THE PROGRESS OF CANCER RESERRCH.

Lyttelton Times, Volume CXIV, Issue 13936, 19 December 1905, Page 11

THE PROGRESS OF CANCER RESERRCH.

(By a PHYSICIAN in the “Pall Slall * Gazette.”) There are certain medical subjects of much importance which never present themselves to the mind of such_ a writer as myself. One’s opportunities must plainly be dedicated to subjects which demand the dissemination of ledge; such subjects abound, and the process of - popular education takes time. One used to assume that it was possible to take up a topic just where one had left off on a previous occasion; but that was, an unfortunate delusion. The sine qua non is insistent reiteration; and thus the writer finds himself in duty bound to recur to the topics which clamorously demand public enlightenment. ; / Nevertheless, it is surely a worthy purpose to reassure one’s readers and to counteract any pessimistic opinions which are not based on fact._ Occasion has long been mine for treating of cancer in this place, but what purpose could, be servedP .There was no habit of diet, for instance, against which to warn tho public .in this connection; ■ there was certainly no epoch-marking discovery -to announce; there was scarcely anything at once true and useful to be said.-But that was yesterday, and this is td^day. CANCER NOT INCREASING. Item first and foremost is the positive denial of the widespread assertion that cancer is increasing among us. The wisest members of the profession have always been very doubtful as. to •this alleged increase. To minds already v prepared by some measure of knowledge the assertion has . never seemed a, likely oife. My business here, I take it, is to be somewhat dogmatic, or else to hold my peace; and I will not discuss ;at length the causes which have led to the that cancer is increasing—the improvement in' death certification, the greater accuracy of diagnosis, the advance in 'surgery, the de-. , liberate use of surgical operations for diagnostic purposes, and so forth. Suffice it that the incidence of cancer has lately been the subject of an exhaustive and critical inquiry by the Imperial Cancer Research 'Fund,’ which has lately issued its second annual report. I may note ’that the statistical investigation of cancer nndqpr this Fund is an excellent instance or the “higher statistics,” and beans "no resemblance to the ignorant abuse, of incommensurable data which

Is usually indicated by the name of ftatisticar inqiiiiy-.' I quote the last Sentence of the invaluable part of this report, which deals with’ the reputed in- , crease of cancer: “There is nothing in the ■ statistical investigations of the , Imperial Cancer Research Fund which points to an actual, increase in the death-rate from cancer.” Jf the reader cares to purchase the report, h© will soon 'assure himself that this dictum is based upon exhaustive, expert and unbiassed inquiry. If the authors have any natural; bias, it must plainly be in the direction of asserting an aggravation of the malady, and thus the greater importance or the work in wh'ch they are. engaged. Their opinion may thus be taken as the latest-, the most surely based, and the most trustworthy that can be obtained. Whenever and wherever the reader hears or sees it asserted that cancer is increasing, he may safely put down the maker of the statement as unacquainted with his subjectmatter. If I may be permitted an ' opinion, the present article is “ worth its place ” on the sole ground that it may tend to remove an erroneous belief which is productive of , much mental Buffering, and is conducive to that distressing and too prevalent complaint which wo call cancer-phobia. There is no inherent probability of the increase of cancer; thpre is-no evidence of it; ■and the crude statistics which have led -to a belief in it have been so 'interpreted only by those whose statistical criticism should more he confined to such tables—fascinating, no doubt, in their way, hut not vital—as the cricket averages, or the effect of Warwick Armstrong’s “leg-theory upon the rate of run-getting on the tented field. NOT HEREDITAP.T OB INFECTIOUS.

