Cancer of the breast begins as a lump, occurring more often to the
outside of the nipple, but may develop in any part. It may or may not
be painful at first, but the skin becomes attached to it; and sooner
or later the nipple is drawn in. It is seen in women over forty, as a
rule. Lumps in the breast, occurring during the nursing period, are
often due to inflammation, but these generally have no relation to
cancer unless they persist for a long time. Any lump which appears in
the breast without apparent cause, or which persists for a
considerable time after inflammation ceases, should be promptly
removed by the surgeon, as without microscopic examination the most
skilled practitioners will be unable absolutely to distinguish between
a harmless and malignant tumor. As even so-called benign tumors often
become cancerous (e. g., inflammatory lumps in the breast, warts, and
moles), an eminent surgeon (Dr. Maurice Richardson) has recently
formulated the rule that all tumors, wherever situated, should if
possible be removed, whatever their apparent nature. Cancer of the
womb may be suspected in middle-aged women if flowing is more profuse
than is usual, or occurs at irregular times; if there is a discharge
(often of offensive odor) from the front passage; and sometimes pain,
as backache, and perhaps paleness. Early examination should be sought
at the hands of a physician; it is suicidal to delay.
Cancer of the stomach is observed more often in men over forty, and
begins with loss of appetite; nausea or vomiting; vomiting of blood;
pain in the stomach; loss of weight, and paleness. Some of these
symptoms may be absent. Improved methods of surgery have rendered
early operation for cancer of the stomach a hopeful measure, and if
cure does not result, the life will be prolonged and much suffering
saved.
Cancer of the lip arises as a small lump, like a wart generally, on
the lower lip in men from forty to seventy. Sometimes it appears at
first simply as a slight sore or crack which repeatedly scabs over but
does not heal. Its growth is very slow and it may seem like a trivial
matter, but any sore on the lower lip in a man of middle age or over,
which persists, should demand the immediate attention of a surgeon,
because early removal is more successful in cancer of the lip than in
any other form.
There are, of course, many comparatively harmless or benign forms of
tumors which will not return if removed and do not endanger life
unless they grow to a large size. Among these are the soft, flattened,
fatty tumors of the shoulders, back, buttocks, and other parts, and
the wen. This is often seen on the head and occurs frequently on the
scalp, from the size of a pea to an egg, in groups. Wens are elastic
lumps, painless and of slow growth, and most readily removed. Space
does not permit us to recount the other forms of benign tumors and it
would be impossible to describe how they could be distinguished from
malignant growths.
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