London's Pulse: Medical Officer of Health reports 1848-1972

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Fulham 1924

Annual report of the Medical Officer of Health for the year 1924

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be obtained in all disorders of the stomach, bowels
or womb." It is urged that early diagnosis is of
paramount importance. "Cancer itself in its early
stages is almost invariably unaccompanied by pain, and
is sometimes painless throughout. This painlessness
of cancer often leads the patient to delay seeking medical
advice. Medical advice should be sought at once,
particularly if a tumour or lump is found in the breast,
if an ulcerated condition exists on the tongue, lip or
skin, which does not heal in a few days, if there is
persistent hoarseness, if a mole or wart shows a tendency
to grow, if blood or mucus is passed with the stools,
if there is a bloody or offensive discharge at other than
the normal monthly periods, especially at the change
of life or after it has passed." The subject of the
treatment of cancer is next dealt with, and the Committee
appear to be of the opinion that in cancer early
operation affords the best chance to the patient,
although they do not feel justified in stating that all
risk of recurrence is necessarily removed even if undertaken
in an early stage of the disease. "There is,
however, indubitable evidence that removal by operation,
though ultimately followed by recurrence, enables
many people to live a natural life in comfort for considerable
periods, while in advanced cases such removal
may relieve or prevent prolonged suffering. There are
many cases, moreover, in which cancerous growths
have been removed once and for all, the patient has
lived for years afterwards without recurrence, and has
ultimately died from an entirely different cause, and
lastly evidence has accumulated that in some varieties
of cancer, and in some situations, radium or X-ray
treatment, or diathermy, carried out by expert medical
practitioners, offers at least as good a chance to the
patient as surgery." It is particularly urged that
"patients should not waste time or money by trying
quack remedies which at best are useless, and at
worst aggravate the disease." It is also urged in the
memorandum that local health authorities should
undertake propaganda and educational work in connection
with cancer, but as this has already been done
by the Fulham Council ever since I became their Medical
Officer of Health, it is unnecessary for me to go further
into this matter.