By Dr. H. HENDERSON PATRICK, Glasgow. MR. CHAIRMAN, LADIES AND GENTLEMEN,
How to tackle the scourge of cancer is, without doubt, the most urgent problem which confronts the medical profession at the present time. For that reason, although this paper may not bring us much nearer the correct solution of the problem, I make no apology for introducing the subject. If I can afford you food for thought or matter for profitable discussion, or if I can enable some to view this subject from a new standpoint, the object of my discourse will be amply fulfilled.
The history of cancer I shall pass over. It was most ably and fully dealt with by our esteemed President, Dr. George Burford, in paper which he read at our Annual Congress in 1924. Suffice to say here that cancer is a disease of great antiquity, writings on the subject being traced back to 1500 B.C., and that there is no reason to suppose that during all those years the features of the disease have altered in any way.
Throughout those centuries the most astute brains in the medical profession have been endeavoring to discover the aetiology of and cure for this disease, and, during recent times at least, ample funds have been available for investigation (except, unfortunately, in homoeopathic circles), and yet no definite answers to the many questions with which the problem bristles have been forthcoming. Of theories there have been many, yet none has been supported by sufficient evidence to make it acceptable to the profession as a whole.
Let us refresh our memories regarding some of the generally accepted facts on the subject. The cancer growth consists of a mass of cells which, in appearance, are indistinguishable from the normal cells of the body. The cells may be of different types, but there is no type which is not normally found in the organism. They perform no useful function. They are not organized in any way, they seem to have one direction of function and one only, and that, proliferation. This has been described, very aptly I think, as an insanity of the tissue. The cells infiltrate the surrounding tissues, not through any special motor power which they possess, but entirely through mutual pressure due to their own multiplication, and their distribution takes the line of least resistance. They may enter the lymphatic channel or the blood-stream and so may reach adjacent or distant parts, carrying with them their power of proliferation.
In their new environment the same process is repeated, until, through time, by their parasitic action, their host is gradually destroyed. Since the masses of cells have no organization, the individual cells are easily killed, giving rise to neurotic areas, and ulceration often occurs. In these cases, septic poisoning or haemorrhage may be the immediate cause of death. The first evidence of the disease is always local. It begins in tissues which are, at the time, in a state of growth, or may be under repair, e.g., carcinoma, the more common form of malignant growth, originates in the epithelial or endothelial tissues, where throughout the whole of life a certain amount of tissue repair is normally in progress. Sarcoma, on the other hand, arises from the tissues derived from the embryonic mesoblast and is common only during the time of life when these tissues are in a state of growth.
Now, what is it that transforms this normal body cell into the cancer cell, into this insane cell which has lost all sense of co-ordination and seems to have only one property left, that of proliferation? All the writers on this subject seem to me to have the idea that the cancer cell has taken on some new life, has acquired some new ungovernable property which it did not previously possess. Is not this a wrong point of view? This power of reproduction is an intrinsic part of every cell during some part of the life of the organism as a potential element of many cells throughout the entire life of the organism.