4. CANCER

In all history, probably no disease has been studied more exhaustively and intensely than cancer. Since the beginning of the '50s more than 5,000 scientists have turned their ef­forts to discovering the secret of this most baffling medical mystery. Financial grants that amount to almost $100 million a year are being thrown into the battle against a disease that kills more than a quarter of a million Americans annually.

Despite the efforts of these awesome forces of science and financial resources, directed toward solving the riddle of can­cer, much of the riddle still is with us—although it may be starting to unfold itself, and new developments are in the news almost every day.

Today we know that cancer is not one disease, but a family of diseases. We know that these diseases are characterized by abnormal growth and spread of cells. If this malignant proc­ess is not controlled or checked, the patient will die.

We also know that many cancers can be cured if they are detected early in their development and treated by surgery or radiation. Also, we know that in the treatment of certain types of malignant growth, hormones, drugs and some radio­active substances have been extremely valuable.

Historically, we know that cancer has been with mankind for a very long time. Human remains from very early civili­zations give indications of occasional bone destruction that was almost undoubtedly caused by cancer. Even skeletons of animals that were on earth thousands of years before man appeared have yielded tumors for our study.

Despite the long history and intense study of cancer, it has been only within relatively recent years that we have made our most important strides in conquering the disease.

In the annals of folk medicine we find much reference to cancer, but again we must realize that the accuracy of diag­nosis was very much in doubt. Certainly the "cures" could hardly have been truly effective against actual cancer.

The following case history describes such a "cure" before the Civil War.

Cynthia Andrews was a pleasant appearing woman of about thirty years of age. At the moment she was weeping as she talked with Mrs. Sarah Alsop, an older woman who lived on a farm several miles away from the Andrews place.

Outside the kitchen window, across the fields, Mrs. Alsop could see Samuel Andrews, Cynthia's husband, working with a team of horses and a plough. It seemed such a pity, she thought, for this to happen to such a nice couple and their three children. If something happened to Cynthia, how would Samuel Andrews manage? Well, there was the cure Mrs. Bacon had told her about! Maybe it would work.

She reached across the kitchen table and patted the hand of her younger friend.

"Now, Cynthia, you mustn't take on like this. Even if Dr. Hennon does say it's cancer. He's old-fashioned and he doesn't know the new ways. Mrs. Bacon told me all about her sister-in-law in Cincinnati. Are you sure it's cancer?"

Cynthia wiped tears from her cheeks and nodded. "It's a lump in my left breast. It's almost the size of a pullet's egg. Dr. Hennon said it must run in our family. He says there is no cure."

"Well, there is a cure for it, Cynthia! That's just the way it was with Edith Bacon's sister-in-law. And I know what to do for it. Cranberries!"

"Cranberries?" Cynthia looked at her guest with hopeful eyes.

Mrs. Alsop nodded emphatically. "Cranberries. And I un­derstand that a Dr. Gunn has written about it in a book."

"You mean I eat cranberries, Mrs. Alsop?"

"No. We'll mash them. Then we'll spread the mashed cran­berries on a cloth for a poultice and put it right over the lump in your breast. Then you must change it three times a day."

"Do you really think it will help, Mrs. Alsop?"

"Don't you worry, child. I'm sure. Edith said Dr. Gunn wrote in his book that a lady who had the same thing used cranberries this way. The poultice just drew stuff right out of the cancer and the lump got soft and finally disappeared."

"Did that happen with Mrs. Bacon's sister-in-law?"

"They say she was too far gone with her cancer for it to work. But yours can't be very far along if it's just the size of a pullet's egg, Cynthia."

With Mrs. Alsop's persuasion and help, the treatment was begun. Unfortunately, the pioneer doctor's diagnosis of can­cer had been correct and Cynthia Andrews failed to recover. If he had understood the surgical treatment of today, she possibly would have been saved.

A review of Dr. Gunn's book, New Domestic Physician, printed in 1858, does tell about a similar case in which the patient is reported to have recovered. He reported that the cranberry poultice "drew out postules that filled like the small pox; and this process was renewed with the same effect, until the whole was drawn away, the cancer becoming softened and decreasing in size at every application, until it finally dis­appeared."

Probably, inaccuracies of diagnosis have resulted in the following "cancer cures" found in specific instances of folklore:

Cancer of the tongue was reported cured in three weeks with a "decoction of the bark of the root of the black haw" continually applied.

A remedy to remove a cancer "without knife" was said to be found in applying "chloride of chronium with a soft swab until the tumor is thoroughly saturated, then apply Indian-meal poultice, made into a dough with glycerine."

A carrot poultice was recommended to cure cancer, as was potash made from the ash of red oak. A solution of brandy and salt was said to be effective, as was the narrow-leaf dock root, red oak bark, or the following cure described by a Midwest settler:

"To cure a cancer, first you take the scrapings from a brass kettle and you mix the scrapings with some mutton suet. Now you put this mixture on the cancer and keep it there until the cancer's gone."

Quite possibly, "cures" such as these may have appeared to be effective in "cancer" cases, but we can readily assume that the "cancers" were non-malignant growths or disorders that quite probably healed despite the treatment. Neverthe­less, because what was mistakenly assumed to be "cancer" was supposedly cured by one of the treatments, that treatment may have gained fame as a "cure for cancer."

It would be an act of remission if we were not to empha­size that there is no medical history that verifies the effective­ness of cures such as those mentioned above. Nor should the subject of "cancer quacks" be overlooked at this point.

First, let us remember that many cancers can be cured if detected early and properly treated by surgery or radiation. Progress is being made in treatment with hormones, drugs, and some radioactive substances, but most cancer cures of today are through radiation and surgery, and probably this condition will remain until other cures may be found and proved by the widespread forces at work to do that job for humanity.

