Cancer Of The Breast Treated Medically

Abstract

The relationship between the period of hormone readjustment in women during middle life and cancer of the breast has long been a topic of controversy. If anything is certain about it, it is that this relationship is a complex one and its study difficult. My impression is that the state of endocrine therapy for patients with breast cancer, whether by surgery, radiotherapy, or the administration of hormones is unsatisfactory. It seems to me that most of it is ineffectual, much of it increases the patient’s discomfort of mind and body, some of it is harmful, and little of it is rational. My object has been to indicate some of the complexities of the subject and to ask for a pause for thought before the surgeon, having removed both ovaries and both adrenals, contemplates taking the pituitary and one or two parathyroids as well, the radiotherapist, having irradiated the ovaries and the pituitary, decides where to strike next, and our amateur endocrinologists, having added nausea, vomiting, edema, bleeding, acne, enlargement of the clitoris, undesired increase in libido, deep voices, and beards to their patients with breast cancer, not always in fair exchange for the symptoms they already had, add still more symptoms to the list. The pause for thought is so necessary because here we have a subject of fundamental interest to cancer research and treatment. If normal growth and development of the breast is under hormone control, if some degree of control of the more differentiated growths can occur naturally, and if marked tumour regression is to be seen occasionally with hormone treatment, we are clearly presented with an opportunity for gaining knowledge. If changes in metabolism effected by alterations in hormone balance can influence tumour growth or promote normal tissue resistance, we may have a chance of enhancing the effect of radiotherapy.