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

by Lucius Duncan Bulkley

Our time does not permit of more than a brief allusion to the subject, but in cancer patients I have so constantly found the salivary secretion acid, and often strongly so, instead of the normal alkaline or neutral, that I cannot but believe that this condition has some bearing upon the subject which we are studying; the saliva also is apt to be acid in diabetes, which is closely allied to cancer. It is to be remembered that the saliva, which amounts in health to between one and two quarts daily, varying somewhat with the food, is not wholly for the purpose of lubricating the mouth and facilitating deglutition, but its enzymes, ptyalin and maltase, effect radical and important changes in the starchy matters consumed. It is also to be remembered that the latter cannot be acted upon by the stomach secretions, but must be passed on to the influence of the pancreatic fluid in the small intestine, in case the action of the saliva has not been effective; hence there follows delayed and imperfect digestion, faulty metabolism, deranged nutrition, and possibly tumor growth. The importance, therefore, of very slow eating, thorough mastication, and perfect insalivation cannot be too strongly insisted on, both as an element of importance in the prevention of cancer, and also as a curative measure in patients in whom the diseased process has already manifested itself.

The so-called internal secretions have also been the subject of much research and speculation of late years, in regard to their influence on metabolism and the life processes of the economy, and many studies have been made concerning their connection with cancer, which cannot be long dwelt upon now; but there seems to be little doubt but that the secretions of the ductless glands in common have much to do with regulating the metabolism of the cells. We know, for instance, that disease of the pituitary body produces bone disorder, resulting in gigantism, that thyroid derangement results in myxœdema, and that disease of the supra-renal capsules gives rise to Addison’s disease, or bronzed skin; and it is not at all impossible that the derangement of secretion of one or more of these and other organs may be an element in the disordered action of certain epithelial cells, resulting in cancer. Harrower calls attention to the fact that cancer is essentially a disease of that period of life when certain of the ductless glands lose their normal function, this loss entailing related changes in the whole chain of interrelated functions of the ductless glands.

The supra-renal glands by their secretion have, as we know, great vaso-constrictor influence, and their complete removal is followed by death; it is more than possible that some failure in this secretion allows the exuberant blood to supply cancerous growths. Sajous says: “Certain growths, particularly the more malignant forms of sarcoma and carcinoma, seem closely connected with adrenal insufficiency and its normal consequences,” and there have been some clinical and research data confirming such a conclusion. Sajous further says, “The adrenals, as supporters of the thyroid apparatus in the defensive process, and in sustaining oxidation, metabolism, and nutrition, seem to offer a new clew to the pathogenesis and treatment of cancer that is worthy of further inquiry.”

The pancreas has been thought to have some influence in a perverted metabolism leading to cancer, Kahle stating that there is a retention of silica in that organ in cancer patients, to even double the normal amount. A treatment of cancer introduced by Beard, also strongly presented by Saleeby, by trypsin and amylopsin, the enzymes of the pancreatic fluid, excited some attention a while ago; but unfortunately no satisfactory results have thus far been obtained from this line of medication, as was fully demonstrated by Bainbridge at the New York Skin and Cancer Hospital, in one hundred cases.

The pituitary gland by its secretion has undoubtedly some coordinating power, with the adrenals and thyroid, over the processes of metabolism, and a number of observers have regarded it as of importance in connection with the genesis of cancer. Little has recently reported some cases of cancer in which pituitary extract with that of the pancreas has produced remarkable results.

The thyroid is now recognized as playing an important part in assisting metabolism, and, like the adrenals and pituitary, its complete removal, with the parathyroids, in animals is followed by death. While the study of the hormones is still in its infancy, there seems to be no question but that the endocrinous glands act conjointly, the one influencing the other, and that together they exert a very great influence in the life processes of the body and on the behavior of its component cells. The thyroid has been shown to be one of the main factors in the management of calcium within the body, which is believed to be an element in cancer, and enhances the catabolism of toxic wastes, which are etiologic elements in this disease. Many have reported favorably on the effect of thyroid feeding in cancer, and after an experience with it in many cases I am convinced that it has been one of the means which contributed to the good results obtained. On the other hand it has been claimed by Stuart-Low that the surgical removal of the thyroid, or part of it, or ligation of the thyroid blood vessels has arrested cancer, in several cases.

Thymus gland feeding has also been reported on favorably by a number of observers (Rohdenburg, Bullock, and Johnson, also Gwyer), they reporting relief of pain and improved general conditions, notably gain in weight and increased hæmoglobin in all but one of sixteen cases, though some of them died. On the other hand Ross reports most unfavorably on the administration of thymus, which he gave to some inoperable and hopeless cancer cases, in which he said that in two or three weeks the tumors had quadrupled in size and the condition of the patients was very much worse; the same occurred also when some cancer patients were given calcium salts freely. Ross makes some interesting suggestions in regard to the thymus, and its relation to calcium and magnesium; these latter are freely utilized in the growth of bone up to the age of twenty-five years, by which time the thymus gland has quite disappeared; but after this time these salts tend to have pathological relations in various tissues, and also cancer becomes frequent.

The internal secretions of the testicles and ovaries are also thought to have some share in metabolic processes, and observations have been made in regard to their influence in cancer. Thus Cahen reported that Beatson’s operation of castration for cancer, done first in 1896, had been repeated by many, so that Lott had reported 99 cases including his own. Of these in 23.2 per cent. the operation caused a distinct improvement in the cancer. In 15 cases the improvement persisted for a year, in 4 cases for 4½ years and in one case for over 5 years. Cahen operated on seven women with remarkable results; in two cases life was prolonged 4 and 6 years respectively. Others, however, have shown by statistics, that damage to the ovaries by disease, or their removal by operation, greatly increases the proclivity to cancer. Several writers have connected cancer with the waning of the sexual powers, and the suggestion is made by Sherrington and Copeman that in the period which antedates the cancer age, the reproductive glands, by means of internal secretions, are able to inhibit the growth of cancer.

In looking back over what has been observed in regard to the secretions, including those of ductless glands, we see that very strong evidence has accumulated to show that they have a very intimate connection with the development of cancer, as was to be expected, since they are very important factors in connection with metabolism.

We have also seen that while there has not been demonstrated any very definite and specific change in the bio-chemistry of tumors, and no specific enzymes or poison secreted by cancer cells which can communicate the disease, there is evidence that the disordered cells secrete a something which deranges the blood and ultimately tends to end life; for the blood in advancing cancer undergoes very radical, degenerative changes, some of which improve decidedly when a cancerous mass is removed surgically, but return with the regrowth of the tumor.