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
There is a wealth of statistics regarding operations for cancer of the
cervix uteri. Despite the figures obtained by radical operators like
Wertheim, the vast majority of those surgeons who practise either
vaginal or abdominal hysterectomy have obtained far inferior results to
those of Byrne, with his cautery, which is still in use. Wertheim once
reported the astonishing figure of 61 per cent of 5‒year recoveries. In
a later report, however, Wertheim stated that only about one half of the
cases that come to him are operable, and of these about one half are
cured by operation, that is, about 25 per cent of all cases. But
experience shows that if these cases could be followed up there would be
very many late recurrences. The claims of Wertheim and others must be
offset, however, by the high operative mortality reported by many; as
the cases must have been incipient in order to be operable, it is
possible that Byrne with his cautery could have done nearly as well, and
Byrne never lost a patient. But Klein of Munich, by circular letters
compiled many statistics, and concluded that the percentage of cure was
but 4.5 per cent, and Klein himself obtained only 3.6 per cent. Reinecke
asserted that only 10 per cent of cases of cancer of the cervix can be
cured.
Fredrick (_Trans. Gynæcol. Soc._, 1905, p. 136) collected the records of
500 hysterectomies for cancer of the cervix performed by prominent
colleagues and himself. Of this entire material there had been but 13
five-year cures. In discussion Henrotin stated that he had practically
given up abdominal hysterectomy. Currier stated that surgery was a
failure as a cure for cancer.
At an earlier session of the Society, 1900, in a discussion of Pryor’s
paper, Van de Warker asserted that surgery had done nothing for cancer;
Lapthorne Smith said that many women did better if left alone. J. Byrne
stated that hysterectomy for cancer was a crime. Engleman thought that
cancers left alone may insure a longer survival than those treated
surgically.
In a discussion before the same Society in 1896 (on Byrne’s paper)
vaginal hysterectomy was discussed. While Boldt, Dudley, and Baldy
claimed excellent results, Segond is known to have had but 5 relative
cures (2‒5 years) in 80 cases. Mundé saw a rapid return in all his 25
cases. Polk had recurrence in every one of 50 cases. Byrne collected
notes of 283 operations by ten men, and the results were as follows:
died, 7 per cent; life prolonged, 11 per cent; and became worse, 82 per
cent.
Public-domain text, read in full here on John Shaqi.
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