TOO MUCH MYSTERY ABOUT CANCER.

Manawatu Herald, Volume XXXV, Issue 1056, 28 January 1913, Page 4

TOO MUCH MYSTERY ABOUT CANCER.

IS SURGERY NECESSARY ?

TREATMENT BY CHEMICAL

SUBSTANCES

“Too much mystery surrounds cancer, the nature of vvhiph has, indeed, been known for many years past, although satisfactory results from treatment are at present but rarely obtained,” writes Dr. Lovell Drage in a recent issue of the National Review. “The disease consists of the assumption by certain cells of parasitic qualities, and the result is the formation of a growth or tumour, which derives its means of subsistence and expansion from its host. The conditions which cause this as sumption of parasitic properties are unknown, but a plausible suggestion is that an organism, either belonging to the animal or vegetable world, obtains access to the cells which are to become cancerous, ami after having initialed the changes, loses its own existence and becomes incorporated in the cancerous cells.

“The growth having commenced, no symptoms of disease are to be detected in the individual attacked until it has either interfered with the work of one or more organs or by pressure has caused pain or discomfort. A cancer, therefore, may have grown for many years before the iudivi dual attacked is aware that he or she is the subject of the dread disease. There are no symptoms of the disease to ,be specially assigned to cancer. After varying intervals of time the growth spreads from the original focus to other parts of the body along the course of the lymphatics, and it is not uncommon to find these channels infected as soon as the original growth is delected. There are periods of activity and quiescence.

“In a few cases a growth has been known to cease altogether, and complete disappearance is not unknown. After the growth has reached a stage of maturity degeneration begins, and, in lact, local death occurs. The most common cause of death is the blood poisoning which arises from the absorption of the poisons caused by the process of destruction. With the exception of the origin of cancer, it does not appear that there is much room for mystery. Moot points there are, no doubt, such as the position of heredity and of the nature of predisposing causes, but so far as the problem of treatment is concerned, the difficulties remain in the same position which they have always occupied.

REMOVING THE PATIENT EROM THE DISEASE.

“Official pronouncements and semi-official communications persist to the effect that surgery alone can ensure either the cure of the patient or amelioration of the distressing symptoms. Charlatanism is the least of the many charges which a doctor incurs if he attempts to treat the disease in any other way than that which the =urgeou proposes. Twenty-five years ago the large mutilalive operations at present adopted were impossible, but step by step the surgeon has made it possible in many cases not only to remove the original focus of disease, but also parts which experience has taught are those most likely to be the subject of subsequent attack. “Surgery has reached the point when the patient can almost be removed from the disease, though it cannot remove the disease from the patient. No satisfaction can be felt at such a result, and it is obvious that at the present moment the treatment of the disease is in an intermediate stage. Surgery can be said to be the best means of coping with the disease at present recognised by the professional Brahmins, but to those who are not Brahmins, but possess the instincts of science, it is only so obvious that there are methods available based upon considerations which in the end will lead to complete success. USE OF EIGHT RAYS LIMITED AND DANGEROUS. “The treatment by exposure of the growth to light rays, such as the X-rays, or those given off by radium, must have a limited applicability ; they are only useful in cases in which the growth is near the surface ot the body, or in such a place in which their application is practicable. “There is, moreover, a fatal objection to the use of these powerful agents; the surrounding healthy tissue is exposed to their

agency as well as the diseased area ; their activity is, therefore, applied to healthy cells, whose vital powers are appreciably lessened. It is no matter of surprise to me, therefore, that the worst cases for medical treatment are those in which treatment by these agents has been attempted. Another objection to this treatment is that cases of success are few and far between.

CHEMICAL, TREATMENT DIKEICUJ.T THROUGH SCARCITY OE SUBJECTS. “Treatment by the use of chemical substances has up to the present time been handicapped by the activity of the surgeon. - It is well-nigh impossible to find persons suffering from cancer who have not sustained at least one mutilative operation, and a mutilative operation involves great interference with the circulation of the blood in the area operated upon, equally great interference with nerve supply, and with lymphatic supply. Treatment by chemical substances is, of course, equally handicapped, as are other

methods of treatment, by the fact that cancer is frequently ot old standing when sufferers apply lor treatment, aud it is also handicapped by professional opposition to any other treatment but surgical. CHEMICAL TREATMENT AND BIOLOGICAL TREATMENT, ‘‘The nature of the disease having already been explained, it can now be stated that chemical treatment can be applied in two ways. The first is by the use of some substance which can be employed therapeutically, of sufficient strength to destroy the growth. The second is the alteration of the environment of the diseased cells, so that their growth can be interfered with and, in fact, prevented. The first is undoubtedly insufficient by itself for any curative purpose, but it may be used in a subsidiary manner. Various powerful substances, such as formaldehyde, have a very destructive action upon cancers which are on the surface of the body aud which have already commenced t decay, and can be used to lessen the evils of putrefactive changes. RESULT OB INVESTIGATIONS.“Some fifteen years ago, when I first began to give my attention to this disease, I was fortunate in enlisting the services of Dr Morgan —now Professor of Chemistry in the Royal College of Science, Dublin—in the work, aud, acting upon the suggestion of Dr Lewis Jones, I investigated various thorium compounds which the former made for me.

“Disappointment followed, and only one compound, the oleate, was found to be of any use. Dr Morgan, however, at my suggestion, made a number of the salts of coumaric acid, nearly allied to cinnamic acid. Organic chemistry provides practically an unlimited field in a subject of this sort.

“None of the old and tried remedies in the hands of the physician have proved of any value in the treatment of the disease, and this being so the obvious coarse for the worker is to obtain new substances of known chemical composition, whose physiological properties can be investigated and ascertained.

“A; the outset observation had led me to the investigation of the cinnamate of sodium, which is a drug capable of producing in the blood a large increase of those white cells which are the most highly organised element in the blood. The exhibition of this compound proved, at any rale, that the attempt to treat cancer medicinally was no forlorn hope. Palliative results were obtained, and Mr C. B. Lockwood very kindly used the treatment in his wards at St. Bartholomew’s Hospital, and relief was given in several cases when that surgeon had done all that his set vices could effect.

A successful, ATTEMPT

“This preliminary attempt was one based upon the second method above mentioned, It was believed that, by altering the constitution ol the blood in the direction of the increase of those cells most profoundly possessing the attributes of living cells, cancerous growths could be attacked, and the attempt was sufficiently successful for the prosecution of further effort. The salts of coumaric acid which Dr Morgan produced were found to possess considerable therapeutic activity. These acids, tested by the RidealWalker method, were found to possess a much hgher antiseptic power than carbolic acid when tested with the enteric bacillus.

“Considerable experience has now been gained of the value of these chemical substances, and from lime to time adjuvants have been added or rejected, and there is now no doubt remaining in my mind that it is possible to mitigate the suffering present in many advanced cases of cancer.

“Unfortunately, the supply of patients who have not been treated surgically or by light treatment is very small —only three in all—so it is impossible to advance at the present time a statement of any value as to rectitude in advising patients to refuse operation. But at least I am not prepared to press operative treatment upon patients to the same extent as formerly, and certainly am prepared to ask for continued work upon the lines on which I have myselt worked. AN HONEST ATTEMPT. “It is a matter of difficulty to understand the mental attitude of official persons, and of those who, without disclosing their identity, continue to give forth semi-official utterances in the press to the glorification of surgery and to the disparagement of those who are only conscious of honest endeavour to advance the treatment of a dire disease.”