Early & Operable
It is often said that early cancer is curable. Yet almost every doctorknows patients who discovered a tiny mass, had prompt treatment, butsoon died from fast-spreading disease. Why? Main reason, says theUniversity of Chicago's Pathologist Paul E. Steiner, is that "early"means many different things.
It may mean early 1) in the sense that it has only just begun to producesigns and symptoms; 2) in the anatomical sense of being small; 3) inthe topographical sense of being localized; 4) in the technical sense of not having invaded other tissues; 5) in thesense of still being susceptible to treatment or of offering a highprobability of cure. "These attributes may coincide in some instances,"says Dr. Steiner in Cancer Research, "but frequently they do not . . .Early-disseminating tumors, in many sites in the body, are incurablealmost from the start and before they are diagnosable. In thebiological sense, they are already late in their youth."
It is fortunate, Dr. Steiner notes, that most tumors arise at siteswhich he calls "expendable." These, if detected early, meaning beforethey have spread, are indeed often curable. But they may soon spread tovital parts. "The surgeon is constantly reducing the number ofanatomical structures that are essential to life, but at this timethere appears to be a limit beyond which he cannot hope to go. Thebrain, heart, some lung tissue, and other organs will probably beindispensable for some time. The [cancers] involving these parts arethreats to life from the time of their origin."
One way to detect many early cancers which otherwise defy diagnosis isby studying the cells in a minute quantity of fluid taken from the bonemarrow through a large-bore needle, reportedresearchers at Ontario's Hamilton General Hospital. Even when cancer isnot directly suspected, and when the symptoms are such common ones asanemia, fatigue, loss of weight, or changes in the white blood-cellcount, they often find telltale cancer cells in the marrow. Afterrunning the tests on 4,100 patients, they now make them routinely inall cases where diagnosis is in doubt, the researchers reported in theAnnals of Internal Medicine.
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