Having now seen how very much can be accomplished in primary cases, that is, in those who have not been submitted to an operation, let us consider what can be done for those truly pitiful cases where surgery has been tried and failed, and where one or many successive recurrences after repeated operations has left the patient even worse than before; and, as some surgeons tell us, worse than the patient would have been if the disease had been left to nature, without operation and with only ordinary medical guidance.
In regard to the cases with recurrent cancer after operation of which there were 72, it can be readily understood that one cannot speak with enthusiasm. But in my former lectures I reported three such cases in which the benefits were certainly very remarkable. I also reported from private practise another totally inoperable cancer of the breast, of two years’ previous duration, with great cachexia, in which the enormous, hard, ulcerating breast was reduced to about half the extent, with a diminution in the large axillary and supraclavicular glands to fully one half their size. The patient suffered no pain from soon after beginning treatment until she peacefully died six months later, of exhaustion and pulmonary edema.
In many cases, both in private and hospital practise, the beneficial effect of a dietary and medical treatment have been very striking, even after recurrences following repeated surgical operations; but it would be unreasonable to expect any startling effects in cases which had become so saturated with the poisonous hormone generated by repeated new developments of cancerous tissue that there were numerous metastases, not only in internal organs and lymphatic glands, but also with cutaneous nodules produced in various parts of the skin through capillary infection.
And yet in most of these cases there has been a betterment of condition in nutrition, color, weight, etc., which sometimes seems to encourage one that the real disease would be conquered. But although life has frequently been prolonged far beyond what might be expected, and discomfort and distress have often been greatly lessened, we have not yet reached the position of checking and curing far advanced cancer at all comparable with what can be accomplished in its early stages. I dislike to weary you with the narration of cases, but a few instances may help you to understand what is meant.
Case IV.—Mrs. D. S., aged 53, first seen July 6, 1916, is a rather recent case of recurrent cancer of the left breast, in private practise, but it is instructive. Over five years ago a small pimple, as she called it, appeared on the left side, which was left alone for five years. Then on January 21, 1914, the left breast was removed by a surgeon of prominence, and all seemed well for six months, when there was some return and a second operation was performed in January, 1915; there was again a third removal in April, and a fourth in August, 1915, all by the same excellent surgeon, and the wound has never healed since. There had never been any attempt at dietary or medical treatment or any effort to check the causes producing the malignant growth.
Since January, 1916, there have been many cutaneous nodules developing around the open sore, which when first seen presented a characteristic ulceration eight inches long, by two or three inches irregularly wide. The axillary glands were enlarged and the left arm, which had been greatly swollen since the first operation, was hard, tense, and painful, and, of course, helpless. The forearm measured 13 inches and the upper arm 14 inches, the right arm being 8½ and 9½ inches, respectively. Her weight, which had been 168 three years ago, was reduced to 133; she was always very constipated and her urine deficient and irritating, calling her also at night; she had long suffered from rheumatism, and also severe headaches up to the menopause, seven years ago.
Under a rigid “green card diet” and the mixture already referred to, with a larger amount of cascara, she began to improve at once in her feelings, the arm became softer, and somewhat flabby, and the nodules, which had been painted with 50 per cent ichthyol, were less prominent. Later thyroid extract being added after meals, brought her weight down a little, but during the last months it had been maintained steadily at about 120 pounds. The urine which at the first was sometimes only 26 ounces in the 24 hours, with great deficiency in solids, has been brought up some days to 45 ounces, with the proportion of solids to the body weight about right. The saliva, which was very acid, is much less so, though still acid and scanty, and the mouth dry.
Not to dwell too long on the case I may say that I find a recent note to the effect that she said that she feels very well and friends think that “there cannot be much the matter with me.” But she still has a considerable ulcerating surface, though with islands of healing; she still has many metastatic nodules in the skin in various places, and the arm, which is still swollen, though no longer tense, is smaller, and, really, the flesh shakes when the arm is quickly moved.
This is certainly a desperate case, after four operations, but the difference between her present condition and what she would have been without treatment can hardly be imagined. For in these five months she probably would have been in her grave, whereas, during all this time she has been traveling back and forth from her home, some distance away in New Jersey, to my office, a happy woman. What the end will be I cannot foretell.
I want you now to see and examine a Bohemian woman who has been treated in my medical clinic for cancer at the hospital since July 26, 1916, something over four months.