For the cancer patient, the effort has paid off in new facilities, new medical equipment and sophisticated treatment. To a great degree, the hurdles described by Dr. del Regato - geography, organization, skill and the rest - are down. Worldwide, 680 research and treatment institutions in 82 countries serve the potential or actual cancer victim. In the United States, more than 90 per cent of the population lives within 200 miles of one of the institutions described by the National Cancer Institute as cancer centers, which offer the most up-to-date cancer treatment and also carry on research into new methods of treatment. And in any hospital specializing in cancer care, a patient can expect certain standardized, effective models of diagnosis and treatment.
The rigor and thoroughness of these models can be seen in the sequence of steps, called a protocol, in the treatment of cancer of the colon or lower intestine. To begin with, a doctor takes a look at the interior of the colon, using an instrument called a sigmoidoscope or colonoscope. If he finds a tumorous growth, he calls upon specialists to perform a biopsy - to remove a piece of it for laboratory analysis to determine whether it is benign or malignant. Usually, he will want the growth cut out in either case.
If the growth is a polyp, or small tumor and is located near the rectum, the doctor himself may remove it. To treat a growth further up the colon, he will call in a surgeon, who also proceeds according to the steps of a protocol. The surgeon generally removes a benign tumor by simply cutting it away at its base; when operating on a malignant tumor, he removes a portion of the colon above and below the growth as well. If the portion is relatively small, the severed ends of the colon are sewed together; if it is large, an opening is made in the wall of the abdomen to let the patient pass bowel movements into a plastic pouch. Finally, to complete the protocol, surgery is generally followed by chemotherapy or by a combination of radiation therapy and chemotherapy.
Such treatments are the work of skilled scientists and craftsmen - the professional soldiers in the war against cancer. The ranks of such professionals range from the field marshals who direct the national and international campaigns, down to the foot soldiers who run tests in laboratories. By comparison, the potential cancer victim is a civilian, who may seem helpless while the battle rages. But this civilian can prevent the battle by simply avoiding the disease. A handful of common cancer-causing agents is responsible for most of the cancer in the world. Armed with knowledge and prudence, the civilians in the cancer war have it in their power to deny cancer most of its chances to attack.