Quick treating no help--medic: Hurts in Some Cancer Cases, Says Specialist

              Hold on to your hats everybody!
A Denver pathologist expressed the opinion here Monday that in some cases of cancer, early diagnosis does more harm than good. And in some cases of cancer, early treatment does more harm than good, added Dr. Jeff Minckler, associate clinical professor of pathology, University. ,of Colorado,                             .            I
Dr. Minckler said surgery atj best may make the patient 'more1 comfortable, is helpful from a psychological point of view; may in some cases prolong life.
"But it is not curative," added the pathologist, a featured speak-er at the silver anniversary meeting of the New Orleans Graduate Medical Assembly.
Interviewed between assembly sessions at the Roosevelt hotel, Dr. Minckler admitted that his statement was probably explosive; would probably lead to controversy.
"But in my opinion," he added, "less time should be given to statistics and to speeches about early diagnosis and more time should be given to basic scientific investigation of tumors." : Dr. Minckler said, "Tumors of the body have been described and redescribed, have been reviewed statistically and added up and down until everybody is sick of lit."
"Early diagnosis of malignant ! tumors in most cases is a myth," added the visiting physician, Who is also pathologist for the General Rose Memorial hospital in Denver. "Nor can you announce pon-tifically that early treatment of cancer is a must. In some cases they get along much better if y&u leave them alone."
Dr; Minckler said with common skin    tumors   of   the   face,   "it
'doesn't make much difference if you diagnose them early or late; that "usually they will stop growing  by themselves."
The pathologist said in cases of breast cancer, "early diagnosis may be a definite disadvantage."
"Statistics show that in breast cancer the survival rate is the same whether you operate, treat them with X-ray or leave them alone," he explained. "Actually it 'is usually more favorable to have a late diagnosis. The longer the ! tumor is there the more favorable
the outcome."
Dr. Minckler said in his opinion intervention in gastric cancer, "will kill the patient quicker by six months.'*
"The only area of cancer where early diagnosis may help is can-i cer of the cervix," he added. "And even this is only a possibility."
The pathologist reitereated his belief that what is needed most is more scientific information concerning cancer;
SCIENTIFIC   CHECKS
"We can obtain this information in various ways," he explained. "It is available through electron microscopy, which means you can magnify a cancer cell enormously. It is available through phase-microscopy, a device to aid in the study of the inner mechanism of the living cell. It is available through radio-isotopes, a tagging and tracing device. Or through fluorescent microscopy, a tagging device by means of which you can tag chemical substances fluorescent-ly, particularly antagonistic substances. Finally there is tissue culture, a process by which tumor cells are grown in the laboratory."
The convention, scheduled to last through Thursday, is attracting more than 2000 representatives of the medical world.
During interviews, preceding their talks, other convention speakers said:
1.  Although, many measles vaccines are being tried but experi-mentaly on human beings, it will •'be at least a year before any are
approved for general use. I            PEPTIC UL0EKS
2.  About 10 per cent of the adult population of the nation develop peptic   ulcer   at   some   stage  of their lives.
3.  Early recognition of curvature of the spine is highly important.
In discussing measles vaccines, Dr. Lewis L. Coriei, Camden, N. J., said three types^ of vaccines are beng actively studied today. > "These include the living aten-uated vaccine, the killed vaccine and a combination of the living vaccine and gamma globulin," explained Dr. Coriell, who is medical j director of the Camden Municipal I Hospital For Contagious Diseases.
The visiting speaker said the living, atenuated vaccine has been tested on 10,000 human\beings.
'These tests show that it produces about 100 percent immunity," he added. "However it also produces a mild form of measles in about 80 per cent of the cases.
Dr. Coriell said when the living, atenuated vaccine is combined with gamma globulin, only five to 115 percent of the patients develop [measles.
MEASLES VACCINE
"Only about two per cent of (those receiving this combination
break out.with a rash," he added. "However there are problems. The cost of the gamma globulin is about 40 cents for children; more for adults. Also yoil need two shots instead of one."
Dr. Coriell said the killed measles vaccine has received extensive trials but is still in need of improvement.
"No one develops measles When they receive the killed vaccine," he added. "But the protection is not so good. It provides 65 vp 96 per cent immunity as compared with 99 to 100 percent in the oraer two."                                      \
Dr. Coriell said measles can b^ quite a severe disease; that presently it carries a half to one per cent mortality rate in this country;   that one  out  of . ^very  100
people who catch measles develops encephalities or inflamation of the brain.
The popular belief that gastric ulcers are more common in business executives was branded as a myth by Dr. Julian M. Ruff in of Durham N. C.
'CRADLE TO GRAVE*
"Ulcers occur from the cradle to the grave and in all walks of life," said the physician, who is professor of medicine at Duke university. "A brick-layer, has emotions just as strong as a city editor."
Dr. Ruff in said peptic ulcers occur in 10 per cent of the adult population of this country. He said many of these ulcers will bleed and that unless bleeding ulcers are handled properly they will terminate fatally.
"The important aspect of the problem is immediate hospitaliza-tion," the physician added. "And after the patient is in the hospital there should be supervision by a team of internists, surgeons and radiologists."
Dr. Ruffin said all bleeding ulcers are potential surgical problems, but that fortunately most of them respond promptly to medical measures^
"These medical measures," he explained," consist of washing out the stomach and constant suction as long as the bleeding persists. Years ago starvation was the accepted treatment. We now feed these patients immediately if they are not actively nauseated. The diet of course must be a strict ulcer diet, consisting chiefly of milk and cream and bland food/'
Dr. Ruffin said the imprtance of transfusions cannot be minimized.
TRANSFUSION
He- said transfusions are life-saving but that they should be used with discretion; that often there is a tendency to transfuse needlessly.
"I'm often asked, 'When does one operate?' " added the North Carolina physician. "This is a difficult question. I would say that
any time it becomes apparent that the bleeding is not going to stop, surgery should not be delayed. If the patient can survive until transfusions can be started and a competent surgeon is at hand he certainly doesn't need to die of a bleeding ulcer."
Dr. Ruffin said an emotional crisis will almost invariably precipitate the recurrence of an ulcer. He said an ulcer. patient, who lives under conditions of constant stress, should be careful of his diet and should take protective medication such as anti-acids or anti-cholinergic drugs.
Dr. John H. Moe, Minneapolis, Minn., advocated early diagnosis of curvature of the spine.
He said if a seyere spinal curvature is not corrected properly, body functions may be interfered with.
PROPER BRACING
Sometimes proper bracing will be all that is needed, explained the physician, who is director of the division of orthopedic surgery, University of Minnesota. In other cases the patient is placed in a cast.
Very severe1 cases may require surgery in which fusion is combined with the use of a metal rod and hooks, he explained.
Dr. Moe said curvature of the spine is quite common among young growing children; that girls are more subject to it than boys.
Convention delegates were welcomed by Dr. Barrett Kennedy, Assembly president; Dr. John F, Oakley, president of the Orleans Parish Medical society; Dr. William W. Frye, dean of the LSU Medical school; Dr. M. E. Lap-ham, dean of the Tulane university medical school; and Dr. Cuth-bert J. Brown, president of Louisiana State Medical society. The past president award was presented to Dr. M. E. St. Martin, outgoing president, by Dr. Richard L. Buck.