Cancer: Its Cause and Treatment, Volume 1 (of 2)

Lecture I

NATURE OF CANCER

It may be safely said that no disease which has afflicted mankind has received as much attention as Cancer, or concerning which there has been as much diligent search to find out its nature and cause. Tuberculosis, which seemed at one time to threaten even the existence of the race, has sunk into relative significance, as we have learned its true nature and conquered some of the causes of its ravages, and reduced its mortality very largely. Syphilis, under various names, forms, and aspects, was formerly much more of a menace than now, and in earlier years caused veritable epidemics, but is now well understood and controlled. Leprosy is less of a terror than in earlier times, since it has been definitely shown not to be contagious. Smallpox no longer rages, and yellow fever, and the plague, and hook worm disease have been hunted down by scientific study and the application of proper sanitary and medical measures. And so on in regard to many of the ills which afflict mankind.

But cancer has held its own and has even increased in frequency, with rapid strides and bounds in some localities, until now it looms large as a national or even universal scourge; it has been estimated to cause the death of half a million persons yearly among the civilized people of the earth, and untold misery and suffering to many times this number. And all this is still going on in spite of the earnest, faithful, and intelligent labors of innumerable research workers, the sacrifice of countless animal lives, and the expenditure of vast sums of money; and the end, as far as relates to its prevention and cure, seems almost as far away as ever, for many surgeons, in past and present times, have acknowledged their inability to cope with the disease.

Much, however, has already been established by scientific research, and still more earnest thought, observation, and endeavor should be given to seeking most diligently for the cause of the disease, in the laboratory as well as in practice; for there must be some cause of cancer, and also some reason for its steady increase.

But it is never to be forgotten that, as Pope says, “the proper study of mankind is man,” and clinical observation, with laboratory research, on cancer as it appears in the human being, must be the ultimate base upon which all true advance in the knowledge of the nature, treatment, and prevention of the malady can ever rest. To effect this we must study the human being in all relations of life, must know the constitution and class of subjects in which the disease is most apt to manifest itself, understand the chemico-physiologic actions going on in the system, before and during the existence of the disease, and by a process of synthesis and deduction understand what is wrong and endeavor to correct it.

All this is indeed a great undertaking, and can only be accomplished by great effort on the part of many careful and skilled observers. But I want, in these lectures, to give you an outline of my own thought and study for many years, and, if possible, to let you see as I do the lines along which investigation should be directed. It is hoped, therefore, that this and the following lectures will throw some light on the connection of cancer with diet and mode of life, and some suggestions as to its prevention and cure.

Parasitism has been excluded: for while at different times many observers have reported various organisms which were thought to be the cause of malignant growths, none of these have been definitely confirmed by others, in spite of earnest endeavor; and all experimental and clinical evidence is against a parasitic etiology of cancer. It is therefore seen how improper it is to speak any longer of “the germ of cancer,” for, as is now widely acknowledged, there is no such germ, it is an ignis fatuus which has been chased in vain.

The contagiousness of cancer has also been excluded, certainly in the sense in which this term is applied to other affections. For while in some animals inoculation experiments have resulted in the transmission of certain tumors, little has been determined except that such tumor material when transplanted can, in some unknown manner, multiply its cells indefinitely and form a focus of malignant disease, with disastrous effects on adjoining tissue. The same occurs in metastasis in cancer patients. But this does not at all explain the true basic nature of cancer, nor its development in those who have had no connection with other patients so afflicted. On the other hand the instances of suggested or supposed human transmission of cancer from one individual to another are so remarkably few, and so exceedingly doubtful, that a recent author, Janeway, states that “no well-authenticated cases of the transfer of a malignant tumor from one human being to another exist.” It has been found impossible to inoculate human cancer into rats, mice, and apes, nor can animal tumors be inoculated into animals of a different species.

Heredity has been advanced as a cause, but statistics fail to verify this in any degree whatever. While certain instances have been brought forward in which heredity seemed evident, the study of large numbers of those afflicted with cancer, in connection with others free from the disease, has shown almost the same proportion of antecedents with cancer in both classes of persons; although some recent evidence seems to show that there is some tendency in different families for different organs. Experimental studies have, it is true, seemed to demonstrate that tumors occur apparently along hereditary lines in some animals in regard to certain organs; but in these instances it is to be remembered that the animals were kept in captivity, and all fed alike, conditions which have been found to cause the development of malignant disease in wild animals when confined in Zoölogical Gardens.

In former years malaria was believed to have an influence in the production of cancer, and some investigators have thought to trace the prevalence of the disease to telluric influences, showing a preponderance of cases along certain water courses, or in certain streets or houses; but no definite proof of such connection has ever been established, and this theory is dismissed by the best authorities. Syphilis, in its latent effects, has also been claimed as an element in the causation of cancer, and undoubtedly the disease may develop, in suitable persons, upon old syphilitic lesions, especially about the mouth, anus, and genital region: but no one well informed in regard to cancer would regard syphilis as the real cause of the disease. All these and other etiological propositions are no longer considered to be tenable, and the very multiplicity of suggested causes shows that we are yet very far from the true etiology of cancer.

Age undoubtedly has a powerful influence in the development of cancer, the vast majority of cases occurring after the age of forty or fifty. But, again, this does not at all explain the true nature of the disease, for only a certain proportion of elderly people are so afflicted, and malignant tumors have been observed in those of all ages, and even in young children. The degeneration of tissue belonging to advancing years undoubtedly renders it more susceptible to malignant disease, but this does not explain why one person is affected and not another, nor why the tissues in one locality or another take on this morbid action.

More recent scientific study has attempted to show that cancer originates from what are called “embryonic rests,” or pre-natal, wrongly placed, tissue elements, which at some time or other take on morbid action and develop into what we know as the various forms of cancer. Williams says, “From a biological standpoint tumor formation must be regarded as a phenomenon of the same order as reproduction in general: that is to say, as a special form of overgrowth of the individual.” But here again it is necessary to determine what causes them at certain times and in certain places to thus proliferate and form new tissue, which then becomes malignant and may proceed to destroy all contiguous tissues, and even to cause death.

Traumatism has been claimed by many as the cause which determines the activity of the misplaced cells, and starts them on their disastrous or rampant course: the various percentages of the cases in which it was believed that traumatism started up the malignant process has varied greatly with different observers, even up to 50 per cent, or more. But it is far from proven that this is always the case, nor does local injury in any way explain the persistency with which malignant disease, when once started, pursues its destructive and even fatal career; nor can traumatism account for the great tendency to recurrence constantly observed, either in the former site or at some distant focus, through the agency of the lymphatic or vascular system. For of multitudinous traumatisms, even in cancer subjects, how few ever develop into malignant disease!

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