Cancer Symposium

At Madison, Wis. last week 500 doctors gathered to hear the nation's foremost cancer specialists discuss what is known and what is not known about the second most common cause of death in the U. S.* Expenses of this cancer symposium were paid by the Wisconsin Alumni Research Foundation which thereby saved local doctors about $75 each.

Dr. James Ewing of Manhattan, undisputedly the world's No. 1 cancer authority, struck squarely at the entire cancer problem by saying: "The public must not expect cancer research to disclose the secret of the cause of cancer, nor to provide a universal remedy for advanced cancer. There is no one cause of cancer. There are many causes, often preventable, and the public should acquaint themselves with the nature of these causes."

Most authentic view of cancer is that it is not inheritable. But the susceptibility to cancer may be inherited. Dr. Maud Slye of Chicago, who was in Europe last week, says that the female offspring of mice which have cancer of the breast will also develop cancer of the breast (TIME, Aug. 31). Last week at Madison Dr. Madge Thurlow Macklin of London, Ont. declared that this inherited organ susceptibility applied to human beings too. Said Dr. Macklin, 43, plump, vivacious mother of three daughters, and the only woman taking part in the cancer symposium: "We find that the members of a family tend to have the same type of cancer, and in the same organ, and at about the same time of life. Thus it is much commoner to find a family in which the mother and two daughters have breast cancer, or uterine cancer, than it is to find a family in which the mother has breast cancer, the daughter uterine cancer, and the son laryngeal cancer. . . ."

Aware of the despair which her words might cause, Dr. Macklin added: "The belief that cancer is inherited need not be a gloomy one. We can hardly make the picture darker than it is when we tell the public that one of every seven or eight adults will die of cancer. No one person can pay a doctor for a complete examination as to the possibilities of his having all the varieties of cancer that there are. But he can be examined for the more common kinds, and for the type someone else in his family has had. Thus we may get the patients for early diagnosis, and save some of them who would otherwise come when it was too late."

Chronic irritation always seems to be the immediate cause of cancer whether the victim is genetically vulnerable or not. The irritation may be mechanical (ill-fitting dentures), physical (pipe smokers' lips), chemical (tar roofers' hands), digestive (caused by bile acids), endocrine (caused by sex hormones). Said Dr. James Bumgardner Murphy of Manhattan:

''Clinicians are familiar with malignant changes taking place in lesions produced by germs, particularly syphilitic lesions in the mouth and in tuberculosis of the skin. In the Rockefeller Institute Laboratory we have seen the production of cancer of the stomach following experimental infection by a nematode, that is, a kind of worm, and malignant changes in the liver associated with tapeworm cysts."

Diagnosis of a full-blown cancer is easy. Diagnosis of an early, curable one may be difficult. It depends upon study of a sample of tissue cut from a living tumor under suspicion. Said Pundit Ewing: "Accurate tumor diagnosis requires a life-long experience and a special training. Not every diagnostic laboratory is equipped to give this service. The State of New York requires a difficult practical examination of all pathologists who undertake to diagnose cancer and wish to be eligible for appointment in any of the many laboratories controlled by the State. It would be well if other states followed this example."

Treatment of cancer is positive and often curative in cases of cancers which can be reached without cutting the patient open. Thus the rate of cure is comparatively high for cancers of the skin, breast, uterus. From those sites the surgeon usually can excise the offensive tumor or the radiologist can shrivel it with x-ray or radium. The great difficulty with cancers of internal organs is that they seldom warn the victim of their presence until it is too late to get rid of them. Nonetheless, surgeons can save the lives of an appreciable number of victims. Radiologists, guided by Dr. Gioacchino Failla of Manhattan and Dr. Henri Coutard of Paris, both of whom spoke in Madison last week, are learning to focus x-ray beams of hundreds of thousands of volts upon cancerous internal organs and to bring about some cures. But no specialist can yet explain why radiations destroy cancers any more than a specialist can describe the exact conditions which permit a cancer to develop.

*No. 1 killer: heart disease; No. 3 killer: cerebral hemorrhage.

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