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

by Lucius Duncan Bulkley

In the classical work of Walshe we find numerous references to the constitutional nature of cancer, original or quoted from recognized authorities, as well as expressions in regard to the futility of expecting that surgical interference would cure the real disease in any great proportion of cases. He says, “It would in theory appear that the removal of a tumor cannot in itself cure the disease, as the local formation is but a symptom of a general vice of the economy.”... “This tissue being, as the normal textures, the seat of nutrition, is like them susceptible of its disordered actions,” and he alludes more or less to the effect of diet on the disease.

The late Willard Parker, one of New York’s great surgeons, in a study of 397 cases of cancer of the female breast, observed from 1830 to 1880, wrote very strongly in regard to the constitutional relations of cancer. In considering the etiology he places constitutional causes first, and says, “luxurious living, and particularly excess in animal food, increases the waste products of the body, and if coupled with insufficient exercise, the waste products are retained in the system and have a tendency to produce abnormal growths.”... “Cancer is to a great degree one of the final results of a long continued course of error in diet, and a strict dietetic regimen is, therefore, a chief factor in the treatment, preventative and curative.” Concluding his study he says, “There is such a consensus of opinion as to the advisability of early removal of the growth, that a discussion of the subject would be useless. So then, in the first place, let us remove the tumor, and thoroughly. But after we have done so, after we have taken it out by the very roots, is this sufficient? No. We must then adopt the means stated above to prevent a second development. We must change the diathesis; we must seek to modify the patient’s constitution so that it will be no longer prone to reproduce the disease: and then only may the surgeon be satisfied that he has done his duty.” He further says, “In regard to the effect of abstemiousness on cancer I can speak with great positiveness, that vegetable, or at least a very bland diet, does check the progress of the disease, and, in some cases now under treatment, has been attended by an alleviation of symptoms; and in a few instances even by a recession of the growth.” He also quotes from Sir Astley Cooper some strong language which, as he says, “shows a broader and more enlightened view of the subject than is contained in the writings of some more recent observers, who have supposed that they were working far in advance of the great English surgeon”; the rather long quotation then given proves that that great surgeon also believed absolutely in the constitutional nature of cancer.

Sir James Paget is often mentioned by writers, sometimes even with derision, as a believer in the Constitutional Nature of Cancer, and his words are very strong; says he, “I believe it to be constitutional, in the sense of having its origin and chief support in the blood, by which the constitution of the whole body is maintained,” and speaks at some length in his lecture, in support of this view; I will give you one other small quotation. “The existence of the morbid material in the blood, whether in the rudimental or in the effective state, constitutes the general predisposition to cancer,” etc. It is remarkable that the views of this prince of surgeons and pathologists should not have carried more weight in regard to cancer, when his other views are so well accepted.

Time does not permit us even to refer to the great mass of more or less similar views and corroborative evidence scattered in books and current literature during the last fifty years, but a few more references may be given. In 1884, and again lately, Merriam has called attention to cancer occurring as a reversion of tissue cells to earlier or embryonic forms under the influence of a disordered, or as he calls it, a poisoned blood stream, from over nutrition from a meat diet; and Haig has long maintained that uric acid is a prominent factor in the etiology of cancer.

While few will agree with Haig in all his conclusions, there is no doubt but that a faulty nitrogenous metabolism plays a not inconsiderable part in the causation of many diseased conditions, as has been also shown in a previous lecture to be true in regard to cancer: and while it may not be actually uric acid or urea which does the harm, as these are relatively harmless end products of metabolism, it is true that the purin and xanthin bases, of many forms, and imperfectly oxidized nitrogenous elements, are active agents in the production of disease. Venus and Isenberg have both written very strongly in regard to the unquestioned value of a vegetarian diet in cancer, the former citing many supporters of the view, from ancient times to the present. If time permitted any amount more of corroborative evidence could be given in regard to the connection of cancer with metabolic disorders.

There have been many scattered articles concerning the chemico-pathology of cancer, all looking in much the same direction as that which we are pursuing, which cannot even be alluded to, but brief mention must be made of a most illuminating and suggestive study by Bristol. Reviewing the many theories of the etiology of neoplasms he shows pretty clearly that cell reproduction comes from outside the cell, or from the surrounding cell medium by a process of diffusion, or by a definite chemical attraction, and is closely associated with the nutrition and growth of the cell, especially the nucleus; also that a fixed ratio between the salts in the blood, lymph, and tissues is necessary for normal activity and reproduction of cells; further that a disturbance in this ratio and an upset in the chemical equilibrium will lead to abnormal metabolism, growth, and reproduction, and result in an atypical growth in the local area involved.

As before remarked, it seems strange that the medical profession and the public have been so slow in accepting the views here presented. But both have become so obsessed with the idea that nothing can be done for cancer except operative procedure of some kind, and so dazzled with the glamour of modern surgery, so fascinated with the apparent definiteness of laboratory proceedings, and so attracted by the glory of purely scientific research, that it is very difficult for any other doctrines to make headway: moreover, any dietary or medical treatment, prophylactic or curative, is very tedious and also difficult, in the way of attention to minute details, etc., and patients weary of restrictions and are restless at seeing little or slow progress made. Haig found the same difficulty with Hospital patients, but does not hesitate to state that in private practice “some undoubted cases of cancer have gotten well” under his dietary restrictions.

But when it is remembered that it is calculated that, under present existing conditions and treatment, fully 90 per cent. of those attacked with cancer ultimately die from it, and that there were last year nearly 50,000 recorded deaths from this cause in the “Registration area” of the United States, covering but two-thirds of its population, and that the disease is rapidly and surely increasing, it behooves the Medical Profession to put forth the best efforts possible to stay the progress of the disease. In New York City, according to the Weekly Bulletins of the Board of Health, there were from May to November, 1914, in 26 weeks, 2173 deaths from Cancer, Malignant Tumor, or an average of 83.5 per week, almost twelve deaths daily from malignant disease.

Operative surgery has unquestionably been of great service in certain cases and along certain lines of cancer, and the claim for the earliest possible removal of morbid growths is certainly a just and proper one; moreover, with our present knowledge it is perhaps wise to attempt to remove the offending mass while there is some hope or prospect of benefit, and personally I am occasionally advising this in proper cases. X-ray and radium have also their sphere of usefulness in a certain class or group of cases, but the excessive exploitation of the latter, not long ago, did harm in raising false hopes in multitudes of sufferers, and as these were shattered so also was confidence shaken in regard to all help for cancer from other than surgical removal.

But every one who has been brought much into contact with cancer knows full well what a mass of recurrent cases exist, possibly many of them due to bad operation, in regard to which surgery has to acknowledge that it can offer nothing more, that they are inoperable and therefore they are regarded as incurable. Every one also knows how many cases there are which have advanced so far before coming to a competent surgeon, that they are also inoperable. Every one likewise knows that there are numerous cases of cancer in internal regions, and in certain localities, and presenting peculiar features, which are also recognized as inoperable, at least with any proper justification. Thus it may safely be said that of the total number of cases of cancer existing at any one time, which would be included under the above classes, fully 50 per cent. are such that operative surgery can offer no hope of material benefit: also, it must be acknowledged that but a relatively small proportion of all cancer cases are likely to secure the very best surgical service, such as claims the highest percentage of success.