Cancer: Its Cause and Treatment, Volume 2 (of 2)Bulkley, Lucius Duncan
Science
Cancer: Its Cause and Treatment, Volume 2 (of 2)
Bulkley, Lucius Duncan
Cancer
OCCUPATION.—Many attempts have been made to trace the influence of
occupation upon the incidence of cancer, but thus far very little of
practical interest has been demonstrated; the difficulties concerning
this investigation are immense, owing to absence of essential and
accurate data. There have been many lists presented, but few of which
agree as to details, and all need to be corrected as to the proportion
of those living at different ages. There is also the question as to the
effect of local or general agencies; thus, as to the result of local
injuries on the skin, and also in regard to other agencies, whatever
they may be, which produce internal cancer; for tables of occupation do
not generally refer to sex, age, or location of the disease.
First, to dismiss the question as to the direct result of local injuries
in inducing cancer of the skin, which, at the most, caused only 3.7 per
cent of all cancer deaths in 1914, we may cite a few instances in which
this appears to be pretty well established.
The occurrence of epithelioma as a direct result of repeated and
protracted exposure to X-ray is familiar to all, and is particularly
interesting because it occurs commonly among younger persons, and at a
time of life when epithelioma is rare; and especially also because the
X-ray is constantly effective in curing epithelioma. The rarity of
epithelioma resulting from X-ray, considering the enormous amount of
exposure which must have occurred in making and using X-ray tubes,
implies, however, that there must be some other cause also at work. It
has been urged, therefore, that the skin tissue being altered and
weakened from repeated and protracted exposure to X-rays, more readily
falls prey to some of the chemical or other irritating agencies which
have been observed to be followed by epithelioma.
Time does not permit even a mention of the various elements, which are
many, that have been credited as excitants of cutaneous epithelioma; but
brief allusion may be made to one which formerly attracted much
attention, mainly in England; this refers to chimney-sweeps cancer, the
mortality from which was at one time at least 5 times greater than that
from cancer in males generally, at the same age. This is now, however,
of relatively infrequent occurrence, owing to the adoption of other
methods of cleaning chimneys. The epithelioma, which more commonly
developed on the scrotum, was believed to be due to the long continued
irritation caused by the constant presence of soot on the part; other
products of combustion and tar derivations have also been accredited
with the same result.
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