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See also:CANCER, or CARCINOMA (from See also:Lat. cancer, Gr. KapKivwga, an eating See also:ulcer) , the name given to a class of morbid growths or tumours which occur in See also:man, and also in most or all vertebrate animals . The See also:term " See also:malignant disease" is commonly used as synonymous with " See also:cancer." For the See also:general See also:pathology, &c., of tumours see See also:TuMouR . Cancer exists in various forms, which, although differing from each other in many points, have yet certain See also:common characters to which they owe their See also:special significance . 1 . In structure such growths are composed of nucleated cells and See also:free nuclei together with a milky fluid called cancer juice, all contained within a more or less dense fibrous stroma or framework . 2 . They have no well-defined limits, and they involve all textures in their vicinity, while they also tend to spread by the lymphatics and See also:veins, and to cause similar growths in distant parts or See also:organs called " secondary cancerous growths." 3 . They are undergoing See also:constant increase, and their progress is usually rapid . 4 . See also:Pain is a frequent symptom . When See also:present it is generally of a severe and agonizing See also:character, and together with the See also:local effects of the disease and the resulting See also:condition of See also:ill See also:health or " cachexia," hastens the fatal termination to which all cancerous growths tend . 5 . When such growths are removed by the surgeon they are See also:apt to return either at the same or at some other See also:part . The See also:chief varieties of cancer are Scirrhus or hard cancer, Encephaloid or soft cancer and See also:Epithelial cancer . Scirrhus is remarkable for its hardness, which is due to the large amount of its fibrous, and relatively small proportion of its See also:cell elements . It is of comparatively slow growth, but it tends to spread and to ulcerate . Its most common seat by far is the See also:female See also:breast, though it sometimes affects See also:internal organs . Encephaloid is in structure the See also:reverse of the last, its softness depending on the preponderance of its cell over its fibrous elements . Its See also:appearance and consistence resemble See also:brain substance (hence its name), and it is of such rapid growth as to have given rise to its being occasionally termed acute cancer . Its most CANCER 175 frequent seats are internal organs or the limbs . Ulceration and See also:haemorrhage are common accompaniments of this See also:form of cancer . Epithelial cancer. is largely composed of cells resembling the natural epithelium of the See also:body . It occurs most frequently in those parts provided with epithelium, such as the skin and mucous membranes, or where those adjoin, as in the lips . This form of cancer does not spread so rapidly nor produce secondary growths in other organs to the same extent as the two other varieties, but it tends equally with them to involve the neigh bouring lymphatic glands, and to recur after removal .
Cancer affects all parts of the body, but is much more frequent in some. tissues than. in others
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According to See also:recent See also:statistics prepared by the registrar-general for See also:England and See also:Wales (sixty-seventh See also:annual-See also:report) the most frequent seats are, in numerical See also:order, as follows: See also:males—See also:stomach, See also:liver, rectum, intestines, aesophagus, See also:tongue,; See also:females—uterus, breast, stomach, liver, intestines, rectum,
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Other statistics give similar, though not identical results
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It may be said, broadly, that the most frequent seats are the female sexual organs and after them the See also:digestive See also:tract in both sexes
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In See also:children, in whom cancer is rare, the most frequent , seats appear to be—under five, the kidneys and supra-renal bodies; five to ten, the brain; ten to twenty, the See also:arm and See also:leg bones
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Cancer tends to advance steadily to a fatal termination, but its duration varies in different cases according to the part affected and according to the variety of the disease
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Soft cancer affecting important organs of the body often proves fatal in a few months, while, on the other See also:hand, cases of hard or epithelial cancer may sometimes last for several years; but no precise limit can be assigned for any form of the disease
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In some rare instances growths exhibiting all the signs of cancer may exist for a See also:great length of See also:time without making any progress, and may even dwindle and disappear altogether
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This is called " spontaneous cure."
Cancer has been the subject of observation from time immemorial, and of the most elaborate investigation by innumerable workers in recent years; but the problems of its cancer origin and character have hitherto baffled inquiry. See also:research
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See also:Modern scientific study of them may be said to have begun with J
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See also: See also:Virchow and the pathological researches of See also:Sir J . See also:Paget, and general See also:attention was directed to the microscopic examination of the cells of which cancer is composed . This led to a See also:classification, . on which much reliance was once placed, of different kinds of cancer, based on the character of the cells, and particularly to a distinction between carcinoma, in which the cells are of the epithelial type, and sarcoma, in which they are of the connective tissue type . The distinction, though still maintained, has proved barren; it never had any real significance, either clinical or pathological, and the tendency in recent research is to ignore it . The increased knowledge gained in numerous other branches of biological See also:science has also been brought to See also:bear on the problem of cancer and has led to a number of theories; and at the same time the apparently increasing prevalence of the disease recorded by the vital statistics of many countries has See also:drawn more and more public attention to it . Two results have followed . One is the See also:establishment of special endowed institutions devoted to cancer research; the other is the publication and discussion of innumerable theories and proposed methods of treatment . Popular See also:interest has been constantly fanned by the announcement of some pretended See also:discovery or cure, in which the public is invited to See also:place its See also:trust . Such announcements have no scientific value whatever . In the rare cases in which they are not pure quackery, they are always premature and based on inadequate data . Organized cancer research stands on a different footing . It may be regarded as the revival at the end of the 19th century of what was unsuccessfully attempted at the beginning .
