The conquest of cancer

by H. W. S. Wright

In combination with surgery this method has its very greatest use in the prevention of superficial recurrences. In every operation, in spite of the greatest care, it is impossible to avoid the setting free into the tissues of a few cancer cells which may grow later into a recurrence. Post-operative radiation bids fair to abolish this type of recurrence, which formerly accounted for a good percentage of all recurrences.

From time to time many methods have been brought forward which have for a little while promised well, but so far none of them has produced results in any way comparable with those obtained by complete removal of the growth by surgical means.

I have not dealt with these in any detail here because, whether ultimately we use drugs, surgery, violet leaves or any of the recently popularised methods of “taking thought” to cure the disease, the main point of my thesis will still hold good, and that is, that by far the most important factor in the cure of the disease is that of early diagnosis. This lies in the hands of the public far more than in those of the medical profession. If the public want early diagnosis they will get it, when they insist on it, just as they get anything else they insist on, from self-government to prohibition, no matter how good or bad it may be for them.

Briefly stated, most cases of early cancer are curable, and the diagnosis of early cancer is only to be made by looking instead of waiting. On these facts, certain constructive proposals can be based. They are so simple that they are not likely to be heeded for some time to come, for the public has always preferred Abana and Pharpar, rivers of Damascus, to washing in Jordan, and I suppose always will do, till we reach a more enlightened age.

Nevertheless I believe it is true, and without exaggeration, to say that about ninety per cent. of all cases could be cured or prevented if the following statements were accepted.

If all persons over forty years of age were routinely examined once every six months to see that they had not cancer, or a precancerous condition, and if these when found were promptly dealt with, then cancers of the rectum, tongue, lip, breast, skin and uterus would cease to be the plagues they are at present.

Similarly, if every patient who had taken more than a pound of bismuth to relieve gastric pain were routinely explored to see that cancer or gastric ulcer did not exist, the large majority of growths in this region would be either prevented or cured. Similar rules can easily be devised to deal with cancers arising in other parts. What is wanted is a change of attitude on the part of everyone concerned. After all, a fortnight in bed, with forty-eight hours of discomfort, is not too great a price to pay for freedom from this disease, and, with proper examination, even this would be unnecessary in most cases.

Every intelligent person is aware that, in order to ensure freedom from dental disease, it is necessary to have his teeth examined every six months, and to have small lesions dealt with in their very early stages. All have come to this conclusion because they know that neglected dental disease means pain; and they now look to see that their teeth are normal, instead of waiting for a toothache to come. It is true that there are still some of our weaker brethren who still wait till they get toothache before they visit the dentist; and for them there is nothing to be done. In the same way, if we wait for the advanced signs of cancer to develop, the position with regard to its cure will remain approximately what it is to-day.

The education of the public up to this pitch is by no means an impracticable proposal. The position with regard to appendicitis is very much the same as that of cancer. What has been done in the case of appendicitis? The mortality is in proportion to the number of hours during which the disease has existed. Twenty years ago appendicitis was responsible for a large number of deaths. During 1919 and 1920 there was, in a large London General Hospital, only one death from appendicitis, and yet there were at least 5 cases dealt with every week. This improvement is entirely the result of education of the public and their doctors. They know that to be cured operation must be early, and so we no longer wait to see whether the patient is going to die; if we suspect it, we look and see whether it is present or not. True, we remove unnecessarily a fair number of appendixes but, by so doing, we purchase, for a much larger number of people, immunity from death by this disease. When exactly the same principle is applied to cancer we shall be in a position to be a great deal more satisfied than we are at present.

One of the most successful ways of treating a patient with fixed ideas is by the use of explanation combined with strong counter-suggestion. This is the method of psycho-analysis and hypnotism. No patient is more susceptible to this kind of treatment than that capricious lady, Public Opinion. If we want to realise the ideals put forward in the early part of this essay, we must mobilise all our resources: the Press; the Platform; the Consulting Room: for a prolonged and intensive campaign against this black spot on our civilization.