Item second.is that recent statistical inquiry—which will not improbably be confirmed by tho Imperial Fund — throws much doubt uponqthe common belief that the tendency towards cancer formation is transmissible by heredity. On this point we cannot as yet speak so" positively, perhaps, as on the last; merely wo note that the many people who have a special dread of .cancer because they know that the disease has affected one or more of their near relatives, can find, in recent inquiry, very considerable cause for _ doubting whether that ■ special dread is in any way justified. 1 am certain that not a few readers will experience stome sense’ .of reb’ef on reading this paragraph. Item third is that we are not justified in believing or suggesting that cancer is an infectious disease. Those who desire to visit and solace stricken fwends may he absolutely confident that no danger to themselves is involved. Statements in the public Press have been apt to'mislead. The Imperial Fund , has proyed that a portion of a neoplasm may be transplanted. in an animal of. the same species as that from which it is taken; and there is no.doubt in our minds that what is true of the mouse 1 is true of the man. But, m the words of Dr Bashford, the General Superintendent of Research: “ The processes by which growing cancer cells are transferred to a new individual are easily distinguishable and fundamentally different from all the known processes qt infection.” Such transference necessitatesa’surgioal operation of the utmost delicacy and difficulty. Thus, for all practical purposes, cancer is no more infectious-than -gout. " So far, then, one is justified mattering the following summary as in all probability true in the sense in which it will he read: Cancer is not, increasing, is not hereditary (?), and is not infectious. : •CURE OF CANCER.' ’ As to the cure of cancer by the knife X am not a surgeon, and so have no bias dr pecuniary interest—there is no question that the percentage of lasting cures of cancer of nearly all organs is 'rapidly ; rising. One of the most important papers read at the recent meeting of the British Medical Association is believed to mark an epoch in the surgery of one variety of cancer, the author! having achieved results, over large numbers of cases, which would have been thought, and would have been, unattainable ten years ago. _ It may he affirmed that the overwhelming majority of cases of cancer are curable by the knife if taken in time. The date of operation is steadily becoming earlier in cancer, as the_ public learns ’ wisdom and the profession improves the art of diagnosis. Hope of cure by other means is, in general, misplaced. The serum of Dr

Doyen, the “’cute” French-surgeon, seems much more than likely to rank with violet-leaves and similar absurdities. nut radium and tho Rontgen rays do unquestionably cure many cases of very superficial malignant growth. But the proper object of cancer research at this time is not statistical, nor therapeutic, but etiological—it is to ascertain tho cause and nature of the disease. So long has progress been delayed, whilst medical science has triumphed over so many other diseases, that many people have'given up hope; but there is not the smallest reason for thinking that the problem is beyond human solution, and, in point of fact, it is in process of solution. CAUSE OF CANCER. Some two years ago there was made a striking announcement by three coworkers who would probably describe themselves as cytologists—students of the living cell. In general, they are botanists. (Pasteur, by the way, was a chemist; and I, for one, welcome the cry of all hands to the pump—whether pumpers or not by profession.) Professor Farmer and Messrs "Walker and Moore announced their discovery oftb© essential difference between a cancer ceil and an ordinary tissue cell. This difference they asserted to consist in the behaviour of its nucleus—or rather, the structural elements of its nucleus—during the process of cell-division. This most signal discovery, which is undoubtedly a direct and spacious stride towards our goal, has now been abundantly confirmed—by the workers of the Imperial Fund, amongst others. It places the whole problem on a new plane, and resolves it into a question in general cytology—the general study of tho living cell. We now know that the process is identical in man and other mammals, in the bird and in the fish. The discoverers have further shown that the peculiarity of cell-di-vision, which is the distinctive .mark of the malignant cell, is found in certain conditions in some simple plants; and they have determined, in some degree, , the causes which lead to it in tho plant. Indeed, we may say that in tho plant the essential fact of the cancerous process can be controlled, at any rate in part. Needless to. say, these workers have been attacking the problem ever since, with .the energy which even . the most supine must surely evolve in such a quest, and with signal success. They have confirmed and defined their original discovery; they have disposed of the belief in various supposed “germs” of cancer; they have explained various features in the anatomy of tho cancer cell; and, quite lately, they have published a preliminary note which hints at a moro striking discovery than even the original one, and which suggests that the key to the whole process is to be found in tne behaviour, under certain conditions, of the white cells of the blood. I believe I am well within the mark in asserting that greater strides have been made in our knowledge of cancer during the last two years and a half than during the preceding quarter of a century.' It is in the nature of scientific discovery that it is subject to a constant acceleration. Bach assured step not merely makes the next-possible, but reduces the period of delay, between one step and the next. ' We must take heart of grace, then. The brutal and lying assertions of cancer cures, almost invariably meaning that someone is trying to fill his pocket at the expense of one of the mest pitiable classes in the community, have mocked our .hopes so often that the heart is sick and loses all hope. Misunderstood statistics aggravate our plight by leading incompetent people to' assert that the disease is not only beyond the possibilities of science, but is steadily tightening its grip upon us. But the reader is now, I hope and believe, a wiser and happier man or woman than he or she was a quarter of an hour ago. We are not out of the wood yet; but wo have map and compasses unknown to the nineteenth cen.tury, and the wood is no denser or bigger now than then.