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

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Fulham 1927

Annual report of the Medical Officer of Health for the year 1927

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42
It is important to note that pain only occurs as an
early symptom in about 8 per cent. of cases, also that
any of the above symptoms may be produced by causes
unconnected with cancer but on their occurrence a
doctor's advice should be sought.
Treatment.—The importance of early operation, now
almost a commonplace, is again referred to ; unfortunately
women generally wait 6 to 9 months after
the onset of symptoms before applying for hospital
treatment which prejudices their chances of recovery,
as it is proved beyond doubt that the results of treatment
in the early stage are, roughly, twice as good
as those in patients whose disease, though amenable
to operation, is approaching the borderline of inoperability.
The danger of delay before commencing
treatment is obvious when one remembers that the
average duration of life in untreated cases is only one
year and nine months. As regards the result of operation,
about 40 per cent. of the patients survive over
five years.
Treatment by radiation (either radium or X-rays
combined with radium) is of great value both in the
early and late stages, but facilities for this treatment
are not generally available in this country. This treatment
requires very special and prolonged training and
experience and is used more extensively on the Continent
than in England. Radiological treatment has
been successful in a small proportion of cases too
advanced for operation, 10 to 12 per cent. of this type
surviving over 5 years, thus establishing a high probability
of cure. The unprecedented results in the more
advanced cases have been such that radiation treatment
is now being used on the Continent in early cases
in place of operation and the results in these cases
are stated to be as good as those obtained by operation.
The author of the reports (Dr. Janet E. Lane Claypon)
however, states that radiological treatment has not
yet been tested over a sufficiently long period to enable
a strict comparison to be made with the best results
of operative surgery.