Meanwhile, the disease has proved to be a bonanza for quacks. This unfortunate fact is not only true today, but has been for a good many years.

For example, back in the era immediately following World War I, Harold, the 15-year-old son of George and Mary Lindquist, became ill. The family doctor diagnosed the illness as cancer and held out little hope for the boy's recovery.

The parents were grief-stricken by the news. They lived in a small Midwest town of only a few thousand population. George Lindquist worked for a farm equipment dealer at a modest salary.

Long into the night, after they had received the frightening news about their son, George and Mary Lindquist talked and tried to find hope in what little they knew about the medical world and cancer.

"We'll go to the big clinic in the city," George finally announced. "We'll get the best we can find."

"But George—we haven't the money. It's so expensive."

"We can sell the house. We have the three thousand in the bank. It doesn't matter. Money doesn't matter now."

"Maybe there's something new," Mary said hopefully through tears. "Maybe the city doctors have a new cure. The money doesn't matter, as you say, George. Only Harold—"

Her husband took her into his arms, awkwardly trying to comfort her as he fought to hold back his own tears. His life seemed to have revolved around his son. So much had been planned. And now they might lose him in just a few brief months.

"I'll raise the money tomorrow," he said quietly. "Don't cry, Mary. We're going to do everything we can. Maybe you're right. Maybe the city doctors have a cure. Old Dr. Morse is kind of old-fashioned. Maybe there's something new. . ."

The next day, George Lindquist mortgaged their small home and the following day they left with Harold for a fa­mous clinic in a nearby city, armed with a letter from Dr. Morse, who knew some of the doctors at the clinic.

"Possibly they do know something," he said in his wise and kindly voice, trying to hide his own skepticism. The couple certainly had a right to try. "I'll feel better if you let them look at the boy."

A week later the Lindquists were back in the small town. Worry and desperation were etched in their faces and deep in their eyes. The clinic doctors had confirmed the old doctor's diagnosis.

"But can't you operate?" George Lindquist had demanded. "Can't you cut it out?"

The clinic doctor had tried to be gentle. "I'm sorry, Mr. Lindquist. It's simply too late."

"How long?" Mary Lindquist's eyes pleaded with the doc­tor, as if he could extend life and give them more precious time with their son.

Again the doctor's quiet, sympathetic voice had no hope to offer. "Not too long, Mrs. Lindquist. I want you to be prepared, and I can't lie to you. A month—maybe two— possibly three."

Thus the Lindquists had brought their son home from the city clinic. Harold, who knew that death was approaching, tried to hearten his parents, but his very illness defeated his sorry attempts.

About a week after their return, George Lindquist came home greaty excited with information he had obtained from a farmer.

"There's a new doctor over at the county seat," he ex­plained. "A Dr. Smithers. He's a different kind of doctor than Dr. Morse. He has a new method and Carl Nelson says that it cures cancer."

"A new medicine?" his wife asked eagerly.

"No, it's not a medicine. It's electricity. I don't understand it too well, but Carl says that this doctor puts metal plates on you and it cures almost anything. He practically guarentees to cure cancer."

"Oh, George! Do you think it's true? Shall we ask Dr. Morse?"

"Carl says some of the old doctors won't have anything to do with it because it's new." George Lindquist looked thought­fully at his wife and his mouth suddenly firmed in determi­nation. "Mary, I'm going over and see this Dr. Smithers tomorrow. If there's any chance at all—it's worth trying."

The following day Lindquist met Dr. Smithers in the neigh­boring town. The new doctor was a smooth-talking, re­assuring, middle-aged man who listened sympathetically to Lindquist and then nodded in confidence.

"Mr. Lindquist, you bring your son here as soon as possible. You have no idea how effective electronic reactions can be. You must understand that now we understand that disease actually is a disharmony of electronic oscillations. We know that each disease has its own vibratory rate. Through the use of our dynamizer we can diagnose whether or not Harold actually has cancer. If he has, we then use the oscilloclast to treat the condition.

"Our Dr. Abrams, who discovered this new, important approach to healing, in his book, New Concepts on Diagnosis and Treatment explains that disease is a disharmony of elec­tronic oscillations. To treat the disease we must detect and measure the alteration and then restore equilibrium."

The "doctor" went on to explain more theories of Dr. Al­bert Abrams, who—The American Medical Association re­marked in its Journal after his death in the early Twenties— "easily ranked as the dean of all twentieth century charlatans."

Dr. Smithers quoted cases and promised help. By the time George Lindquist left the office he was convinced that Dr. Smithers could save Harold's life.

Lindquist rushed home and told the good news to his wife and son. They wept with relief and joy. Even in his critical illness Harold's expression expressed new hope.

The following day Harold was taken to the county seat and to Dr. Smither's office. The doctor gave Harold a quick, perfunctory examination that barely seemed to be an examination. He then took a drop of Harold's blood, placed it on a piece of filter paper, and put the blood sample in the "dynamizer"—a box distinguished by a complex of wires attached to it.

Harold was then placed so that he faced west, and Dr. Smithers had him stripped to the waist. He began to tap Harold on the abdomen. So the diagnosis was begun. When it was finished, Dr. Smithers announced that he was able to diagnose the illness. It was truly cancer with additional complications.

"Now we shall resort to the oscilloclast to correct the con­dition," Dr. Smithers announced confidently. Immediately he began to prepare the equipment to be used on the boy. Wires, plates, intricate connections and a scientific-appearing ma­chine were brought into play.

Harold was treated for his cancer.