As early as 1792, at the See also:suggestion of Mr
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See also: In this establishment the fully equipped means of clinical and laboratory research were See also:united under one roof and manned by a See also:staff of investigators under the direction of Dr W . S . See also:Lazarus See also:Barlow . In the same See also:year the Deutsche Comite As . Krebsforschung was organized in See also:Berlin, receiving an annual See also:subsidy of 5000 marks (£25o) from the imperial See also:exchequer . This body devoted its energies to making a See also:census of cancer patients in See also:Germany on a definite date . Aspecial ward for cancer was also set apart at the Charite hospital in Berlin, with a See also:state endowment of 53,000 marks (£256o) per annum, and a laboratory for cancer research was attached to the first medical clinique under See also:Professor Efnst von See also:Leyden at the same hospital . A third institution in Germany is a special cancer See also:department at the Royal Prussian See also:Institute for Experimental See also:Therapeutics at See also:Frankfort-on-See also:Main, which has been supported, like the Imperial Cancer Research Fund in England, by private contributions on a generous See also:scale . The fund just mentioned was initiated in See also:October 19o1, and its operations took definite shape a year later, when Dr . E . F . Bashford was appointed general See also:superintendent of research .
The See also:patron of thefoundation was See also: They continue this process so persistently that they first invade and then destroy the surrounding tissues; nothing can withstand their march . They are moreover carried to other parts of the body, where they establish them-selves and grow in the same way . Their activity is carried on with relentless determination, though at a varying See also:pace, until the patient See also:dies, unless they are bodily removed . Hence the word " malignant." The problem is—what are these cells, or why do they behave in this way ? The principal answers put forward may be summarized:—(1) they are epithelial cells which grow without ceasing because the connective tissue has lost the capacity to hold their proliferative See also:powers in check (H . See also:Freund, following K . See also:Thiersch and W . Waldeyer); (2) they are embryonic cells accidentally shut off (J . F . Cohnheim) (3) they are epithelial cells with a latent See also:power of unlimited proliferation which becomes active on their being dislocated from the normal association (M . W . H . Ribbert and Borrmann) ; (4) they are stimulated to unlimited growth by the presence of a See also:parasite (Plimmer, Sanfelice, Roncali and others); (5) they are fragments of reproductive tissue (G . T . Beatson); (6) they are cells which have lost their differentiated character and assumed elementary properties (von Hausemann, O . Hertwig) . The very number and variety of hypotheses show that none is established . Most of them attempt to explain the growth but not the origin of the disease . The See also:hypothesis of a parasitic origin, suggested by recent discoveries in relation to other diseases, has attracted much attention; but the observed phenomena of cancerous growths are not in keeping with those of all known parasitic diseases, and the theory is now somewhat discredited . A more recent theory that cancer is due to failure of the normal secretions of the See also:pancreas has not met with much See also:acceptance . Some generalizations bearing on the problem have been drawn from the work done in the laboratories of the Imperial Cancer Research Fund, They may be summarily stated thus . Cancer has been shown to be an identical process in all vertebrates (including fishes), and to develop at a time which conforms in a striking manner to the limits imposed by the See also:long or short See also:compass of See also:life in different animals . Cancerous tissue can be artificially propagated in the short-lived See also:mouse by actual transference to another individual, but only to one of the same See also:species . Cancerous tissue thus propagated presents all the characteristic features of the malignant growth of sporadic tumours; it infiltrates and produces extensive secondary growths . Under suitable experimental conditions the aggregate growth of a cancer is undefined, of enormous and, so far as we can See also:judge, of limitless amount . This extraordinary growth is due to the continued proliferation of cancerous cells when trans-planted . The processes by which growing cancer cells are transferred to a new individual are easily distinguishable and fundamentally different from all known processes of infection . The artificial See also:propagation of cancer causes no specific symptoms of illness in the See also:animal in which it proceeds . Under artificial propagation cancer maintains all the characters of the See also:original tumours of the See also:primary hosts . Carcinoma and sarcoma agree in possessing all the pathological and cellular features of malignant new growths . Simultaneously with the active pursuit of laboratory research much statistical work has been devoted to establishing the broad facts of the prevalence and incidence of cancer on a See also:firm basis . The point of most general interest is the apparently steady increase of the disease in all countries possessing fairly trustworthy records . It will be sufficient to give the figures for England and Wales as an example . |
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