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WHO WHAT WHY WHERE THE AMERICAN CANCER SOCIETY. 47 BEAVER STREET, NEW YORK, N. Y. is cancer? C oncer is not a d isease c aused b y a g erm or infection coming from outside t he b ody. I t is a d isease, which, for s ome r eason a s y et u nknown, d evelops w ithin the body, o nd if n ot stopped i n time e ventually kills its victims. I n o rder to u nderstand t he natUre (2)## ### co:ncer a nd h ow i t d evelops, w e m ust first u nderstand t he f undamental p rocess o## growth. Your b ody i s o omposed of billions of units o f livin<;r m atter c alled cells. The individual cell is so s mall t hat i t c an b e s een o nly w ith the a id 0## a powerful microscope. I t is, t here## fore, a mazing to r ealize t hat e ach o ne of u s , s tarted life a s cr - single fertilized e gg cell. Within ~ few h ours this first cell divided i nto two cells, e ach s imilar i n a ll r espects to t he . other. A s hort time l ater t hese t wo cells divided into four, a nd four into eight, a nd s o on. This p rocess of <;rrowth t hrough cell ruvisiens w ent o n r apidly b efore birth, emd t hen contin~ed at a s omewhat s lower r ate u ntil e aeh . o~e of u s r eached a dult life. W hen cidult life i s r eached, w e s top growing. The v arious t ypes of cells c arry o n t heir s pecial duties h ut cec:;rse r eproducing n ew c ells ex- c ept to r eplace w orn o ut o r d estroyed tissue. The t endency of t he cells to divide, which w as s o i nsistent i n e arly life, is n ow h eld i n check. I t i s a s t hough s ome g rowth restraint p ulled o n a b rake a nd s aid, " Stopl" A nd i n t he n ormal h ealthy b ody this restraining o r controlling factor r emains i n c harge for t he r est of o ne's life. OUTLAW C EUS But 'sometimes a cell o r g roup of cells g ets ' o ut of h and, i gnores t he n ormal r estraints, a nd b egins m ultiplying crazily a nd e ndlessly. T hese " outlaw" c ells p ush a side n eighboring tissues, r obbing t hem of food a nd t hus c ausing t he d eath of n ormal cells. G athering s trength, t hey c ontinue their ruthless a nd r elentless p rogram of conquest. Not c ontent w ith i nvasion of n earby t issues, t hey d ispatch m embers of their " gang" to other p arts of t he b ody, t raveling b y w ay of t he l ymph o r b lood s treams, to s et u p n ew h ead- . q uarters a nd c arry o n t heir o utlaw activities of uriceasing growth a nd destruction. This transformation of normal, l aw-abiding . c ells into l awless, c riminal cells i s c alled c ancer. At this point i t i s well to r emember t hat n ot all a bnormal g rowth o r t umors a re c ancer. S ome t umors a re s urrounded b y a limiting m embrane, a nd a lthough t hey c rowd n earby t issues, t hey d o n ot d estroy t heir rieighbors. Nor d o t hey s pread to o ther p arts of t he b ody. T hese a re k nown a s b enign tumors, a nd o rdinarily c an b e r emoved w ithout difficulty. O n t he other h and, t here a re m any k inds of m alignant t umors w hich m ay differ i n v arious r espects, s uch a s l ocation i n t he b ody, a ppearances u nder t he microscope, a nd r esponse to treatment. But t hey a ll h ave t hree important characteristics i n c ommonuncontrolled growth, the t endency to s pread t hrough t he b ody, a nd t he p ower to kill if not t reated a dequately a nd i n time. causes cancer? By this time y ou a re p robably w ondering w hat i t i s t hat c auses s ome c ells to r ebel a gainst t he o rderly p rocess of g rowth a nd to s tart off o n a r ampage of l awless e xpansion, . destruction, a nd d eath. Unfortunately, w e d o not y et k now e xactly w hy this h appens. W hat w e d o k now i s t hat c ertain old-fashioned i deas h ave b een e xploded a nd c ertain . o ther c onditions a re n ow r ecognized a s contributing factors. S OME f ALSE N OTIONS First, let's e xplode t he false notions. C ancer i s not c aused b y a s ingle s evere injury, or b y t he u se of a luminum c ooking vessels, or b y e lectrical refrigeration, o r b y a ny p artic alar food o r c omb ina tion of foods, or by the u se e f alcohol, o r b y k issing o r