"Bring him back in five days," Dr. Smithers announced, after he had collected his high fee for the diagnoses and treatment. "We shall repeat the treatment next Tuesday."

The Lindquists returned home in high hopes. Even Harold seemed to believe that he felt an improvement, although the doctor had warned that it would take time.

On Sunday night George Lindquist frantically called their old friend, Dr. Morse. Something was terribly wrong with Harold. The doctor arrived within the hour and his quick diagnosis was positive.

"It's finally come," he told the frightened parents. "Just as we expected. This is terminal—possibly within hours. I'll stay with you."

By morning Harold Lindquist was dead, but for another two years Dr. Smithers continued to "treat" cancer in the county seat until public opinion finally forced him to leave the area.

This is but one case of thousands that are on record to tell the cruel, unhappy story of the "cancer quack," who is still with us.

Perhaps, in this day of considerable public enlightenment concerning medical matters, it might be difficult for some to believe that intelligent people could be taken in by a "quack" like Dr. Smithers. This is far from being the truth.

Today's topflight medical quack may be a most convincing person. Charles S. Cameron, M.D., speaking as a medical and scientific director of the American Cancer Society, has said: "By far the most dangerous group of cancer quacks are neither fools nor small-time charlatans. They are big-time operators—rich, influential, persuasive. They are not pri­marily concerned with milking the illiterate or the supersti­tious poor. They are out after you and millions like you—the sophisticated, alert, newspaper-reading, college-going American middle class."

Dr. Cameron points out that recent victims included the wife of a leading educator, a wealthy industrial executive, and the child of an international figure.

"These top-level quacks do such a convincing job," Dr. Cameron emphasizes, "that even after their victims die, the bereaved families rise up in print, on legislative floors and even in court to defend them against all criticism!"

Oliver Field, serving as director of the Bureau of Investi­gation of the American Medical Association, had this to say about specific "cancer cures" in New Horizons, Iowa's cancer magazine, in the fall, 1957 issue:

Today there are a good many physicians, 'drugless healers' and others, who claim to have, or use in their practice, a par­ticular or peculiar method of curing cancer. They may use any number of substances, to be taken by injection or by mouth, as a means whereby the body may overcome disease processes and thus 'normalize' cancer tissue. They may utilize machines, diets, adjustments, or even 'laying on of hands.' Cancer patients or their families and friends should appreciate the cold fact that no single substance can qualify, as of today, as the 'penicillin' for cancer.

Frequently the "cancer quack" victim actually does not have a cancer, but is convinced by the quack that he does. The treatment usually is expensive. The actual cancer victim who succumbs to the quack's smooth sales talk, all too often exchanges the only chance for life in the hands of a compe­tent physician for the useless administrations of a charlatan. In these cases, death almost invariably is the result.

Some states are establishing cancer commissions or similar control measures to protect the public from quacks. Until such safeguards have been established everywhere, the follow­ing suggestions enumerated by Dr. Cameron should be care­fully observed by anyone seeking medical help:

1.  Be suspicious of a doctor who promises a sure cure when other doctors will not.

2.  Beware of the doctor who says he has an exclusive method or who tells you he charges "just for the injection."

3.  Be on your guard against the doctor who tells you that organized medicine has ganged up against him.

4.  When in doubt about a man who says he is a cancer specialist ask your family doctor to phone him and determine his status. The American Cancer Society and your local County Medical Society can also furnish information about many known cancer quacks.

The list of quack remedies is very long. Some of the reme­dies undoubtedly are of folk medicine origin. None of them has proved to be effective, of course.

In a paper on Cancer Charlatanism by Charles E. Horton, M.D. and associates, 62 specific "cures" are exposed. Included are milk of goats fed on hemlock, sulphuric acid and pow­dered asbestos, baking soda, saltpeter, fig leaves, arsenic, po­tato poultice, croton oil, a diet of carrot juice with milk, cod liver oil, camphor, colored lights, iodine, and many other methods or substances.

If anyone wonders if everything has been tried, he can certainly assume that all the familiar drugs and substances have been tested and that new things are being tested con­stantly—probably far beyond his imagination.

At the Cancer Chemotherapy National Service Center in Washington, D. C. hundreds of our best drug experts, under the direction of the National Cancer Institute, the Veterans Administration, The American Cancer Society, and the Da­mon Runyon Memorial Cancer Fund screen about 40,000 substances each year.

Dr. John R. Heller, president of the recently integrated Memorial Sloan-Kettering Cancer Center, has said: "The Chemotherapy Center is running the greatest single cooper­ative effort the country has ever known against a single disease."

The program costs $50 million a year and its director, Dr. Stuart M. Sessions, reflected its purpose in a brief statement in 1959: "Primary cancers may be cured by surgery and radiation. But in cases where cancer has spread to other parts of the body, the greatest hope lies in drugs that can reach and destroy malignant cells wherever they happen to be."

Drug companies contribute importantly to this vital re­search program by sending on promising samples of drugs— which have passed their own excellent screening processes— for the more extensive screening.

Government scientists in the field point out the high costs of this type of work and the rather slim chances of a hope for financial gain. They further explain that: "The drug com­panies need our help to get going. And without the help of the drug industry, we cannot succeed."

Researchers in this program are searching for three things, principally: 1. Chemicals powerful and effective enough to kill cancer cells without harming normal cells. 2. Drugs capa­ble of producing changes in a patient's body so that cancer-infested tissue will not be susceptible to further growth and spread the malignancy. 3. Compounds capable of blocking chemical activity of abnormal cells in the early stages of cancer.

