CONQUEST OF CANCER

Evening Post, Volume CX, Issue 49, 26 August 1930, Page 10

CONQUEST OF CANCER

TRIUMPH OP RADIUM

NECESSITY OF CONTROL

The splendid devolopment of radium thereapy in England and on the Continent of Europe now practically guarantees the cure of many forms of cancer if taken at the proper stage, said Mr. K. Campbell Begg, who returned from a six months' visit to Europe and America, by the Makura to-day. Insufficiently radical treatment has proved to be not only valueless, hut harmful. The present urgent necessity is the restriction of the use of radium to those who have been thoroughly trained in modern methods. With this in view, the Mount Vernon Hospital, in the neighbourhood of London, is being made the main centre in England for cancer treatment by radium, and will be the post-graduate school to give courses to surgeons for a diploma in the use of radium therapy.

The work on radium had now progressed to' the point w,here it had become fairly clear what the real limitations of the remedy were, said Mr. Bogg. Radium thoroughly administered had proved to be the weapon of choice in all cancers about the mouth and throat, and pre-eminently in one of the moßt prevalent forms —namely, cancer of the uterus. A very large percentage of this form, of the disease could be definitely cured. Unfortunately the remedy had not proved nearly so successful in cancer of the abdominal organs, notably the bowel. .It was in thoso conditions, however, that surgery had proved so successful, so that, taking the only two remedies available at the present time, radium and surgery, a large part of the field could be successfully covered. ' EARLY TREATMENT ESSENTIAL. That the profession had so littlo to offer in the way of cure of cancer, relative to the large incidence of the disease was due to several factors. In many cases the patients came too late to give the remedies applied a reasonable opportunity. This regrettable circumstance arose to some extent from factors which one can hope to control by teaching the public to consult their doctor when the first symptoms developed on the one hand, and by training the profession to recognise the possible gravity of early symptoms on the other. For instance, a large number of bowel cancers could be cured by surgery if the" sufferer had come to operation a few months earlier. On the other hand, it had to be remembered that there were cases—and they were by no means insignificant in number—in which the patient was not warned by any symptoms whatever until the disease had become incurable, nor could present methods make a diagnosis possible until too late. "Those who would attack the scourge soon find themselves on the horns of a dilemma," said Mr. Eegg. If intensive propaganda is .carried out to induce the public to search for early cancer, the fear of the disease descends like a cloud over the whole people, especially the :'emale population. The fear of cancer enters into every home, and every small symptom is hailed as the first onset of the fell disease. It is a serious matter for consideration among those who have the best opportunity of judging whether the neurosis and hypochondria induced by such widespread appeal to the public is not a greater evil than a good. "The education of the profession to the better fulfilment of its task in not excluding cancer because the symptoms are slight is an obvious plan of campaign which is free from the reproach of the unfortunate influence which propaganda direct to the public has been proved to have. The need of such missionary work among the ranks of the profession itself is well recognised in all countries. Radium, indeed, to the vast bulk of the profession, is invested with certain magical properties which it is far from possessing, and in some parts of the world shrewd corporations have not failed to exploit this for their own gain. There exists in ' New York a company which not only supplies radium emanation to any member of the profession who asks for it, but will issue directions for its use by correspondence. Badium. thus shares the fate of quack exploitation which has been the lot of almost every medical or surgical remedy, notably electricity, radiation, and X-rays. "WHICH OP THE ALTERNATIVES? The difficulty of the decision as to whether one or the other of the only two remedies we know for cancer should be used in a given case, whether alone or in combination demands, to avoid bias, that the same man should be equally capable of carrying into effect either form of treatment. And it is just here that the great difficulty lies. "Surgical judgment, operative skill, and a thorough knowledge of most approved methods of using radium is a combination at present exceedingly rare. The most pre-eminent mci} in the radium world are taken as a whole, by no means the most' pre-eminent in the surgical, and. vice versa. While this is true in the countries where the medical sciences are most developed, it is, of course, evea more pronounced in the younger ones. No general surgeon, however eminent, can in these days hold his^own even in the comparativel ly minor matter of operative skill with Burgeon specialists in various fields. The general principles of radium treatment are, however, the same in all departments, so that once these are learned they can be applied with comparative ease in different territories. According to my way of thinking the only way in which radium can be effectively used is by every general or special surgeon making himself acquainted with its use, so that he can employ it ivith the same facility as surgical methods, and therefore have no particular bias one way or the other. The main centres of radium knowledge in the world are at present Stockholm, Paris, Brussels, and London, and the best authorities are probably Forsel, Regaud, and Bayet in the three former places and probably Cade in London.

"It is a significant fact that while the main authorities differ in regard to the exact methods of application, on some points all are agreed, namely: (1) A good proportion of the radium available should be in the form of radium sulphate, the "actual salt of radium for direct application, and not in the form of radium bromide in solution for the preparation and distribution of radium emanation.

(2) That the treatment must be so thorough and systematic right from the beginning that every eanccr cell is killed, as piecemeal cure is impossible. The golden moment is the first treatment or others directly continuous with it. The application of radium or emanation in any form may cause such a regression of the growth as to satisfy for the time being patient and surgeon, but every treatment ' makes' the cells more resistant and difficult to influence by subsequent ones. Belief may be given, but no real progress is made towards cure.

Insufficiently radical radium treatment is as useless as insufficient surgical removal of the growth, though its evil consequences may be less rjwkMy appawjn*. I* *» swoi'dingly

more than doubtful if any good service is being rendered by supplying untrained general practitioners with a supply of radium emanation. "Again in the treatment of cancers about the mouth and other parts, the co-operation of a dentist skilled ia making plates and other fittings containing lead^to protect the gums and other parts from the action of the radium used is essential. MORE KNOWLEDGE IN ! EMPLOYMENT. "The main consideration is that tho one idea of radium and yet more radium taken by itself as the solution of the cancer question is futile," concluded Mr. v Begg. "More trained men, better hospitals for early diagnosis, better Bystems of bringing team diagnosis to bear, and better provision economically for all classes to receive this diagnosis are with us far more vital questions. The restriction of the use of public supplies of radium to those who have proved themselves alike capable surgeons and au fait with the latest knowledge in the use of methods of radiation should be our principal aim. The additional supplies of the material should go hand in hand with the increase of men capable of using it, and the indiscriminate supply of emanation to all and sundry should be discountenanced.