Outlook on Cancer

313 Pages·1977·9.593 MB·English

by  Sir Rodney Smith KBE, PRCS (auth.), Ronald W. Raven O.B.E., T.D. (eds.)

OUTLOOK ON
CANCER
OUTLOOK ON
CANCER
Edited by
Ronald W. Raven, D.B.E., T.D.
Former Member of Council, Royal College of Surgeons of England
Consulting Surgeon, Royal Marsden Hospital and Institute 'of Cancer Research
Consulting Surgeon, Westminster Hospital
London, England
PLENUM PRESS· NEW YORK AND LONDON
Library of Congress Cataloging in Publication Data
Main entry under title:
Outlook on cancer.
Proceedings of the seventh and eighth annual symposia of the Marie Curie
Memorial Foundation on Cancer, held at the Royal College of Surgeons of
England, London, England, May 13th, 1975 and May 11th, 1976."
Includes index.
1. Cancer-Congresses. I. Raven, Ronald William. II. Marie Curie Memorial
Foundation .. [DNLM: 1. Neoplasma-Congresses. QZ200 094 1975-76]
RC261.AI095 616.9'94 77-8636
ISBN-13: 978-1-4615-8824-5 e-ISBN-13: 978-1-4615-8822-1
DOl: 10.1007/978-1-4615-8822-1
Proceedings of the Seventh and Eighth Annual Symposia of the Marie Curie
Memorial Foundation on Cancer, held at the Royal College of Surgeons
of England, London, England, May 13th, 1975 and May 11th, 1976
© 1977 Plenum Press, New York
Softcover reprint of the hardcover 1st edition 1977
A Division of Plenum Publishing Corporation
227 West 17th Street, New York, N.Y. 10011
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted,
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
FOREWORD
When the 1975 and 1976 symposia of The Marie Curie
Memorial Foundation took place at the Royal College of
Surgeons of England it was IDY great privilege to say a
few words at the opening of each of them. It is equally
a privilege to contribute these few introductory words to
the Volume recording these symposia and I believe that it
would not be inappropriate to recall with minor mod
ifications some of the thoughts that occurred to me when
I opened the symposium in 1976, for they do reflect the
spirit of determined optimism, but without complacency,
that characterized the contributions on both of these two
occasions.
In common with many others I always looked forward,
from year to year, to the Meetings and admired each time
the spirit which was so apparent and so very much in tune
with the general philosophy of a surgeon, the spirit
which admits that to a doctor and all others who care for
patients cancer is a grim and terrible foe but suggests
that, rather than sitting down and grizzling about it, we
should bestir ourselves, do our best, whatever the
difficulties, and at least try to do a little better each
year.
The title of the symposium in 1976 was typically
stimulating,-"Towards a Solution",- not, admittedly a
study of the solution itself but a title emphasising that
the position was not static - that it was mobile, that we
moving forward and we do know where we are going.
~
Some years ago a distinguished British surgeon,
visiting the United States, found in one centre what he
regarded as a totally unacceptable degree of inertia in
v
vi FOREWORD
the operating theatres where some lamentably slow operating
was explained by the excuse "this is a Halsted School"
(Halsted was a very distinguished American surgeon at the
turn of the century). "He taught his pupils to be met
iculous and careful and was himself a slow operator.
What was good enough for Halsted is good enough for us".
Returning to this topic when he gave an address in the
evening, the British visitor said "You know, it seems to
me that in this centre you regard Halsted's footprints
in the sands of time as fox-holes to be defended to the
death - and re-excavated as they crumble - instead of
merely as evidence of the direction in which he was
travelling" •
Today, at least I believe that we do know the
direction in which we are travelling and I particularly
applaud the refusal to become bogged down and static, the
refusal to respond to difficulty with apathy, the det
ermination to maintain momentum in areas where progress
is being made.
