Some of the methods that have been used for centuries are still valuable in detecting cancer, but modem medicine has developed many new techniques for aiding diagnosis of disease.

One of the most important single procedures used by the physician is the use of his hands in order to palpate or feel changes that have occurred underneath the surface of the body. As medicine is practiced in some parts of the world, patients seldom get time even to remove the necessary clothing to permit the doctor to look at the skin or to put his hands on various portions of the body in order to feel changes that have taken place.

When there is a suspicion of a new growth the doctor will look to see if there is any visible sign of a change on the surface of the body. He will then press with his fingers to determine whether or not lumps may be felt underneath the skin, or whether the outlines of various organs in the abdomen have been changed from what is usually felt.

New instruments have been developed that enable the doctor to project his powers of observation in a way that was not possible fifty years ago. There is now an electrically-lighted instrument for every entrance and exit of the human body. The cystoscope, the bronchoscope, the esophagoscope and the gastroscope are types of instruments which enable the doctor to look into the urinary bladder, the bronchial tubes, the stomach, and many other portions of the body.

With the X-ray the doctor can detect changes in the outlines of organs inside the body, and by combinations of the use of the X-ray with the use of certain drugs that can be taken internally he can get pictures of changes in outline and in functioning of various tissues of the body. He can even see tumors which project into the cavities inside the brain. In addition, there are devices such as the electroencephalograph which enable the doctor to determine changes in the function of the brain. There are also functional tests for the kidney, the stomach, the liver, the heart, and other vital organs.

Transillumination means that light is thrown through the tissues of the body; this is one of the tests that is used particularly in studying the breast for the presence of new growths. New also in the study of cancer is the use of radioactive isotopes. We know today that certain chemical substances taken into the body will be carried by the blood to certain organs or tissues, where they are deposited. Thus, more than 90 per cent of iodine taken into the body goes directly to the thyroid gland. Calcium is deposited in bones and teeth. Some substances go directly to the liver. Radioactivity attached to these chemical substances goes with them, and they can then be detected in various portions of the body by use of the device called the Geiger counter, which shows the presence of the radioactive substances by a clicking sound. All over the country research is now being made to determine how valuable radioactive isotopes can be in aiding not only in diagnosis but also in treatment of cancer.

New also in the study of cancerous changes are the studies that are now being made on the blood. Certain conditions such as excessively rapid growth of the red blood cells, called polycythemia, or excessively rapid growth of white blood cells, as in leukemia, can only be detected by examining specimens of the blood under the microscope. Since these conditions come on insidiously, a proper examination will always include the taking of a specimen of blood and an observation of this blood under the microscope. It will include also counting of the cells in the blood, because there are several different types of cells and the relative percentages of various types of cells in the blood may be of the greatest significance in relation to determining the existence of these conditions that are called cancer of the blood.

Some conditions that occur in the body, while not necessarily cancerous, may be considered precancerous, or early stages of changes in the tissues that might eventually lead to cancer. Thus, women should be examined after childbirth to determine the presence of injuries of the tissues, and the proper repair of damage may prevent subsequent irritations that lead to cancer. Erosions, which are rubbed spots on the surface of the organ, need to be given proper care. Ulcers of the stomach occasionally develop cancerous manifestations. Continued irritation of the gall bladder by gallstones may in some instances bring about the kind of irritation that results in excessive and wild growth of cells. Bear in mind that none of these conditions is the cause of cancer. They are contributing factors which have to be studied.

Cancers of the lung, the intestines, or the stomach usually come on insidiously, and the person affected may not be aware for some time of the nature of his condition. Often people are reluctant to let the doctor know when the symptoms first appear; sometimes they fail to pay attention because of fear or ignorance. Doctors believe that many more cases could be saved if only people would come to the doctor sooner.

From a British clinic comes the report that 55 per cent of patients with cancer of the breast waited for more than three months after noticing a lump before consulting the doctor. Over 16 per cent waited longer than a year.

Cancer of the skin, breast cancer, and cancer of the uterus give indications of their presence early, and a high percentage of these patients can be cured if the condition is diagnosed early and properly treated.

Early diagnosis in such cancers depends chiefly on paying attention to symptoms affecting the lung and getting promptly a good X-ray study. The mass X-ray studies for presence of tuberculosis have helped to locate many cases of cancer.

Treatment Of Cancer

Modem medicine has three chief means for eliminating cancer from the body. These are surgical operation, radium, and X-ray. By surgical operations the entire cancerous structure is removed and usually with it the organ that contains the cancer, if that is not a vital organ. Some cases of tumor are especially susceptible to radioactivity. They are called "radiosensitive." Other types are resistant to the radioactive rays. The X-ray, particularly the modern type of high-voltage, deep-penetrating X-ray, can be used in areas in which radium cannot be implanted and to which radium cannot extend.

This does not mean that every case of cancer can be treated by just one method. Every cancer is different from every other cancer. The doctor must decide in each instance the forms of reatment that will be most helpful. In some instances not only surgery, X-ray, and radium are employed but also other techniques. The female sex hormone or estrogens are used in the control of cancer of the prostate. With cancer of the breast early attention is vital. If a cancer of the breast comes to proper medical attention within the first few months the woman can have practically her normal life expectancy. If she delays to the time when the cancer has extended to the glands under the arm her life expectancy may be greatly reduced. Studies made of thousands of cases of cancer of the breast prove with certainty that early attention prolongs life. Delay is likely to be fatal.

Not so many years ago a cancer of the lung was invariably fatal. In 1933 a surgeon for the first time removed an entire lung by operation, because of the presence of cancer. The patient was another doctor. That patient is still alive. Today there are hundreds of people throughout the United States who have had all or part of a lung removed and who have survived the operation successfully. Thus what was an invariably fatal condition now yields in a considerable percentage of cases to modem methods of treatment, and patients recover. Similarly, cancer of the stomach was formerly considered invariably fatal. The percentage of recoveries in cases that are diagnosed early and that submit to proper surgical treatment is considerable. Unfortunately, far too many wait too long. The prolongation of life includes years which are exceedingly valuable, because these conditions do not generally occur in extremely young people but usually in men and women at the top of their productive periods.

The death rate for cancer is still high. Two hundred thousand Americans now die of cancer each year. The new knowledge that may come through research may even serve to prevent the appearance of cancer among great numbers of people whose fathers or mothers or ancestors may have had cancer and died of it and who therefore form something resembling a stock or type in which cancer is more likely to occur than among the population generally.