Cancer of the breast occasionally begins in lumps which are the seat of chronic inflamma tion, so that it is well in case a woman has a lump in the breast to have it carefully examined by a physician every six months or so in order to be sure that a cancer is not beginning.
Chronic irritation, therefore, is the only cause for cancer which we know of, and yet it is curious that not everyone who has chronic irritation develops cancer. There is some peculiar personal quality in the tissue which is necessary before a cancer will develop. An example of this is the fact that leg ulcers which are so very common among old people almost never give rise to cancer, although ulcer of the stomach so frequently does. There is, there fore, something besides the ulceration and the chronic irritation which makes the cancer start.
Cure of Cancer.— The only generally suc cessful cure for cancer is its removal as early as possible by surgical means. The use of the knife is preferred to caustics or cautery be cause it permits of a cleaner cut and more rapid healing. Of course, the knife is the only possibility for deep internal cancers involving the stomach or intestines; but occasionally cancers of the skin are treated by caustic with fair results. It is, however, better to have the cancer cut out clean, as the scar is then much less marked and the healing is more rapid. It is, also a satisfaction for the patient to know that all the cancer is out of the body, instead of having it burned out by some slow caustic. A
certain number of cancers of the 'face, and especially small early cancers in other sites, can occasionally be cured by either radium or X-ray, but as yet we have no published statistics to show what proportion of cases can be per manently cured by either of these agents; the number of cures reported after some 10 years of use of both these is exceedingly small, and the results are not nearly so good as those which follow surgicat removal of the entire tumor. For it must be remembered that cancer is not a blood disease and that when it begins it is no larger than a pin-point, so that if we could make a diagnosis and cut it out in time, every cancer would be curable. The difficulty is to make a diagnosis and as the symptoms of cancer are obscure and often are entirely absent, it is impossible for a physician to learn of the beginning of the disease in time to cut it all out. With every improvement in diag nosis of cancer, the possibility of curing the disease is increased.
Bibliography.— Hoffman, F. L., 'The Mor tality from Cancer Throughout the World' (Newark, N. J., 1915); Kettle, E. H., 'Pathol ogy of Tumors' (New York 1916) ; Williams, W. Roger, 'The Natural History of Cancer' (New York 1908) ; Woglom, William H., 'The Study of Experimental Cancer: A Review' (New York 1913).