a n y other form of c ontact b etween p ersons or b etween p ersons a pd a nimals. S ince c ancer i s not c mlsed b y a g erm o r infection, i t i s n either c ontagious n or infectio1:l.s. N or i s c ancer n ecessarily h ereditary. Evidence i nclicates t hat c hildren m ay i nherit a c ertain d egree of susceptibility w hich s hould m ake t hem m ore a lert to w arning s ignals. ' But t here i s n o r eason to a ssume t hat c hildren w ill i nevitably d ie of c ancer b ecause o ne o r b oth pcrrrents d ie o f t he d isease. T HIS M UCH W E K NOW . . N ow for whext w e k now a bout the c auses of c ancer. I t i s c lear, a bove all, t hat c ancer n ever d evelops i n h ealthy t issue. This m eans t hat a ny c ondition w hich r esults i n t he brecrk- ' clown o r d eterioration of n ormal c ells m ay b e p reparing t he w ay for t he r evolution c alled c ancer. F or ' e xample, i rregularity of e ating d oes n ot e ause c ancer, b ut it m ay r esult i n unhealthy c onditions within t he d igestive s ystem, w hich s ooner o r l ater g ive r ise to c ancer. O ne-half of a ll cerneer i s f ound i n t he d iges tive tract. A pproximately o ne-third of a ll c aneer i s i n t he s to mach. H ence, w henever i ndigestion p ersists l onger t han t hree w eeks a d octor s hould be c onsulted a t e nce. T HE R OLE O F I RRITATION I. A s eco nd i mpor tant factor in the d evelopment of ca n ce r is continua l o r c hronic i rritati on . It i s a s t h ough L"he c ells of s ome b ody t issue b e come a nnoyed b eyond e ndurance , l ose p a tience , b reak i nto op en r evolution, a nd b egin b uilding u p t heir r ebel a rmy t hrough c ell division. T here a re t hree t ypes of irritan ts: c hemical, t hermaL a nd m echan ical. Th ere a re m any c hemicals w hich h ave be en f ound to p roduce c ancer i n t he l ab orat ory. C ontinued overexp osure to hot s un a n d h igh t emperatures m ay c ause c ancer of t he s kin. C onstant rubbing of a mole, wart, or o ld s car m ay b e s ufficie nt m e chanical i rritation to c ause rebellion a nd g rowth of m alignant t issue . S USCEPTIBILITY O ne m ore f actor s hould b e m entioned h ere, t hough its origin a nd i nfluence a re a s y et little understood. This i s i ndividual s usceptibility. I t s eems o bvious t hat c ertain p eople a re m ore s usceptible t han o thers to t he d anger of c ancer. W hether t his is d ue to t he f aulty functioning of c ertain g lands o r to t he p resen ce o r a bsen ce of c ertain c hemical s ubstances i n t he b ody, o r to s ome c ondition a s y et u nsuspected, i s n ot k no wn. Scientific r esearch i s still trying to d iscover t he complete a nswer to t he age ~o ld r iddle-what c auses c ancer? does cancer strike? Cancer v ictims a re t o b e f ound a mong y oung a nd old, a mong m en a nd w omen, a mong m arried a nd u nmarried. No a ge g roup i s free from c ancer. B abies a re s ometimes b orn w ith it, a nd o ver t wo t housand c hildren u nder 21 d ie of c ancer e very y ear i n the United States. lungs, stomach, p rostate g land, i ntestines a nd rectum, throat a nd m outh. A mong w omen, t he h azardous s pots a re w omb, b reast, i ntestines a nd r ectum, stomach, a nd g enito-urinary o rgans. A n u nmarried w oman i s m ore l ikely to h ave c ancer of t he b reast t han a m arried w oman w ho n urses h er c hildren, w hile c ancer of t he c ervix (outlet of t he w omb) o ccurs m ore often a mong m arried w omen w ho h ave b orne c hildren. T HE D ANGEROUS Y EARS N evertheless, it is true t hat c ancer s trikes m ore p eople i n t he o lder a ge g roup, a nd m ore Women t han m en i n middle life. More t han h alf of a ll c ancer d eaths o ccur b elow t he a ge of 6 5-that is, i n t he m ost productive y ears for b oth m en a nd w omen. C ancer kills 60 p er c ent m ore m en a nd w omen i n t he p rime of life (between 45 a nd 60) t han a re . k illed b y a ll c ontagious a nd infectious diseases. M oreover, c ancer i s t he c hief c ause of d eath a mong w omen b etween 30 a nd 60; . i n fact, i t i s r esponsible for o ne o ut of four d eaths a mong w omen b etween ,the a ges of 