THE CAMPAIGN AGAINST CANCER.
AT this hour cancer is advancing against us, in terms of the death-rate ; yet, despite its present success against his body, it will not much longer advance against " man's unconquerable mind," wherein its defeat is now being prepared. Very briefly, in an epitomized con• spectus, the lines of our advance may be indicated, omitting the special subject of preventible cancer due to tar, paraffin, tobacco and other chronic irritants.
The surgeons have never relaxed in their unequal, because unaided, fight against cancer. Year by year, ever since the time of Lister himself, they have improved their technique, studying especially the disposition of the enemy and following it wherever found. The statistics of surgical success steadily improve. In this country we have never yet begun to give surgery a fair chance, because we have neglected our duty of warning ourselves betimes, and thus the surgeon is, for the most part, called in too late. In the United States, great progress has been obtained by the educative efforts of the American Society for the Control of Cancer. Seventeen years ago I tried to initiate such an effort in this country, but the idea that the doctor should be, as he calls himself, a teacher, was not then :acceptable. Last November, how• ever, being in Boston during " Cancer Week," I had the opportunity of learning at first hand how well this work is being done, at last, over there. We must do likewise. Mr. C. P. Childe, F.R.C.S., of Portsmouth, whose authori tative pen wrote the volume, The Control of a Scourge, in Messrs. Methuen's New Library of Medicine in 1906, is to be the President of the British Medical Association at its meeting in Portsmouth next month, and I hope that he may return to the subject, for which public opinion, is now so tardily prepared.
The radiologists are making positive and valuable' advances against cancer. Whether working with radium, or by means of the Röntgen rays, the radiologists have a weapon of which the full possibilities have only very lately begun to be realized. The latest report of the Radium Institute, which we- owe to the initiative of King Edward, indicates very real progress even against the most malignant types of malignant disease. These results synchronize with those now being obtained in many places by the more exact, thorough and skilful use of the Röntgen rays, chiefly under the stimulus of the workers at Erlangen, in Bavaria. So important are these results that I here restate, with added assurance, the general proposition which, during the past two years, I have believed to be warranted : that henceforth the radiologist should be regarded as the strictly co-equal colleague of the surgeon in the treatment, from the first, of every case of malignant disease. Hitherto the surgeons have been practically in sole possession of this field, but hereafter they must accept the entirely equal authority of the radiologist. The surgeon who resents this propo- sition will ere long find himself in an untenable and gravely invidious position. It is immensely important that the public fear of operation, causing many to refrain from asking advice until it is too late, should be modified by the proposition above laid down, which means that the fear of operation as absolutely inevitable in every case where malignant disease is diagnosed may be modified by the possibilities of radiation.
The statisticians have begun to survey the whole range of malignant disease throughout our species and even in some of the forms of animal life from which much may be learnt bearing upon our own problem. But nothing like a really adequate statistical inquiry has yet been made. We need not only a static but also a kinetic or moving picture of the facts. The great increase of cancer during the present century is not uniform in all countries and classes. The distribution of the disease shows most striking featureS. We must correlate all the data ; we must note the relations between the movements of the disease and changes in national practice—dietetic practice not least ; and thus we may hope to obtain indications of the most hopeful lines for experimental research in the laboratories. It is absolutely essential, as I hive insisted for years, that this inquiry shall be international. The League of Nations should preside over the inquiry, and perchance national frontiers, instead of being a curse to mankind, as usually hitherto, may be of service as defining large demographic and racial experiments—on types and changes of diet especially—which may give us a priceless clue.
. The experimental biologists are beginning an advance of great importance. They are studying, in isolated but surviving tissues, including malignant growths themselves, the conditions of growth and of the changes in type which occur in living cells as they multiply. The remarkable discoveries made in France in recent years have been confirmed and extended in London by the Imperial Cancer Research Fund ; and now we know that growth of a malignant, because uncontrolled, type is liable to occur in certain tissues if and when they are freed from the normal control of other tissues in their neighbourhood. This remarkable inquiry cannot be properly dealt with in a line or two ; but I will not leave it without remarking that the social organism is also liable to become the victim of malignant growths, where the mutual control and balance of its parts is abrogated by the knaves and fools who give the lovely name of liberty to malignant licence.
The bio-chemists are learning how to construct specific drugs, which will " fix " and kill one kind of cell—for Instance, the parasite . of sleeping sickness or syphilis— and not another. This principle of chemo-therapy must, sooner or later, yield specific remedies against the malig- nant cell.
Such, set forth within these strait limits, are the leading lines along which, if we will put money in its place, which is the service of life, and if we work together, as the new campaign would have us do, we shall most speedily vindicate Wordsworth's immortal line.
CRUSADER.
Previous page
