Baltimore Evening Sun (22 January 1914): 6.
Whatever their difference of opinion as to the value of radium in the treatment of inoperable cancers, all the surgeons worth hearing seem to be agreed that early surgical interference is the best of all remedies against every sort of malignant tumor. And in this view they are backed up by facts and figures which must needs carry conviction to every reasonable man. The records of the Surgical-Pathologlcal Laboratory at the Johns Hopkins Hospital show clearly that the chances of a permanent cure, if the knife be resorted to promptly, are very high, and they show equally clearly that those chances decrease with every day of delay. And as the cure becomes remote, the immediate danger and damage of the operation become greater. That is to say, a new and small cancer may be removed without much pain and without much mutilation, but an old and dispersed cancer leaves an appalling wound behind it.
The Hopkins reports are now being analyzed and tabulated, and those for cancer of the lip, tongue and breast are already complete. The tongue figures show that the prompt removal of the benign legions which precede actual cancer—i. e., tobacco, blisters, white spots and sore places about the teeth—results in 100 per cent. of cures. In the second stage—i. e., that of malignant warts—complete removal is equally effective. But when the actual cancer appears the proportion of cures drops at once to 50 per cent.
In cancer of the breast the danger of delay is equally apparent. In the milder form, called adenocarcinoma, the percentage of cures in all cases is 76, but in the late cases—i. e., those in which the cancerous nature of the tumor is already obvious to the eye—the percentage is but 64. In the early cases it is 100 per cent. In these early cases there is a warning lump in the breast, but no outward sign of malignant tumor. The operation begins with an exploratory incision, which enables the surgeon to see the actual tumor. When he determines, either by the eye or by the microscope, that it is malignant, the complete removal of the breast—the Halsted operation—follows. All of the patients so treated get well.
In the more malignant forms of breast tumor, the general percentage of cures drops to 36, and that in late eases to 33, or one patient out of three. But even here the cures in early cases reach 85 per cent. In other words, the patient raises her chances of recovery from 33 to 85 per cent. by going to the surgeon early. And in lip cancers the reports show that prompt operation in the earliest stages yields 100 per cent. of cures, and complete operation in the later stages 75 per cent, If the operation is incomplete and the cancer returns, the percentage of cures drops to 33.
Incidentally, the Johns Hopkins figures show that great progress has been made in the treatment of cancer in late years, despite the fact that no specific for the disease is yet known. Once it has developed, the doctors are wholly unable to cure it, in the sense that they can cure diphtheria and malaria, but they can at least cut it out, and so get rid of it. This cutting out is effective in the early stages for the simple reason that cancer, at the start, is always a purely local disease. But once it has begun to disperse throughout the body it becomes inevitably fatal. The cause of the success of early operations lies in the fact that they remove the tumor before it has begun this deadly process of dispersion.
Thus it becomes apparent that early diagnosis is a very important thing in cancer. If the patient gets to the surgeon while the tumor is still purely local, its removal is almost certain to prevent any further trouble. And in this business of early diagnosis there have been great advances during the last 10 years. Not only are physicians and surgeons more alert for the early signs of cancer than they used to be, but patients themselves have learned the danger of unhealed sores, and so they are reaching the operating room earlier and earlier, and more and more of them are going away cured. The Johns Hopkins figures give graphic proof of this.
In 1908, for example, but 8 per cent. of the patients who came to the Hopkins with suspicious sores on their lips were still in the pre-cancerous stage, with its cure-rate of 100 per cent. But by 1913 the number of them had jumped to 18 per cent. In the same way, the number of those so far gone that their cancers were inoperable dropped from 18 per cent. to 8½ per cent. And so in tongue cancers. The number of patients with easily curable pre-cancerous lesions jumped from 8 to 30 per cent., and the number with inoperable cancers from 18 to 10 per cent.
Such has been the effect of investigation and education in five years. Cancer still remains an incurable disease, and there is even no certain knowledge as to its cause, but what they can’t cure the surgeons can at least remove—provided they are consulted in time. It was with the aim of educating the public to this fact that the Society for the Control of Cancer was recently formed. Once the facts in its possession are laid before the people, as the facts in the possession or the tuberculosis propagandists were laid before them 10 years ago, it is certain that the death-rate from cancer, now one of the most deadly of diseases in this country, will be materially and permanently reduced.
A DAILY THOUGHT. Jeder ist sich selbst del Nächste.—Spanish proverb.
Can it be that the foreman of the American Issue composing room has taken to drink? On the cover of the current issue he prints a fine wood cut of the Hon. Robert Crain—and calls it “Rev. Thomas H. Hare, newly elected superintendent of the Maryland Anti-Saloon League.” But maybe I am unduly suspicious of the foreman, who, for all I know, may be laid up with chickenpox and thus have no responsibility for the strange deviltries going on in the American Issue office. The true culprit, indeed, may be the Hon. Charles M. Levister.
The editor of the Evening Sunpaper hands me the following inquiry from a valued subscriber:
Noting in the Free Lance of January 9 an article under the caption of “Historical Note From a Current Magazine,” purporting to give the origin of the coffee berry, I would like very much to have the Free Lance publish the name of the magazine containing the article referred to. E. M. Y.
The article referred to by the hon. gentleman said nothing whatever about the origin of the coffee berry, but merely described the discovery of its physiological effects, or, more accurately, of the effects of the caffeine in it, But let it pass. The magazine from which the quotation was made was the Zeitschrift für Giftlehre, Nr. 613.