Preventable Diseases

by Woods Hutchinson

The great fundamental difference between cancer and any infection lies in the fact that, in an infection, the inflammations and poisonings and local swellings are due solely and invariably to the presence and multiplication of the invading germs, which may be recovered in millions from every organ and region affected, while swellings or new masses produced are merely the outpouring of the body-cells in an attempt to attack and overwhelm these invaders. In cancer, on the contrary, the destroying organism is a group of perverted body-cells. The invasion of other parts of the body is carried out by transference of their bastard and abortive offspring. Most significant of all, the new growths and swellings that are formed in other parts of the body are composed, not of the outpourings of the local tissues, but of the descendants of these pirate cells. This is one of the most singular and incredible things about the cancer process: that a cancer starting, say, in the pancreas, and spreading to the brain, will there pile up a mass—not of brain-cells, or even of connective tissue-cells—but of gland-cells, resembling crudely the organ in which it was born. So far will this resemblance go that a secondary cancer of the pancreas found in the lung will yield on analysis large amounts of trypsin, the digestive ferment of the pancreas. Similarly a cancer of the rectum, invading the liver, will there pile up in the midst of the liver-tissue abortive attempts at building up glands of intestinal mucous membrane.

This fundamental and vital difference between the two processes is further illustrated by this fact: While an ordinary infection may be transferred from one individual to another, not merely of the same species, but of half a dozen different species, with perfect certainty, and for any number of successive generations, no case of cancer has ever yet been known to be transferred from one human being to another. In other words, the cancer-cell appears utterly unable to live in any other body except the one in which it originated.

So confident have surgeons and pathologists become of this that a score of instances are on record where physicians and pathologists, among them the famous surgeon-pathologist, Senn, of Chicago, only a few years ago, have voluntarily ingrafted portions of cancerous tissue from patients into their own arms, with absolutely no resulting growth. In fact, the cancer-cell behaves like every other cell of the normal body, in that, though portions of it can be grafted into appropriate places in the bodies of other human beings and live for a period of days, or even months, they ultimately are completely absorbed and disappear. The only apparent exception is the epithelium of the skin, which can be used in grafting or skinning over a wide raw surface in another individual. However, even here the probability appears to be that the taking root of the foreign cells is only temporary, and makes a preliminary covering or protection for the surface until the patient's own skin-cells can multiply fast and far enough to take its place.

A similarly reassuring result has been obtained in animals. Not a single authenticated case is on record of the transference of a human cancer to one of the lower animals; and of all the thousands and thousands of experiments that have been made in attempting to transfer cancers from one animal to another, only one variety of tumor with the microscopic appearance of cancer—the so-called Jensen's tumor of mice—has yet been found which can be transferred from one animal to another.

So we may absolutely disabuse our minds of the fear which some of our enthusiastic believers in the parasitic theory of cancer have done much to foster, that there is any danger of cancer "spreading," like an infectious disease. Disastrous and gruesome as are the conditions produced by this disease, they are absolutely free from danger to those living with or caring for the unfortunate victim. In the hundreds of thousands of cases of cancers which have been treated, in private practice, in general hospitals, and in hospitals devoted exclusively to their care, not a single case is on record of the transference of the disease to a husband, wife, or child, nurse or medical attendant. So that the cancer problem, like the Kingdom of Heaven, is within us.

This conclusion is further supported by the disappointing result of the magnificent crusade of research for the discovery of the cancer "parasite," whether vegetable or animal, which has been pursued with a splendid enthusiasm, industry, and ability by the best blood and brains of the pathological world for twenty years past. I say disappointing, because a positive result—the discovery and identification of a parasite which causes cancer—would be one of the greatest boons that could be granted to humanity; not so much on account of the actual loss of life produced by the disease as for the agonies of apprehension engendered by the fact of the absolute remorselessness and blindness with which it may strike, and our comparative powerlessness to cure. So far the results have been distressingly uniform and hopelessly negative.

Scores, yes, hundreds, of different organisms have been discovered in and about cancerous growths, and announced by the proud discoverer as the cause of cancer. Not one of these, however, has stood the test of being able to produce a similiar growth by inoculation into another body; and all which have been deemed worthy of a test-research by other investigators besides the paternal one have been found to be mere accidental contaminations, and present in a score of other diseases, or even in normal conditions. Many of them have been shown to be abnormal products of the cells of the body in the course of the cancer process, and some even such ludicrous misfits as impurities in the chemical reagents used, scrapings from the corks of bottles, dust from the air, or even air-bubbles. These "discoveries" have ranged the whole realm of unicellular life,—bacilli, bacteria, spirilla, yeasts, moulds, protozoa,—yet the overwhelming judgment of broad-minded and reputable experts the world over is the Scotch verdict of "not proven"; and we are more and more coming to turn our attention to the other aspect of the problem, the factors which cause or condition this isolation and assumption of autonomy on the part of the cells.

This is not by any means to say that there is no causative organism, and that this will not some day be discovered. Human knowledge is a blind and short-sighted thing at best, and it may be that some invading cell, which, from its very similarity to the body-cells, has escaped our search, will one day be discovered. Nor will the investigators diminish one whit of their vigor and enthusiasm on account of their failure thus far.

The most strikingly suggestive proof of the native-born character of cancer comes from two of its biologic characters. The first is that its habit of beginning with a mass formation, rapidly deploying into columns and driving its way into the tissues in a ghastly flying wedge, is simply a perfect imitation and repetition of the method by which glands are formed during the development of the body. The flat, or epithelial, cells of the lining of the stomach, for instance, begin to pile up in a little swarm, or mass, elongate into a column, push their way down into the deeper tissue, and then hollow out in their interior to form a tubular gland. The only thing that cancer lacks is the last step of forming a tube, and thereby becoming a servant of the body instead of a parasite upon it.

Nor is this process confined to our embryonic or prenatal existence. Take any gland which has cause to increase in size during adult life, as, for instance, the mammary gland, in preparation for lactation, and you will find massing columns and nests of cells pushing out into the surrounding tissue in all directions, in a way that is absolutely undistinguishable in its earlier stages from the formation of cancer. It is a fact of gruesome significance that the two organs—the mammary gland and the uterus—in which this process habitually takes place in adult life are the two most fatally liable to the attack of cancer.