45 a nd 60. T HE D ANGER Z ONES C ertain s ites a re c ommonly r ecognized a s d anger zones. A mong m en, t hese d anger z ones a re lips, are its warning signals? W e c ome n ow to t he m ost e ssential information in this b ooklet-the f acts w hich m ay a ctually m ean t he d ifference b etween life a nd d eath for y ou o r s omeone y ou l ove., T here i s a s y et n o a ntitoxin o r s erum to protect y ou a nd y our f amily from c ancer. T he o nly d efense a t t he p resent t ime i s knowledqe. KNOW, t hen, t hat c ancer often g ives s ome k ind of w arning i n its e arly s tages, a nd t here a re s even d anger s ignals. T herefore, i t behooves y ou t o k now w hat t hese s ignals a re. KNOW, too, t hat d elay i s d angerous; t hat t he i nstant a s ignal a ppears, o ne s hould g o to a p hysician for a thorough p hysical examination. ! of h is h ench men to dist ant p arts of y our b ody. T he s ooner t his d anger ous c riminal is d iscovered a nd i dentified, t he g reater a re y our c hanc es of cure. KN O W tha t perin i s u suclly a l ale s ymp ## tom; t herefGre to w ait for p ain i n m ost in"stGInces i s to w ait too long. A bove GIll, K NOW t he d anger s ignals a nd b e p repared to a ct promptly: A ny s ore t hat d oes n ot h eal-particularly a bout t he" ton q ue. m outh o r l ips. Do n ot p ass i f off a s " nothinq a t a ll." G o to t he d octor. A p ainless l ump o r t hickening. e specially i n t he b reast. l ip. o r t on q ue. Do n ot w ait " to s ee w hat h appens." Go t o t he d ector. I rreqular b leedlnq o r d ischarge from a ny n atural b ody o peninq. Do n ot w ait for p ain. G o to t he doctor. P rogressive c hange i n t he c olor o r s ize of a w art. m ole o r b irthmark. Do n ot t ry s alves o r o intments. G o to t he d octor. P ersistent indiqesUon. Do n ot w ait for l oss o f w eiqht. G o to t he d octor. P ersistent h oarseness. u nexplained c ouqh. o r difficulty i n s wallowinq. Do n ot a ssume t h.t i t i s d ue to s mokinq o r s ome o ther form of irritation w hich w ill Clear u p. G o to t he d octor. A ny c hanqe i n t he n ormal b owel h abits. Do n ot a ttempt to d iaqnose y ourseU. G o to t he doctor. T here i s n o t ime to b e l ost i f y ou ~ee o ne of t hese d anger sicmals. O nce C ancer, t he R ebel, s tarts h is c riminal c areer of o utlaw ~"rewth a nd d estruction, h e d oes n ot p ause. Y our o nly h ope i s t o s lop h im b efore h e b ecomes too p owerful a nd h as d ispat c hed s ome I people wait U nfortunately, m an y p eople p ut off g o ing to a d oc tor for a n e xamination. S ome j ust w a it for a m o re co nven ient t ime. O thers d e lay b ec ause t hey d o n ot r ealize h ow serio us t he c onsequences of p ostponement m ay b e. Still o thers a re s o a fraid t hat t hey w ait a s long a s p ossible b efore f inding o ut w hat th ey think w ill b e b ad n ews . T here a re e ven those w ho a void a n e xamination b ecause they t hink t here i s s ocial d isgrace c onnected w i th h aving c ancer a nd t hey s hrink from h aving i t d iscov ered. A s a m atter of fact, t here i s n o m ore d isgrace a bout h aving c ancer t han a bout h aving a b roken a rm o r ### l eg. W hatever t he r eason, a ll s uch d elay o nly g ives t his e nemy m ore a nd m ore o pportunity to s tart h is i nvasion f orces o n t he ir r uthless m arch through y our b ody. N OT A LWAYS C ANCER I t is r eassuring to k now t hat c ancer i s often c urable i f d iagnosed a nd t reated i n time, a nd t hat a d anger s ignal d oes n ot n ecessarily m ean c ancer. F or e xample, c ancer i s t he c ause for o nly a bout h alf of t he c ases of b leeding from t he n ipple. Bleeding from r ectum a nd b ladder o r b lood i n t he u rine d oes n ot i nvariably l;!lean c ancer, b ut d oes m ean t hat s omething i s w rong a nd a c areful e xamination offers t he o nly c hance for s afety a nd p eace of mind. A BOUT T HIS A ND T HAT P erhaps y ou a re w ondering a bout v arious t ypes of t issue a nd g rowth. For e xample, w hat a bout f reckles? Do t hey e ver t urn i nto c ancer? S imple f reckles d o not, b ut flat m oles w hich l