The magnitude of this research effort is indicated by Mi­chael B. Shimkin, M.D., Associate Director for Field Studies, National Cancer Institute, Bethesda, Maryland, in statements in a paper presented to the 4th National Cancer Conference at the University of Minnesota in September, 1960:

"The number of chemicals and crude products that have been tested on mice and other animals bearing transplanted tumors now approaches 100,000, and over 100 materials have received clinical attention."

Dr. Shimkin stated that at least 20 chemical agents "already have gained a place in the clinical management of cancer, and some of them in specific types of disseminated neoplastic disease produce complete remissions that are maintained for many months. These effects are real but incomplete. Truly effective agents for the treatment of cancer are not to be found among the drugs now available, but await discovery in the future."

In contrast with drugs familiar to many laymen, the areas of drug research in which the cancer researchers work seem as much a part of the space age as was "calomel and salts" a part of the turn-of-the-century era. Even those laymen who speak familiarly of certain antibiotics, sulphas, tranquilizers and steroids usually find the drug language of cancer fighters unfamiliar and complex.

These workers speak knowingly of drugs such as 6-mercap-topurine, chlorambucil, methotrexate, androstanolone, and azaserine. These are only a few of the exciting drugs that are being used in the field. Obviously, they are a far cry from the "simples" known by our forefathers in folk medicine practice.

At present, the search for drugs in the battle against cancer is concentrated largely in four types of material. First, there are the chemical warfare mustard gases, usually called the "alkylating" agents. Second, there are the anti-metabolites, which include the folic acid family. Third, there are anti­biotics which seem to control the normal chemical process of cells. Fourth, there are the more familiar hormones which relieve prostate and breast cancer.

One of the most hopeful areas of effectiveness of drugs is in acute leukemia (cancer of the blood) in young children. Just how effective these drugs may be is explained in liter­ature from the American Cancer Society, 1960: "Before 1948 there were no specific chemical compounds, or drugs, effec­tive against acute leukemia. Half the children stricken died within four months of diagnosis; 90 per cent within 11 months. Today, through the help of these drugs, half of the 800 patients at one Boston hospital are still alive after 14 months of treatment. Ten per cent have survived two and a half years. One child survived eight years and two months."

It should be noted that there is a mistaken belief among many persons that leukemia mostly occurs in children. Fur­thermore, many persons do not realize that leukemia actually is a form of cancer. It is only in comparatively recent years that medical dictionaries have properly identified leukemia.

The facts about leukemia reveal that it kills five times more adults than children. It claims 11,000 Americans each year, and in 1959 claimed 9,000 victims aged 50 and over.

This form of cancer involves blood-forming organs which manufacture white blood cells. When leukemia strikes, these organs fail to function properly and flood the body with white corpuscles—leukocytes—and crowd out vital red cells.

It is, of course, inoperable so surgery cannot be used as it is successfully used to cure many other forms of cancer. X-ray therapy and other kinds of radiation have halted the disease, as has treatment with drugs. So far these are only temporary remissions.

Dr. Sidney Farber of Boston recently summed up the ef­fects of drugs in this avenue of treatment: "There are still no chemicals that can be regarded as 'cures' for leukemia in any form, but increased knowledge of the mechanism of the action of some of these compounds has led to great optimism. What we must find is why these drugs fail, and what can be done to bridge the gap between remissions and relapses."

Biochemists already are on the trail of one possible solution through the use of synthetics that may combat the cancer cells' resistance. In another approach, Dr. William Prusoff of Yale University has produced a new drug for leukemia, iodo-desoxyuridine, that has reduced the growth of cancer cells in mice by 70 per cent. It is now being tested on leukemia victims.

Other experiments show encouraging results. Enough prom­ise has been shown, and progress made, that the Cancer Society has stated: "This cure will come. Substantial ad­vances already have been made against leukemia in humans, and judging from the results of current animal experiments, more advances can be expected."

The society further explains that although leukemia still is incurable, "a half dozen different compounds are now being widely used in chronic and acute leukemia to keep patients alive and comfortable for extra months and even years."

One of the most promising chemical agents yet discovered in the effort to halt cancer is a compound known as metho-trexate or amethopterin. The compound was administered to a score of women suffering from a rare form of cancer called choriocarcinoma. Dr. Roy Hertz of the National Cancer Institute subsequently reported that six of the patients were cured, and that the disease was apparently suppressed in another five.

A disturbing problem in the treatment of cancer with drugs is to find a method of using drugs strong enough to kill cancer without destroying normal cells. Significant progress now is being made in solving this problem.

A method devised by Dr. Robert D. Sullivan of Manhattan's VA Hospital and Memorial Sloan-Kettering Cancer Center, administers a drug continuously by arterial drip, with damaging effects switched off every few hours by in­jection of an antidote.

After treatment of a number of patients in this country promised success in this method, more research was begun in Africa where other cancer treatments had not been used. One highly encouraging case involved a Jaluo woman whose cervix had been ravaged by a cancer growth. After four courses of treatment, over 15 days, the cancer shrank. Within a month it is reported to have disappeared. Four months after treatment the woman still was well, and U. S.-African doctors in mid-1960 were endeavoring to find out what other forms of cancer might be successfully attacked by the new technique.

Another technique has been developed by surgeons at Tu-lane University School of Medicine in New Orleans. There Dr. Oscar Creech, Jr., Chairman of the Department of Sur­gery, hit upon the idea of separating a cancerous organ from the rest of the body's circulation and connecting the diseased organ to a heart-lung machine in a separate circulation. In this manner, large doses of anti-cancer drugs could be deliv­ered precisely where needed without affecting the rest of the body.

After considerable experimentation with animals—virtually all of which survived, none the worse for their experience— it was decided to try the method on human patients.

