CANCER CONTROL Cancer control is the practical application of the established facts and sound working opinions concerning the prevention and cure of cancer. Although, as has been indicated, no means has yet been discovered of completely suppressing or preventing can cer, there are various procedures which give some measure of protection against it. The present hope of reducing deaths de pends upon the fullest possible employment of these protective procedures.
Looked at as a community problem, to control cancer it is necessary not only that the public should have information which will enable them to recognize the earliest suspicious symptoms, but be induced to apply for competent medical attention upon the first appearance of these signs. Periodical medical examina tions are urged as a means of detecting cancer. Physicians, on their part, must be alert to come to an early decision as to the diagnosis and prompt and skillful in applying the proper treat ment. To instruct the public and to give the medical profession a knowledge of the latest and most useful information on this subject is the object of an organized warfare against the disease, carried on in the United States since 1913 by the American So ciety for the Control of Cancer, composed of about 2,000 members and with official representatives in all the States of the Union. In the course of the year a large amount of printed matter in the form of circulars, booklets, newspaper articles, posters and maga zine stories appears. There are lectures and scientific papers delivered, and radio talks given. In fact, every known means of publicity which is applicable for the instruction of the public upon the largest possible scale and with the least expenditure of money, is employed. The annual meeting of the society takes place on the first Saturday in March and a periodical has been issued by it every month since 192o, giving information of interest and service concerning the disease. And this is only one of many similar societies existing in most of the civilized countries of the world.
In 1926 an international meeting of representatives from most of the countries of Europe met in the United States under the auspices of the American Society for the Control of Cancer, in order to exchange experiences with regard to the methods avail able for prevention and treatment. During the course of the meeting resolutions were drawn up and unanimously agreed to as follows : ( I) The causation of cancer is not completely understood, but it may be accepted that for all practical purposes cancer is not to be looked upon as contagious or infectious.
(2) Cancer itself is not hereditary, although a certain predis position or susceptibility to cancer is apparently transmissible through inheritance. This does not signify that, because one's parent or parents or other members of the family have suffered from cancer, it will necessarily appear in other persons of the same or succeeding generation.
(3) The control of cancer, so far as this subject can be under stood at the present time, depends upon the employment of measures of personal hygiene and certain preventive and curative measures, the success of which depends upon the intelligent co operation of the patient and physician.
(4) Persons who have cancer must apply to competent physi cians at a sufficiently early stage in the disease, in order to have a fair chance of cure. This applies to all forms of cancer. In some forms, early treatment affords the only possibility of cure.
(5) Cancer in some parts of the body can be discovered in a very early stage, and if these cases are treated properly the prospect for a permanent cure is good.
(6) The cure of cancer depends upon discovering the growth before it has done irreparable injury to a vital part of the body and before it has spread to other parts. Therefore, efforts should be made to improve the methods of diagnosis in these various locations and the treatment of the cancers so discovered.
(7) The public must be taught the earliest danger signals of cancer which can be recognized by persons without a special knowledge of the subject, and induced to seek competent medical attention when any of these indications are believed to be present.
(8) Practitioners of medicine must keep abreast of the latest advances in the knowledge of cancer in order to diagnose as many as possible of the cases of cancer which come to them.
(9) Surgeons and radiologists must make constant progress in the refined methods of technic which are necessary for the diag nosis and proper treatment not only of ordinary cases but of the more obscure and difficult ones.
(io) There is much that medical men can do in the prevention of cancer, in the detection of early cases, in the referring of patients to institutions and physicians who can make the proper diagnosis and apply proper treatment, when the physicians them selves are unable to accomplish these results. The more efficient the family doctor is the more ready he is to share responsibility with a specialist.
(1 1) Dentists can help in the control of cancer by informing themselves about the advances in the knowledge of the causes of cancer, especially with relation to the irritations produced by imperfect teeth and improperly fitting dental plates. They can also help by referring cases of cancer which they discover to physicians skilled in the treatment of cancer in this location. It may be doubted whether all dentists fully realize the help which can be obtained from X-ray photographs in revealing not only the state of the teeth but the condition of the bone surrounding them.
(1 a) Medical students should be instructed in cancer by the aid of actual demonstrations of cancer patients, and this to a sufficient extent to give them a good working knowledge of the subject.
(13) The most reliable forms of treatment, and, in fact, the only ones thus far justified by experience and observation, depend upon surgery, radium and X-rays.
(14) Emphasis should be placed upon the value of the dis semination of definite, useful and practical knowledge about cancer, and this knowledge should not be confused with that which is merely theoretical and experimental.
( i 5) Efforts toward the control of cancer should be made in two principal directions : (a) the promotion of research in order to increase the existing knowledge of the subject, and (b) the practical employment of the information which is at hand. Even with our present knowledge many lives could be saved which are sacrificed by unnecessary delay. (G. A. S.)