ook like d ark f reckles o r b irthmarks m ay b ecome m alignant a nd s hould b e w atched for a ny c hange i n c olor o r size. W hat a bout c orns? T he r ecord s hows t hat c ancer r arely d evelops i n a n o rdinary c om. N evertheless, s ince c ancer m ay o ccur i n a ny , b ody t issue, i t w ould b e u nwise t o i gnore a ny form of c ontinual irritation. W hat a bout l umps i n t he b reast? Not a ll ### l umps i n t he b reast a re m alignant. H owever, b ecause s ome a re, e very s ingle o ne s hould be c arefully e xamined to d etermine w hether c ancer i s p resent. W hat a bout h emorrhoids? H emorrhoids a re e nlarged v eins i n t he w all of t he r ectum. C ancer i s s ometimes f ound i n t he t issue u nderlying a h emorrhoid; therefore, " bleed- ing p iles" s hould a lways b e r egarded w ith s uspicion a nd c arefully e xamined. Your o wn p hysician c an m ake t he p reliminary e xamination w hich m ay r eveal t he ### p ossibility of c ancer. H owever, i t i s not a lways p ossible to k now from a superficial e xamination w hether a t umor i s b enign o r m alignant. No r eliable s kin o r b lood t est h as b een d eveloped for t he d iagnosis of c ancer, a lthough m any p eople c laim to h ave d one so. The o ne c ertain m ethod of d etermining w hether o r n ot r ebel c ells a re o n t he m arch is to h ave a c ompetent p athologist e xamine a s mall p iece o r s ection of t he s uspected ### t issue u nder t he m icroscope. S uch a n examination i s c alled a b iopsy. W here i t i s n ot p ractical to d o a b iopsy, a s i n t he c ase of i naccessible p arts of t he b ody, ### a n X -ray e xamination m ay b e u sed i n m aking t he d iagnosis. C ancer of t he s tomach, for e xample, c an b est b e d iagnosed b y X-ray, w hich r eveals c lues to t he p resence of c ancer w hen t he s tomach is filled with a d ense s ubstance. T here a re a lso t imes w hen exploratory s urgery i s justified i n o rder to m ake p ossible a b iopsy to p rove t he p resence o r a bsence of c ancer. I t i s o bvious t hat nol a ll d octors o r all h ospitals a re e quipped to d iagnose a ll t ypes of c ancer. E very p hysician c an m ake t he k ind of e xamination t hat r eveals t issue of a s uspicious c haracter. I f a b iopsy o r s urgical o peration i s t hen n ecessary, h e m ust t hen h ave a ccess to a h ospital w ith c omplete d iagnostic e quipment, i ncluding a n o perating room, a l aboratory for t he m icroscopic d iagnosis of tissue, a nd X-ray equipment. , is -caocer treated? , T here a re t hree-and o nly t hree-methods of t reating c ancer w hich a re a ccepted a nd a pproved b y t he m edical p rofession: surg~ry, X -ray a nd r adium. No s erum o r m edicine h as y et b een d eveloped w hich i s of t he s lightest v alue i n t reating c ancer. T he p hysician m ay u se o ne, two, o r a ll t hree of t he a bove m ethods. E ach c ancer p atient m ust b e t reated a s a n i ndividual . p roblem, s ince t he t ype a nd a mount of t reatment n eeded will d epend u pon t he l ocation, t ype a nd s ite of t he c ancer, its duration, its r ate of growth, a nd o ther factors. No t ype of t reatment s hould b e u ndertaken u ntil a complete e xamination h as b een m ade b y a t horoughly c ompetent p hysician. S urgery r emoves t he c ancer from t he b ody. N either t he u se of s urgery n or r adium c auses the s pread of c ancer. I f c ancer a ppears i n o ther p arts of t he b ody a fter a n o peration o r i rradiation t reatment, i t i ndicates t hat t he r ebel c ells h ad a lready b egun to i nvade o ther t erritory b efore t reatment w as b egun. , T here i s n o e ssential d ifference b etween t he a ction of X-ray a nd r adium. W hen p roperly u sed, b oth will d estroy c ancer c ells without s eriously i njurinq n eighboring normal cells. T here a re v arious m ethods of u sing r adium. _H ollow n eedles c ontaining r adium m ay b e i nserted into t he c ancer g rowth o r i n t he t issue s urrounding it, o r both. R adium i n a s uitable c ontainer m ay b e p laced i n c ontact w ith t he g rowth, a s i n c ancer of t he s kin. I n l arger q uantities