"Towards a Solution" •••••••••••••••
Yes - and if one cannot immediately reach this goal,
at all costs let us continue to move forward with det
ermination - and with optimism.
SIR RODNEY SMITH
PREFACE
The annual symposium arranged by the Marie Curie
Memorial Foundation is concerned with an important
practical aspect of Cancer and is attended by a large
audience of members of the caring professions, who part
icipate in the discussions for mutual benefit. The
material for this book is provided by two symposia and
comprises the lectures given by the invited speakers,
with the discussions that followed.
The book is divided into two parts. "Cancer and the
Nation" is the subject of part 1. Whilst cancer affects
all nations in different WalfS, each has its own methods
for control, which are dealt with here with reference to
the United Kingdom. The annual rise in cancer mortality
and the considerable morbidity it causes stimulates us to
a greater effort to achieve control; there is no reason
for complacency, much remains to be done. A good picture
of the present position can be seen here.
"Cancer - Towards the Solution" is the encouraging
subject of part 2, for there are clear indications that
we are making steady progress towards this desirable goal.
There are good grounds for a more optimistic outlook
because of newer methods of diagnosis and the development
of combination treatment in addition to knowledge which
is coming from research - clinical, epidemiological and
laboratory. Bridges are now essential between clinical
and research work for the benefit of patients. We have
travelled far during recent decades, but an uphill
journey still lies ahead.
RONALD W. RAY EN
vii
ACKNOWLEDGEMENTS
As Chairman of the Symposia it is a privilege to
make the following acknowledgements for so much help and
support.
The President and Council of the Royal College of
Surgeons of England for the facilities provided for
these large meetings. Miss Hazel Child, B.A. of the
College administrative staff. Mr. Paul A. Sturgess and
Dr. D. C. Williams of the Marie Curie Memorial Foundation
administrative and research staff.
The lecturers at the meetings who have provided the
material for this book.
CONTENTS
PART 1
CANCER AND THE NATION
Mortality and Morbidity ..... 3
Rodney Smith, K.B.E., M.S., P.R.C.S.
National Cancer Needs 7
Ronald W. Raven, O.B.E., O.St.J., T.D., F.R.C.S.
National Cancer Screening . . . . . . 19
O. A. N. Husain, M.D., F.R.C.Path.
Industry and Cancer . . . . . . . . . . 57
M. D. Kipling, V.R.D., M.R.C.S., D.P.H.
Changing Risks in the United Kingdom . . . . 71
Francis J. C. Roe, D.M., D.Sc., F.R.C.Path.
Progress Towards Effective Computer Systems in Medicine 87
Barry Barber, M.A., Ph.D., F.B.C.S., F.lnst.P.
Cancer Education and Training--Medical . . . 103
R. A. Sellwood, M.Sc., Ch.M., F.R.C.S.
Cancer Education and Training--Nursing 109
Robert Tiffany, S.R.N.
Cancer Education and Training--Medical Social Work . . 119
Joyce Bardsley, C.Q.S.W.
ix
x CONTENTS
Cancer Education and Training--The Public . . . . . . . 127
Ian Burn, F.R.C.S.
Cancer Research in Britain .......... 135
M. G. P. Stoker, C.B.E., M.D., F.R.S.
PART 2
CANCER -- TOWARDS THE SOLUTION
Encouragement from Research on the Cancer of the
Individual Patient . . . . .. ... 147
John R. Hobbs, M.D., F.R.C.P., F.R.C.Path.
Cancer--New Hope for Young and Old . . . . . . . 163
Ronald W. Raven, O.B.E., O.St.J., T.D., F.R.C.S.
Cancer Diagnosis and the E.M.I. Scanner ........ 177
Richard Hayward, F.R.C.S.
Health, Nutrition and Vitamins in Malignant Disease .. 189
Ariel F. Lant, Ph.D., F.R.C.P.
Newer Chemicals for Cancer Treatment . . . . . . 201
lain W. F. Hanham, M.R.C.P., F.R.C.R.
Combination Treatment ...... 219
M. Baum, Ch.M., F.R.C.S.
How to Prevent Cancer . .. 233
Francis J. C. Roe, D.M., D.Se., F.R.C.Path.
Organising Cancer Work ... 247
Ian Burn, F.R.C.S.
Encouragement from Recent Statistics . . . . . . . . . 255
A. M. Adelstein, M.D., M.R.C.P., F.F.C.M.
Delegate List 277
Representatives from the Media 309
M.C.M.F. Staff 309
Index 311
Part 1
CANCER AND THE NATION