Cancer: Its Cause and Treatment, Volume 2 (of 2) — John Shaqi
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
In the Transactions for 1912 (Discussion of Neal’s paper, Wertheim’s
operation) Bovee stated that only 10 per cent of cancers of the cervix
were operable. Polak had no survivors from operations, although four
were living from Byrne’s cautery method. Chalfant had 3 cures (6 years)
in 30 cases. In general the saving of life was offset by the high
operative mortality. Later I shall report two remarkable cases of very
extensive cancer of the cervix which have entirely recovered, with
normal cervix, without operation.
In regard to operative results in cancer of the stomach there are
relatively few satisfactory statistics. W. J. Mayo reported recently
(Levin, Hoffman “Statistics of Mortality,” etc., 1915, p. 210) on 996
cases of carcinoma of the stomach. Of these 344 cases only were operable
and of the latter 25 per cent remained cured five years and over, after
operation. In other words, about 9 per cent of cases of carcinoma of the
stomach can be cured by surgery at the hands of Mayo, how much less in
the hands of most other surgeons? Against such success must be opposed
the analysis of 1,000 cases of cancer of the stomach by Friedenwald
(_Amer. Jour. Med. Sci._, November, 1914). He states “of the entire
number, operations were performed in 266 instances; of these there is
not one patient living.” But few lived more than a year after operation;
the majority died within the first six months.
In cancer of the gall bladder several good operators have reported that
there have been absolutely no good results.
In cancer of the rectum there is a high operative mortality and very
questionable ultimate curative results; indeed, there are very few
reliable statistics in regard to this. In 27 perineal and sacral
operations Mayo reports 7 per cent primary mortality, and in 44
abdominal and combined abdominal and perineal operations 20 per cent
operative mortality. Tuttle reports a higher operative mortality. While
there are no available data in regard to the duration of life after
operation, it is well known that the disease usually recurs, and in many
a colostomy is performed, with all its distressing features and very
intangible results.
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