Joe St. Pe, a 72-year-old farmer, was the first patient to receive the treatment. He suffered from black melanoma, one of the worst forms of cancer. The cancer was confined, at the time, to the left leg up into the lymph nodes in the groin.

Rather than undergo removal of the leg and buttock by surgery, the old man gave permission to go ahead with the experiment. In a minor operation the thigh, femoral arteries and veins concerned with the affected area were tied off where they led into the body. Below the tie-off point they were connected to a heart-lung machine.

For a half-hour a powerful anti-cancer drug, phenylalanine mustard, was circulated through the leg in a quantity usually administered to the entire body. In effect this was actually giving the cancer area about eight times the usual dose of the drug.

The farmer was up the next day, went home in 10 days, and after three years there was no recurrence of the cancer and St. Pe was again farming his land.

Since then the method, called "perfusion," has brought encouraging results. Although it is too early to determine if the cures have been permanent, of a total of 227 patients treated by Dr. Creech's group, 112 were treated long enough to lend significance to follow-ups. Of these, reported in 1960, had cancers that were quiescent. Twenty-seven patients had temporary regressions. In 30 patients the treatment had no effect. The method is being tried by surgeons the world over.

Hodgkin's disease, which is cancer of the lymph nodes, now is being treated with apparent success by nitrogen mustard.

Chemicals called ethylenimines, which come from com­pounds used in Germany to refinish rayon, have shown value in reducing large, inoperable cancers of the breast, lungs, and lymph glands, as well as in eliminating pain.

A drug called DDD may be valuable in reducing cancer-stimulating hormone output of glands. A crystalline chemical called kinetin may lead to new discoveries in experiments at the University of Wisconsin.

Chemicals that are related to heparin, the anticoagulant that prevents blood-clotting, are promising in cancer control. Compounds called polyethylene sulphones, which are heparin substitutes, may be able to control cancer without dangerously thinning the blood.

One of the most promising drugs is cytotoxan, a German compound for leukemia, which is also reported to be one of the most effective drugs in treating lung cancer, as well as uterine and larynx malignancies.

The body, itself, apparently has a natural defense chemical, properidin, which, possibly, enables persons to throw off malignant cells.

This was demonstrated most dramatically when volunteer prisoners in the Ohio State Penitentiary allowed living cancer cells to be injected under their skin. No harm came to the prisoners, but the experiment enabled Sloan-Kettering Insti­tute cancer researchers to learn more about the significance of properidin.

An antibiotic, azaserine, has cured cancers in animals by blocking the pathways by which cancer cells get nourishment and "starving" the cells to death. The antibiotic is now being used on human malignancies.

Many scientists believe, in fact, that the answer to a cancer cure may be in the field of antibiotics which has produced such "miracle drugs" as penicillin.

An antibiotic is a chemical substance produced by micro­organisms which has the capacity, in dilute solutions, to in­hibit the growth of, or to destroy, bacteria and other micro­organisms.

About 30,000 of the 40,000 substances screened each year are in the antibiotic classification.

Meanwhile, hormone therapy has been important for some time in the treatment of cancer. The medical definition of the hormone is: "A discreet chemical substance secreted into the body fluids by an endocrine gland, which has a specific effect on the activities of other organs."

A pioneer in this field of treatment, Dr. Charles Huggins, of the University of Chicago, believed that at least some cancers are dependent on the proper balance of the hormones. Hormones can stimulate the growth of some cancers, and halt the growth of others.

Today many cancer patients are being kept alive and ap­parently well because of hormone therapy. It is a rather com­mon practice to treat cancer of the breast in women and prostate cancer in men with sex hormones. Surgery has been used to remove glands which produce some of-the hormones that effect cell growth to help extend the lives of thousands of patients.

Among hormones that are being used in the treatment of cancer, or that show promise of success, is cortisone, which is used in treatment of breast cancer, prostate gland cancer and some leukemias. Dr. B. J. Kennedy of Minnesota has reported that large doses of cortisone given to thirty women with inoperable breast cancer resulted in the women all feel­ing better, and in evidences that bones destroyed by cancer had begun to heal, and that cancers which had spread to the lungs decreased in size or disappeared.

Researchers at the Cancer Chemotherapy Center indicate that several synthetic hormone drugs being tested may be much better than cortisone in the treatment of acute leukemia, and that others appear to be more promising than testosterone, the male hormone used in treatment of breast cancer.

While researchers are continuing their attack upon cancer in the areas of chemicals, antibiotics and hormones, we know that in surgery and radiation we already have two methods that effect cancer cure every day.

Because doctors realize that it is the spread of cancer that kills people, one trend today is to combine surgery with drug therapy. Thus the surgeon may apply anti-cancer drugs imme­diately after surgery to take care of tumor cells which may have escaped into tissue space and blood stream during the. operation. The combined therapy is called "drug-adjuvant surgery."

One such recent drug, used following surgery for breast cancer, is called thiotepa, and appears to have cut the recur­rence rate by half.

New surgery techniques, better anesthetics, blood trans­fusions, new controls of surgical shock, have helped make daring and radical operations to remove massive amounts of cancerous tissues more successful than ever before.

Among the most successful operations are those used in uterine cancer in women. Almost all the pelvic organs now can be successfully removed. Patients are usually up in a few days; the symptoms of cancer and the pain are gone.

Breast surgery is quite common in cancer cases. Cancer of the stomach may be treated by surgical removal. Cancer of the rectum can yield to the scalpel, and the care of an arti­ficial anus no longer requires use of an unpleasant rubber bag. People now may live much more normal lives after a "colostomy." Cancer of the bladder may be treated by sur­gery, as can cancerous thyroid conditions.