r adium m ay b e u sed a t a d istance from t he b ody, t he r ays p assing t hrough a n o pening i n t he c ontainer i nto t he c ancerous g rowth. A lso t he g as e manating from r adium, k nown a s r adon, m ay b e a pplied b y m eans of suitable c ontainers i n t he s ame m anner a s t he r adium s alt from w hich i t i s o btained. ### S URE S IGNS O F A Q UACK A ny p erson w ho a dvertises a c ancer c ure, g uarantees a c ure, o r d emands p ayments i n a dvance of t reatment m ay u nquestionably b e r egarded a s a q uack. No r eputable, e thical p hysician w ill d o a ny of t hese t hings. F ew q uacks h ave h ad m edical t raining; therefore t hey h ave n o f undamental knowledge a bout t he n ature of c ancer o r r ecognized m ethods of t reatment. Q u :::::ks a re d angerous b ecause t hey t ake t he p atient's m oney u nder f alse pretenses, t hus d epriving h im of t he m eans for o btaining c ompetent treatment e lsewhere. W hat i s far m ore i mportant, q uacks w aste v aluable ti me, often d epri v ing t he p atient of his l ast chan ce for a dequate t reatme nt a nd cure. 175,000 A mericans - 20 e very h our. A t t he p resent r ate o ne i n e very e ight i s d estined to d ie of c ancer. 2. Realize, h owever, t hat m any c ancers a re c urable i f c aught i n time. It i s e stimated t hat o ne-third to one-half of those w ho n ow d ie of c ancer c ould be s aved o n t he b asis of p resent k nowledge a bout d iagnosis a nd c ure . A t l east 55,000 l ives c ould pe s aved e very y ear; ## 1.000 l ives c ould b e s aved e v ery w eek; s ix lives c ould b e s aved e very h our. I t i s u p to y ou a nd o ther A mericans to l earn t he f acts a nd u se t hem i ntelligently. can cancer be cured? C anc er i s c urable i n a l arge p ercentage of c ases w hen d iagnosed e arly a nd t reated a dequately. T he following t able i s concrete proof of the i ndisputable fact t hat c ancer i s n o l onger a h opeless d isease: % of c ures i f T ype of c ancer t reated e arly B reast . ### ### ### 7 5% 7 5% Cervix of w omb Mouth . 75% L ip ### . 95% S~n 9 5% Rectum 50,0;' B ladder ### 5 0% % of c ures U t reated w hen m oderately a dvanced ## 40% 15% 25% 2 5% 2 5% 10% 10% W HAT C AN Y OU D O T O G UARD A GAINST C ANCER? 1. R ealize t hat c ancer, a s t he s econd g reatest c ause of d eath in this country, h as b ecome a n i ncreasing t hreat to e very h ome. Last y ear c ancer k illed o ver 3. L earn t he d anger s ignals a nd g o t o y our d octor p romptly i f a nyone of t hese s ignals a ppears . Insist t hat m embers of y our f amily l earn t hese s ignals a lso a nd u nderstand t he i mportance of p rompt e xamination . ,! ### 4. A rrange for a periodic h ealth e xamination for yourself a nd o ther m embers of y our f amily. S uch a n e xamination s hould r eveal a ny c onditions w hich m ight l ead t o c ancer. A t horough p hysical e xamination s hould i nclude: C at.lul i nspection of t he . ntlre b ody IIUJ'. f ac. a nd h eatt. b lood v essel a nd l unq e x## a mlnation. E xamination b y s iqht a nd t ouch of a ll b ody o peninqs t hat c an b e s o e xamined### ###u ch a s m outh. nostrils. e ars. t hroat. . lDu### ######### y aqlDa. r ectum. E xamination of s tomach a nd i ntestinea b y X -ray, m icroscopic e xamination o f b lood. u rine, a nd a ny a uspected t issue. S pecial e xamination of b reasts I n w omen. O ther e xamlnations a s i ndicated, a s o f t he e ye, b ladder. a nd p rostate w ith a ppropriate i nstruments. 5. T ake p ains to p revent p rolonged o r c hronic irritation to a ny p art of the body_ This s hould i nclude protection from overexposure to s un a nd wind, prompt r epair .of birth injuries to the womb, permitting the b reasts to function n ormally, r epair of j agged teeth, a voidance of ill-fitting . d ental p lates, t emperance i n the u se of tobacco, correction of chronic c onstipation. I n o ther w ords, a void u nnecessary a buse of a ny t issues; r emember thad c ancer n ever d evelops i n h ealthy tissue. I C ONNECTICUT C ANCER S OCIETY. I NC. S tate Office 95 N orth M ain ' S treet W aterbury 14, C onnecticut jI