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

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Acton 1924

[Report of the Medical Officer of Health for Acton]

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8
Memorandum 3 of the Ministry of Health contains certain
facts relating to Cancer of the Breast and the results of operation
in connection with this condition.
In every case of Cancer of the breast, the problem of operation
is one of primary importance, and two questions naturally arise,
viz. the immediate risks of the operation and the chances of nonrecurrence
of or cure of the disease.
Under modern conditions, deaths directly attributable to the
operation, if performed by skilful surgeons and in well-equipped
institutions, have been reduced in the case of breast operations to a
fraction of 1 per cent. This figure is reassuring in view of the fact,
that at the present time early surgical interference affords the one
chance for a patient suffering from cancer of the breast. Cases
of cancer treated only with internal medicines, or external applications
or by dietic methods are not being effectually treated.
What measures of success may be expected from the operation?
It is satisfactory to obtain figures from the Ministry of Health
as these are authoritative and not biassed by the views of the actual
operator. The Memorandum states with confidence that, even
under the unsatisfactory conditions imposed by the late stage at
which many cases come under surgical observation, the mean
duration of life is prolonged several years.
In the special circumstances of operation at the most favourable—that
is, the earliest moment after recognition of a lump in the
breast, there is an average prolongation of life amounting to many
years. Although the term prolongation of life is used, it is certain,
that cure, in the widest popular sense of the word, has frequently
been effected by early operation, i.e., patients have lived ten, fifteen,
twenty or more years and died ultimately of some other disease.
Another Memorandum on Cancer issued by the Ministry
of Health on the main lines which experimental cancer research has
followed in recent years, is interesting to local authorities because
of the bearing of such research on the necessity or desirability of
disinfection after a death from Cancer. Certain broad conclusions,
negative as well as positive, are deducible from the several branches
of this work.
From very early times men's minds have been exercised
by speculation or conjecture on the causation of cancer, and within
recent years an enormous amount of research work has been carried
out, in order to ascertain the grounds on which the various conceptions
and theories of the cause or causes are based.
From an administrative point of view the two most important
theories are those which may be called the infective theory and the
chronic irritation theory.
The underlying conception of the first theory is the presence
of a microbe or microbes; it was supposed that cancer was due to


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