Cancer of the skin, lip and tongue may frequently be treated with surgery. Since these cancers may be more easily discovered, early diagnosis and treatment make the incidence of cure hopefully high, especially in the cases of cancer of the skin.

Hayes Martin, M.D. says in Cancer, A Study for Laymen, published by The American Cancer Society, Inc.: "Skin cancer can be and should be eliminated as a cause of death. Its location is favorable for treatment and for early and rela­tively easy diagnosis. The chances of its being localized in its early stages are good.

Of the three, cancer of the mouth is the most dangerous. Nevertheless, Dr. Martin points out that, "A large proportion of mouth cancers can be cured if the growth remains local and treatment is given in its early stages."

Surgery is of paramount importance in treating cancer of the lung, which is now the leading cause of cancer death in men. The estimated number of deaths from lung cancer for 1960 was placed at 36,000 Americans—31,000 men and 5,000 women.

The first person operated on successfully for cancer of the lung was still living and carrying on an active medical practice 22 years after the operation. Since that operation, cancer of the lung has been, as Charles Cameron states in The Truth About Cancer, "... a potentially curable disease. But only a fraction of the potentially curable cases have actually been cured. The reason? The same as before: too late." Of course, he refers to the necessity of early diagnosis. A chest X-ray film usually reveals the condition.

As most of the public knows, a great amount of contro­versy has raged around the relationship between lung cancer and cigarette smoking.

The American Cancer Society in 1960 gave these facts:

1.  At least 23 studies in eight countries have shown that lung cancer patients are predominantly cigarette smokers.

2.  No evidence of any kind has ever been produced that is inconsistent with the generally held view that excessive smoking is one of the principal causes of lung cancer.

3.  The Society's own 44 month study of the smoking habits and fate of 187,783 men from 50 to 70 years old has shown that:

a. Death from all causes combined rises with the number of cigarettes smoked daily. Rates were more than two times as high for two or more pack-a-day smokers as nonsmokers.

b. Men who stopped smoking had death rates lower than those who continued to smoke.

c. Lung cancer death rates were more than 10 times as high among regular cigarette smokers as among men who had never smoked.

d. Coronary death rates for smokers ranged nearly two and a half times as high for two or more pack-a-day smokers as the rates for nonsmokers.

e. Deaths from lung diseases other than cancer were nearly three times as high among cigarette smokers as nonsmokers.

f. Deaths from cancers of sites such as the mouth, esophagus, tongue, and larynx among smokers were more than five times as high as the rates for nonsmokers.

4. A study of the smoking habits of 200,000 veterans showed that regular cigarette smokers had a significantly higher death rate than nonsmokers.

5. An independent Study Group on Smoking and Health composed of seven leading American scientists has reviewed all the available evidence and concluded: "The sum total of scientific evidence establishes beyond reasonable doubt that cigarette smoking is a causative factor in the rapidly increas­ing incidence of human epidermoid carcinoma (cancer) of the lung."

6.  The British Government has launched an educational campaign warning of the hazards of cigarette smoking.

7.  The United States Public Health Service has declared: "The Public Health Service feels the weight of the evidence is increasingly pointing in one direction: that excessive cig­ arette smoking is one of the causative factors in lung cancer."

It is interesting to note that despite the rather well-publi­cized facts concerning the relationship between cigarette smoking and lung cancer, cigarette sales have increased stead­ily over the last four years and an estimated yearly consump­tion of cigarettes in the United States is placed at 475 billion cigarettes.

Over the last ten years, some surgeons have adopted a comparatively new surgical technique with cancer that has been quite effective. This is the practice of taking a "second look" and even third and fourth looks. The "second look" practice is credited to Dr. Owen H. Wangensteen of the University of Minnesota School of Medicine.

The idea is exactly what the words imply. After an oper­ation for cancer has been performed, a second operation—or "second look"—is made about six months later. In about half the operations so performed, bits of cancer missed in the first operation have been found forming new tumors. The "second look" technique seems to be especially effective in cases involving cancer of the colon.

Almost everyone who has a basic understanding of cancer recognizes that irradiation with X-rays or radium long has been a highly effective method of treating some cancers.

Shortly after X-rays were discovered in 1895, and radium in 1898, researchers learned that the two agents did more damage to cancerous tissue than to normal healthy tissue.

In the last ten years radiation specialists have greatly im­proved the effective application of X-ray, radium and radio­active compounds.

Tremendously powerful two-million-volt machines pinpoint X-rays into the deepest parts of the body. The field of radio­active isotopes has yielded new and important aids in fighting cancer. "Synchrotons" and "betatrons" along with "linear accelerators" and "radioactive cobalt bombs" are part of the new language of cancer treatment in such centers as the University of California, Los Angeles, where the first atomic reactor designed for medical treatment was built.

At the University of Illinois a giant betatron can beam X-rays even upon the hypothalamus, seat of emotion deep in the brain. The Argonne Research Hospital in Chicago has radioactive cobalt 60 machines, most powerful of the arti­ficially produced nuclear radiations for cancer treatment. At the University of Minnesota radioactive cobalt has been effec­tive in "melting" cancers in lung and liver areas.

Experimentation is being pushed with other radioactive substances. Radioactive yttrium has been effective in destroy­ing the pituitary gland in advanced cancer cases. Halting the pituitary's action forces a cessation of cancer-stimulating sex and adrenal glands. Yttrium also is used to treat glioma, a kind of brain cancer.

Boron and uranium are used in treating brain tumors. Radioactive phosphorus is used to extend life for adults suf­fering with chronic leukemia. Radioactive gold is employed to treat prostate gland cancers.

