The conquest of cancer

by H. W. S. Wright

Let every member of the State have the opportunity to avail himself or herself of what Science and Art can do for him: let none who has the will suffer because he has not the means. But the too easy provision of means for the avoidance of consequences of neglect does, very seriously, put a premium on neglect and penalise those who themselves make effort in the right direction. Again: hard on individuals though it would seem, there is a very real racial advantage in the elimination—natural and inevitable, unless we interfere—of those who will not take advantage of opportunities offered them. We are not automata: we exercise choice; when the opportunity of choosing rightly is offered us, if then we choose wrongly, we have no right to demand escape from the consequences, at the expense of others.

At any rate, if the facts relating to Cancer are plainly stated, every man has but himself to blame if he shrink from obtaining such diagnosis and treatment, as is now available, at the earliest moment. It were better still that he avoid from the beginning all what we know to be predisposing causes of cancer: all the errors of omission and commission in respect of the physiological and spiritual—or physical and psychical—functions and relations of his Self.

It is the principle, the pursuit of the unattainable ideal, that really counts. The simple injunction to eat greens and take paraffin is the physiological counterpart of seeking to make people moral by act of Parliament, religious by church-going, and intelligent by attendance at evening lectures. But even if we make all possible effort, we cannot all hope to escape, and the necessity for seeking early diagnosis when things go not well is as imperative as is true the maxim that “A stitch in time saves nine”.

There is perhaps one more question that may be touched upon: that of the so-called increase of cancer. It is commonly stated that cancer is increasing: it is as commonly asked if this is really so. As a matter of fact, the question (which we are usually told can be only answered by statisticians) is one that statisticians can only answer when we have agreed what they are to understand by it. And that is not so easy as may be at first thought.

It is certainly true that, in the British Isles, the number of deaths certified each year as due to cancer of one form or another is gradually and steadily increasing, both absolutely and relatively to the population. But then we have in the first place, to consider whether cancer is not diagnosed more frequently in ratio to the cases seen than was formerly the case, and, in the second, to remember that cancer is, on the whole, a disease suffered during the second half of life. Now, our population is an older one than it was: the birth-rate is falling: so many youths who would now be vigorous men of thirty-five to forty lost their lives in the war; and lives are, on the whole, longer than they were, owing to a diminishing liability to suffer from certain ailments other than Cancer.

Supposing that children ceased to be born, at the same time that the Ministry of Health succeeded in “abolishing” all diseases except cancer, and the Home Office and Police reduced the probability of death from accident, from homicide, and from suicide, to vanishing point. Would we not then all die from either “old age” or from “cancer”? If so; should we be justified in declaring that cancer had “enormously increased” since the successful institution of control of our own deaths and other peoples’ births?

We are, indeed, again confronted with the old problem of the one and the many, under one of its numberless aspects. From the point of view of the statistical bureaucrat, cancer is increasing. That is to say, an increasing number of deaths, and an increasing proportion of deaths, are every year presented to him, both absolutely and in relation to the population. And so many more perforated cards are in consequence manipulated by his counting machine.

Can it be said that, for any one reader of these pages, the chances of death from cancer are year by year increasing, as are the chances of being run over in the London streets? Who can say?

But this is true. We must all die. We are, for the most part, anxious to postpone the day of death, and many of us dread, more than aught else, a death from cancer.