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(4) Cancer Clinics.—In spite of the valuable results obtained by this method in America, only
one attempt has been made in this country to form such a clinic. More than a year ago the Brentford
Union called a conference of public health authorities as the result of whose deliberation they attempted
to establish a Cancer Clinic at the West Middlesex Hospital (the Poor Law Infirmary) to which patients
of all classes might go for diagnosis and suitable treatment. This attempt, however, came to nothing,
chiefly owing to the state of the law which, it was decided, made it illegal for the Guardians to treat
any persons who did not come within the scope of the Poor Law.
9. What Local Authorities can do.—The following outline of a scheme shows what might
be done by a Local Authority for the control of Cancer, and I would observe that, though the scheme
as a whole is novel, the individual measures suggested have all stood the test of experience either in
this country or in the United States of America.
Outline of Scheme for the Control of Cancer.
1. Propaganda.—This may be considered in two parts :—
A. As regards the Medical Profession.
B. As regards the General Public.
A. The Medical Profession.
The co-operation of the medical profession is obviouslv essential for the success of any Cancer
campaign.
(1) Meetings of Local Medical Practitioners to be convened for the purpose of considering the
means to be employed for the control of Cancer. (Vide Ministry of Health Circular 426, para. 19.)
(2) Postgraduate lectures and Demonstrations for the Medical Practitioners in the area conducted
by recognised authorities on the subject.
(3) Cancer Clinic. (See below under Diagnosis.)
B. The General Public.
(1) Leaflets for Distribution, treating either of the disease as a whole or of certain forms of it,
e.g., Cancer of the Breast. Such leaflets could be distributed to patients attending the Municipal
Clinics, to Municipal Employees, to householders, etc.
(2) Posters which should, if possible, be pictorial, and each of which should aim at teaching
one lesson only in a simple manner.
(3) Advertisements in the local press.
(4) Articles in the same place.
(5) Lectures.
2. Diagnosis.—After very careful and prolonged consideration of the subject, I am convinced
that by far the most important measure for securing the early diagnosis and treatment of Cancer—
and one that has not so far been tried in this country—is the—
Cancer Clinic for Free Diagnosis. (Vide Ministry of Health Circular 426, Para .20 (1)). The
organisation of such a Clinic (or clinics) should be as follows :—
(i.) Clinic to be established or maintained by the Local Council.
(ii.) X-ray equipment should be provided.
About 60 per cent. of cases of Cancer cannot be diagnosed without the use of
X-rays.
(iii.) Beds should be provided for the temporary admission of patients suspected of suffering
from Cancer of the alimentary tract, etc., to enable a thorough examination to be made
by means of a Barium Meal and X-rays.
(iv.) Diagnosis should be Free and available to all persons applying for it. In the
case of persons admitted for the purpose of a Barium Meal a small charge in respect of
maintenance might perhaps be made.
(v.) Staff.—The minimum staff necessary for the efficient conduct of such a clinic would be :—
(a) Surgical Specialist.
(b) Radiologist for X-ray diagnosis.
(c) Nurses—the number required depending upon the number of patients examined
and the number of beds provided for the temporary accommodation of patients.
(vi.) Sessions.—Two sessions per week might be sufficient as a beginning, being subsequently
increased as necessary.
3. Treatment.
(i.) Conveyance by ambulance of patients to and from hospital, i.e., any hospital where arrangements
were made for their treatment by surgical means or otherwise. (Vide Ministry of Health
Circular 426, para. 20(3).)
(ii.) Deep X-ray Therapy at a hospital established or subsidised by the Council.
(iii.) Surgical Treatment at the same place.