Developments in this area of treatment are constant and in step with the nuclear age where the nuclear-physicist has become part of the medical team.

What causes cancer?

This is still the big question. Indeed, there is a long-accepted opinion in medical circles that cancer probably will be controlled long before its cause or causes are discovered.

A recent report from the American Cancer Society says: "As to cancer's cause, or causes, headway is being made."

The Cancer News report on the 4th National Cancer Conference, 1960, couches the opinions aired in the conference in these words: "The suspected causes of cancer—from atomic configurations within a molecule to cosmic rays from outer space—were considered, and many speakers described the induction of cancer in experimental animals. The diffi­culties of extrapolating to man the results obtained in animals left unanswered the question of what causes human cancers."

There is considerable agreement among scientists that can­cer may be connected with air pollution, excessive radiation, chemical irritants, and infections.

Lately, increasing evidence has turned up that viruses are linked to cancer. A great many scientists are working in this field of exploration and almost weekly, it seems, additional knowledge has been unearthed.

Scientists already have determined that several types of cancer in chickens and mice are caused by a virus agent. Although reports from the 1960 conclave of cancer experts brought forth the statement that: "There still is no conclusive evidence that a virus is responsible for any human cancers"— experiments conducted by Dr. S. O. Schwartz of the Hektoen Institute for Medical Research in Chicago indicate the possi­bility that human leukemia might be caused by a virus.

Later in the year, after the cancer session, Dr. John R. Heller told the Oklahoma division of the American Cancer Society that eight different types of animal cancer have been established as caused by viruses.

With this announcement came a revelation of even greater importance from Dr. Heller: that vaccines already have proved up to 95 per cent effective in preventing some animal cancers.

In his Oklahoma talk, Dr. Heller said:

"Our first job is to try to prevent cancer. If we can't prevent it then we can try to cure it. If not that, we can arrest or palliate it.

"Looking ahead, it is not improbable that a cancer—per­haps leukemia—may be found to be caused by a virus or a combination of viruses. Once a viral agent is incriminated, the immunization is possible.

"We presently know about 400 substances that can cause cancer in laboratory animals. Once we make the step from animal to man, we can begin to protect ourselves."

Thus it is possible that scientists now are on the track of possible immunization against at least some types of cancer. For instance, a vaccine already has been prepared from rabbit serum that protects mice from leukemia. Eventually this trail may lead to a vaccine to prevent leukemia in man. Most authorities believe it is possible and there is a growing opti­mism about the possibilities offered by immunology in the fight against cancer.

It should also be noted that there is a large and growing number of drugs to palliate cancer, relieving pain and restor­ing patients to a measure of comfort and useful living.

From the above report on cancer, as we look at it in the light of a "space age," it is obvious that even as cancer still remains one of the greatest medical riddles for man to solve, there never has been so much effort, determination, and so many resources centered on an attempt to solve the mystery of a disease.

When we realize what great forces of science are being employed in the fight, it would seem preposterous to assume that a poultice of crushed cranberries would cure a cancer, or that a mechanical contraption put together by a charlatan could be successful—when some of the finest minds and greatest skills of the world are enjoined in the battle against the disease.

What can we do, ourselves, in fighting cancer? Here are cancer's seven danger signals:

1.  Unusual bleeding or discharge.

2.  A lump or thickening in the breast or elsewhere.

3.  A sore that does not heal.

4.  A change in bowel or bladder habits.

5.  Hoarseness or a persistent cough.

6.  Indigestion or difficulty in swallowing.

7.  Change in a wart or mole.

When any of these conditions become evident and remain for two weeks or so, the family doctor should be consulted. He is your first line of defense against cancer.

A yearly physical examination is also advised. A doctor knows where to look for cancer, and how to detect it.

Cancer detection and diagnosis is largely a doctor's job. Occasionally, a doctor may suspect cancer by merely listening to the complaints of a patient, or by looking at a tumor on the skin or lip. He may need X-ray examination or other methods of visualization. He may want a small sample of a tumor for microscopic examination. The sample is called a biopsy.

New methods of detecting cancer keep pace with other developments in medical progress. Certain blood tests appear to be effective. Radioactive potassium is being employed to determine whether breast lumps are benign or malignant. Radioactive arsenic is being used to spot brain tumors. Another test that employs pituitary extract helps determine if there is cancer of the adrenal glands. A new method of detecting cancer of the colon is highly effective.

Machines that separate blood are being used in detection work. Electronic and colorimetric equipment has been em­ployed. X-rays, ultraviolet and infrared radiation help analyze tissues.

Education programs have helped instruct thousands and thousands of women in the technique of breast inspection for lumps. Other cancer detection precautions are common knowl­edge to probably millions of persons.

Alice Maguire, a middle-aged housewife with three chil­dren, seemed to be worried about something. Pat Maguire, her husband, came home one evening from the garage where he worked and found his wife in tears as she tried to prepare dinner.

-Realizing that something was wrong, he closed the door between the kitchen and the dining room to keep out the children, and turned his wife around to face him. He held her for a moment, kissed her, and wiped away the tears.

"Look, Alice," he said quietly, "what's wrong?"

"Oh . . . nothing, Pat. Honestly. It's nothing. I guess I'm just out-of-sorts."

He shook his head. "That's no good. You're not like that. What is it?"

She looked up into his face and finally sighed. "I'm scared, Pat."

"Scared? Of what? What's wrong?"

"Some blood."

"Blood!"

"Some blood and discharge down there. I—I thought, maybe, at first, it was from love-making, only—well, it's been a week now since any of that and there was some blood today."

