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103
APPENDIX G.
REPORT ON THE WORK OF THE CANCER CLINIC AT HEALTH CENTRE (1), 9, WILLESDEN
LANE, KILBURN, N.W. 6.
For the Year, 1930.
by
AGNES HILL NICOLL. M.A., M.B., Ch.B., D.P.H.
This Clinic is held on the first and third Thursdays of the month from 7 to 8 p.m.
During the year 1930, 43 patients attended, of whom 30 were women, and 13 were men. 21
women and 11 men were new cases, and 9 women and 2 men had attended during 1929, but were still
under observation at the end of that year.
The total attendances for the year was 83, giving an average of 3 to 4 per session.
The ways by which the clinic had become known to these 43 patients were as follows :—
14 had read articles on the subject in the local press.
8 had seen the Council's advertisement in the local press.
6 had seen the posters displayed in the Health Centres, shops, libraries, etc.
5 had heard of it from the Council's health visitors.
5 had heard of the subject during their attendance at the Mothercraft classes held at the
Centre.
4 had been recommended to go by friends who had themselves attended, or by councillors.
1 had read an article in Better Health.
The 43 patients came to the clinic complaining of the following conditions :—
21 had pain or irritation in some part of the body, the most frequent sites being the abdomen,
the breast, and the tongue.
9 had a lump or swelling.
6 had discharge from the uterus.
1 had irregularity of menstruation.
6 had chronic digestive or intestinal troubles.
In about one third of the cases the complaint had existed for under three months ; in another
third, the duration was from three months to one year ; while in the remainder, symptoms had persisted
for periods which varied from one to ten years.
In every case an attempt was made to find out the reason for delay in seeking relief of the
symptom complained of.
In 12 cases the matter had not been considered important, until the existence of the Clinic
and its objects had been brought to notice.
In 11 cases the patients were too busy to " waste time " going to doctors or hospitals, and
had only come because the symptoms were getting worse.
In 10 cases some treatment had been obtained at the beginning, but had either been inadequate
in itself or had not been continued, and had failed to give relief. The patients
had given up hope, until, hearing of this Clinic, they had decided to try again.
In 3 cases an investigation had already been made in hospital, but had been negative.
In 3 cases the patients had consulted their own doctors and been reassured, but the symptoms
had continued.
In 3 cases the patients feared cancer, and had not sought relief lest their suspicions should
be confirmed.
In 1 case some time previously an operation had been advised, but at a fee which the
patient could not afford.
After inquiry into the history, and a careful physical examination, each case was disposed
of according to its needs, the guiding principle being a preventive one. Thus, if there was the slightest
doubt as to the diagnosis the case was referred to hospital for further opinion or special investigation ;
if any condition was found which, even if not definitely pre-cancerous might lead to chronic irritation,
or, might later change its character, the patient was advised to have it treated or removed, and was
sent to hospital, doctor, or dentist for the purpose ; and if the symptom complained of was found to
be due to some cause quite remote from cancer or its pre-disposing causes, the patient was as far as
possible put in the way of obtaining appropriate relief.
Of the 43 cases dealt with :
25 were referred to various hospitals for further investigation or treatment.
9 were sent back to their own doctor or to the hospital which they had already been
attending.
2 were advised to get Dental treatment.