has branches in the overseas dominions, and if New Zealand takes the initiative in forming a branch I shall indeed feel that my visit here has not been in vain. “The secret of the origin of cancer is buried deeply in the early history of life upon tho earth, and will not be fully unveiled until biology and biochemistry have made great further strides. All the more reason why no time should bo lost and why tho younger nations with their vigour and freshness of outloo¥ should join the older nations in the search. “It is for each man in the world to ensure, so far as in him lies, that a full knowledge of cancer is ready against the day ho needs it for himself or those dear to him. One of your requirements in New (Zealand is a special institution for cancer patients, curable and incurable, associated with research lab oratories for the study of the disease. “I show you the honoured portrait of V. Samuel Whitbread, who in 1782 first set the coresponding seed in London and founded the present Middlesex Cancer Hospital.

[FINANCIAL ASPECT.

“Finance is an important aspect of the cancer problem. I have been told by a layman that vast amounts of money have been wasted in cancer research. As a !matter of fact, the amount expended tho world over in this research is ludicrously small in proportion to the importance of the object and the results already attained. Even in England the expenditure does not amount to one penny pel head per annum of the population. I say, therefore, deliberately and without forgetting the generosity of some individuals, that at present the world does not deserve to know the final secret of cancor. Such a treasure is not to be brought for twopence. 1 can best explain what I mean if I compare the search for knowledge about cancer with the search for a commodity much less valuable whether the estimate be made in terms of happiness or of money, viz., kerosene It lias been found useless by the oil companies to prospect for oil on a

small scale. Borings are being made all over the world at a cost which runs into millions per annum. Most of these borings are useless, but the business men who make them know that the mne.y spent is not wasted, and that the small percentage of successful wells will pay a hundredfold for the failures.

“Cancer research must be conducted upon the same principles upon and ade quote scale, at many centres and with proper financial support. Let Hie world readjust its values to a truer scale, and or every pound spent in boring tor oil, spend even a shilling on the cancer problem. It is a highly difficult- and uncertain enterprise, but sooner of later the well of knowledge will flow. Many minds in every country of the world must be directed to the subject independently and form different angles. Canada iias solved the problem of diabetes; fo New Zealand, if all its inhabitants put their shoulders to the wheel, may fall tie glory of settling the cancer problem. THE CAUSE 01< GANGER.. “] propose to use an opportunity to-day for the purpose of laying bolero you my views on the origin and causes turn of cancer. Carry your minds back then to the dawn of the world, un counted millions of years ago, when life first appeared upon its surface in the form of amoeba-like organisms each a single cell a single unit of living protoplasm, animated by two fierce passions—the desire for food and the desire to double its ego by the simple process of cell-division. “A title later in time there aiosc from these unicellular organisms organ isms composed of many cells living together in a communal life like that of a small village or a great city, 'lhe cells are now specialised into groups and each kind of cell follows a trade or profession, exerting for the comnuin ity its special skill, receiving from the community in exchange food, warmth and protection. To carry out the scheme, and to ensure that each cell receives its due share of food ami of such cell-products as it no longer makes for itself ,elaborate systems of conduits, the circulatory lymphatic and glandular systems have been envoived and equally elaborate machinery tomparable with the telegraphs, telephones and newspaper and business offices of the city brings information ol the outer world, and controls the activities of the cell-community.

‘it is a part of the bargain that the individual cell shall abandon the primitive right to unlimited cell division. In the many-celled animals this right is reserved to the cells ol the ovary and testis. “Note, however, that if the foregoing sketch of evolution is true each of one of the higher animals is descended from a primitive onc-celled organism with an irresistibe appetite lor flood and for niuLtiplicaHjii. .Note, further that these are the appetites which dominate the cancer cell, and you may be led to conclude that earner is an atavistic reversion of certain cells of tho body to tho state of their primitive one-cel led ancestors. Such a conclusion would, in my opinion ,be correct. The cancer cell is a selfish uni cellular■ organism derived by direct descent from the cells of the body but living among them as a parsite. “You might further be led to compare the cancer cell with its fierce anti social individualism, to an anarchist jn the body politic, and to inquire whether the anarchinl represents a spontaneous reversion to the savage primitive type of man, or whether he is the product of disorders in the social organism. Experience shows that the anarchist does not appear in prosperous and happy communities. It is therefore probable that in cuieer the reversion to the primitive cell type is conditioned by disordered bodily function. In other words, tho body has failed to carry out the contract under which the cell abandoned its right to unlimited multiplication. Under that contract each cell of the body lias the right to its share of the pioduets of all the other cells. It Las also a right to protection from external irritation.

“It is my object now to show how the contract has been violated. The writer’s observations led him to believe that the origin of cancer is intimately associated with local obstruction of the lymph vessels in the area where the cancer arises. To produce cancer tho obstruction must bo of long standing, must have lasted from twenty to thirty years. It may not be complete enough to cause obvious lymphatic oedema, but may manifest itself only by papillary hyperthrophv j and increased cellnlarity ol the subepithelial corrective tissues.”