"But maybe it's near that time or something—"

"No. It isn't that, either. Pat, that's the way cancer starts sometimes."

"Cancer! For God's sake, Alice—you can't—" Now he looked as frightened as she had looked.

"Remember Martha Tinsdale? It started that way with her. She told me at the time."

"Then you'd better get down to Dr. Diller right away!"

"I called today. I have an appointment for tomorrow afternoon."

Pat tried to put a small, reassuring smile on his face. "It's going to be okay, honey," he said. "I'm sure. Probably just a cut or something. But we ought to make certain."

"Yes," Alice said softly. "I've got to know."

That night Pat kept a protective arm over his wife as she slept, and he stared into the night, wondering what the doctor would say. Alice had cried a little before she had dropped off to sleep, and he had talked hard to assure her that Dr. Diller would know exactly what to do. Only what if there was nothing to do? Cancer! What if they couldn't save Alice? Fear closed over him and he wished he could get up without disturbing Alice. He wished he could walk. There was no use trying to sleep.

The next day Alice Maguire went to the doctor's office. Dr. Diller listened to her fears and smiled encouragingly.

"I'm glad you didn't wait," he told her. "That's the fatal mistake too many women make. The secret is to catch it early." The doctor looked at her case history. "You haven't been in for an examination for almost three years—there were no indications of trouble then. You should come in every year."

"I felt all right," she nodded.

"I took a Pap smear," Dr. Diller explained, "just as I'll do today, unless a biopsy is clearly indicated. And I don't believe it will be."

The "Pap Smear Test" was first developed by Dr. George Papanicolaou more than 20 years ago. The theory upon which it works is relatively simple. Cells on the surface of the organs of the body are constantly being shed. This occurs with both normal and abnormal cells. In certain areas of the body castoff cells are. caught up by body secretions. When this fluid is stained and placed under a microscope, expertly trained pathologists can readily determine if some of the cells are cancer cells.

The test was first applied to the vagina. It has since been extended to breast secretions, sputum, and stomach washings. Doctors recommend that it be part of the pelvic examination that every woman should have yearly. Thousands of women can thank it for early cancer detection and cures.

It was such a pelvic examination that Dr. Diller now per­formed on Alice Maguire.

When he was finished, Alice looked at him anxiously.

"I didn't find anything in the examination, but the real answer will come from the laboratory," he explained. "Call me day after tomorrow. We'll probably know then."

It was a long, worrisome waiting period for Alice and Pat Maguire. On the appointed day she called the doctor.

"I want you in today," he told her. "You'd better bring Pat with you."

Alice swallowed hard, feeling a cold shiver of fear pass over her.

"Then there's something there?" she asked in a small, frightened voice.

"Possibly," Dr. Diller said. "And don't worry. If there is something, we probably have it very early."

When the Maguires faced their doctor they were as fright­ened as a couple could be. Within a few moments he had reassured them that, although it was obvious that cancer was present, there was an excellent chance that Alice Maguire would be saved through surgery.

He explained that despite the fact that uterine cancer is the second most common cancer in women (breast cancer is first), the uterine cancer death rate among U. S. women has declined, more than 40 per cent in 25 years. About 55 per cent of such patients are now being saved.

"What happens next?" Pat Maguire asked nervously.

"Alice is going to the hospital," Dr. Diller said. "Preferably tomorrow. This probably will mean a hysterectomy—removal of the uterus—and possibly we'll have to take the ovaries, too. But you have your family now, and thousands of women live quite normally after hysterectomies."

"Do you think we're in time?" Alice asked bluntly.

The doctor nodded. "Yes. You came to me early. I think there is an excellent chance for recovery—but, of course, we can't be certain until we operate and see what's there. But I don't anticipate any trouble."

Dr. Diller's anticipations proved to be correct. In Alice Maguire's case, the cancer was quickly discovered and re­moved before it could spread. Now, after six years, she is healthy and extremely active in community affairs.

Thousands of similar cases with happy endings might be cited. Thousands more could have been saved if they had sought medical aid in time.

The fight against cancer involves thousands of persons and some of the finest minds on earth today. Hardly a week passes without a new discovery along the battlefront against this disease which—according to estimates—will strike 45,000,000 Americans now living.

Progress certainly is being made. One cancer patient in every three is now being saved in this country. Not long ago it was only one in four. The American Cancer Society makes a pertinent observation about these statistics:

"Of every six persons who get cancer, two will be saved and four will die. Nos. 1 and 2 will be saved. No. 3 will die needlessly. He could have been saved if proper treatment had been received in time. Nos. 4, 5 and 6 will die of cancers which cannot yet be controlled. Only the results of research can save these patients. . . This means that half of those who get cancer could and should be saved."

In an enlightened age, the following recommendations concerning cancer should be heeded by everyone:

First, have a health checkup every year.

Second, know the seven danger signals quoted elsewhere in this chapter. If your signal lasts longer than two weeks, tell your doctor.

Third, heed the words of Dr. Charles S. Cameron, former Medical and Scientific Director of the American Cancer Society: "Man's best weapon against cancer is man himself. Frequently a physician will detect cancer when it has not yet produced symptoms that are bothering or sometimes even noticeable to the patient. To best protect yourself from cancer, you must meet two requirements—acquire a working knowledge of cancer's early symptoms (the danger signals) and have regular checkups from your family doctor. Such health habits are paying off in lives saved. You are your own best defense against cancer. See your doctor regularly."

To which might be added these words from Arthur God­frey: "We human beings must learn to live with this cancer menace. We mustn't fear it so much that we avoid discussion and examination. We must not fear to use the word, cancer."

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