Cancer: Its Cause and Treatment, Volume 1 (of 2)

by Lucius Duncan Bulkley

Unfortunately, there have been relatively few studies of the plasma of the blood in this or other diseases; and yet the condition of this fluid must be of the utmost importance, as from it are derived the nutrient principles not only of the solid constituents of the blood, but also those of the entire system, about 8 per cent. of it being serum albumen and serum globulin. It also holds in solution the phosphates, carbonates, sulphates, and chlorides, the latter often varying greatly, and being chiefly responsible for the isotonic relation of cells and serum. In cancerous cachexia a diminution of carbonic acid, a constantly diminished alkalinity, and an increase of acid principles of the blood have been fully demonstrated, pointing in all probability to the existence of an acid intoxication. The formation of the corpuscular elements of the blood must be greatly interfered with when metastases occur in the blood making organs, the lymphatic tissue, bone, marrow, and spleen, which probably occur more frequently than is generally recognized. It seems that the toxic secretion from a cancerous mass has a distinct action upon the blood, for after complete removal there is often observed an increase of hæmoglobin, as I have witnessed, and a high leucocytosis has disappeared after the removal of schirrus of the breast, only to return again with the recurrence of the tumor. Abderhalden states that in from two to three weeks after the operative removal of cancer, certain defensive ferments can no longer be found in the serum.

Many laboratory studies have been made upon the chemistry of cancer tissue, seeking to determine the nature of the toxin produced, and its experimental effect on animals, but thus far no great results have been obtained. It has been observed, however, by Gruner that when cancer juice is injected intra-venously a marked lymphocytosis arises, which is followed by the appearance of large mast cell myelocytes in the blood. This cancer juice is supposed to be autotoxic in cancer patients, and to comprise toxic albuminoids, which being in quantities too great to be quickly neutralized poison the system, especially the blood and the hæmatopoietic organs.

In regard to the real bio-chemistry of cancer, we are still greatly in the dark. Vast numbers of studies and researches have been made to determine the real character and nature of the bio-chemical changes which occur in cancerous tissue, and the mere recounting of the reported findings and theories elaborated from them would occupy far more time than can be profitably given in these lectures. Some have claimed very positive findings which account in a measure, at least, for the pathological conditions, while others, as Beebe, state that “the chemical study of tumors is in its infancy. We have scarcely proceeded far enough to know where the medical problems are, nor have methods now available been perfected to such an extent as to enable a decisive experiment to be made.” “No phase of metabolism,” says he, “has been described in cancer which does not have a counterpart in non-cancerous conditions. This applies to such questions as the nutritive relations between the cancer cells and the normal body tissue, to the nitrogenous balance, retention, elimination of sodium chloride, excretion of acetone, the relation of ammonia excretion, and a possible acidosis.” He adds, however, “Diet doubtless forms an important part in the growth of cancer, possibly even in the origin of the disease.” It is encouraging, therefore, to find that this able and careful laboratory investigator recognizes, in a measure, the basic cause of diet, toward which all evidence points so strongly, although the definite connection may not yet have been established by laboratory methods.

In all our study in regard to the relation of diet to cancer it must be remembered that there are divers elements and agencies which combine to produce the many and various disordered conditions of the body, to which we give the names of different diseases, and that cancer is no exception to this general rule. For instance, in old-fashioned gout the patient may have consumed an excess of Port and Madeira wine for years before the system finally rebelled and acute gout resulted; and among the causes for the systemic reaction we know that frequently it is great mental strain or shock which has so disturbed metabolism that the wine was no longer tolerated. Much the same is true in regard to cancer and nitrogenous diet. And we will see later that mental disturbance and nerve strain or shock often seem to be causative elements; also that constipation, or intestinal stasis, is so common in cancer subjects that it must be looked upon as one of the contributing causes among others, to be mentioned later.

Although it is quite possible that many of the reported bio-chemical changes found in primary cancerous tissue and metastases may not be of etiological importance, it may be interesting to briefly refer to some of them as indicating the vital alteration in tissues connected with what we recognize as malignancy; even as in acute and chronic gout the affected tissues exhibit abnormal conditions in regard to uratic deposit.

Many writers, some of them dating back many years, agree that albuminous constituents predominate in cancer tissue, and, as in actively growing structures in general, sugar forming substances abound. Wolter states that cancer of the breast contains 20 per cent. more nucleo-proteids than the normal breast. Casein is also present in breast cancers, and the abundance of fatty matters, contained in the cells of such neoplasms, is well known. In regard to the proteids, Wolff, after many studies, concludes that their character is identical with that of normal tissues, and it is only the quantitative distribution of these that differentiates the tumor from the physiological tissue. Wells agrees with others that there is no very distinctive character in the bio-chemistry of malignant tumors, but by reason of their excessive chemical component, as compared with benign tumors, they naturally show a high content of nuclear proteins; they, therefore, contain a high proportion of phosphorus and iron.

Interesting observations have also been made on other characteristics of cancerous tissues, such as the great abundance of enzymes of great variety which are actively autolytic, also in regard to certain relations of cholesterin, in regard to which Ewing has recently said, “There appears to be something in the chemical or mechanical nature of the irritation of cholesterin which is peculiarly effective in producing atypical proliferation of epithelium”; this has been found to be no less than 65 per cent. greater in quantity in fatty deposits, as in the mesentery, in subjects of cancer than in healthy persons, etc., etc. It would weary you to no purpose to attempt to refer further to the bewildering mass of research studies in connection with the bio-chemistry of cancer which are found in special literature: much of it is fragmentary and some of it contradictory, but all has its value as contributory to our knowledge of the actual conditions developed in connection with cancer growth; but up to the present time it cannot be claimed that any very practical results have been thus attained which will aid us in treating the disease.

As all cell life and proliferation of tissue depends on the activity of the cell nuclei, much attention has been paid to the changes found in them and the behavior of the centrosomes and chromosomes, all of which is too technical for us to consider here: suffice to say, however, that several observers have demonstrated heterotypic mitosis in malignant tumors, and that histologic examination confirms what other judgment has indicated, namely, that the cancer cell differs from a normal tissue cell mainly in its aberrant action under some stimulus, probably derived from the animal fluids by which it is surrounded. Thus we come back to our original proposition, for these fluids are, of course, but a reflection of the nutrition of the body or diet, as modified by the action of the various organs, including the internal secretions; all this is influenced again by the action of the nervous system.

It is difficult to produce definite proof in regard to the influence of nervous and mental strain and shock in the production of cancer, but careful observers have long claimed that there is such an influence, and from what I have seen I am firmly convinced that in some way these conditions often do so disturb the metabolism, or otherwise operate, in such a manner that cancer results. The influence of the mind upon the body is unquestionable, as has been so fully illustrated by Tuke, and from what I have observed I cannot doubt but that the mental depression common in those with the beginning of a process which they fear might result in active cancer, has much to do with accelerating its growth; whereas, on the other hand, the hopefulness which can arise with the attempt to change the diseased process by diet and proper medication, has much to do with the favorable results which may follow in suitable cases. In the same way the constant fear of recurrence after operative removal can have its share in inducing and perpetuating the metabolic error which excites the tissues to renewed cancerous action. I know that some of you will think that this is fanciful theorizing, but many a scientific fact, in many branches of science, has been worked out from a theory which at first has seemed fanciful.

We will now consider some of the data which have been recorded in regard to the relation of the secretions and excretions of the body to cancer, including the internal secretions.