The Crab

The Unseen Fight Against Cancer

by Thelma Brumfield Dunn MD.
Batt Bates and Company (916 Preston Avenue, Charlottesville, Va. 22901), 204 pp., $8.50 (paper)

The Cancer Connection: And What We Can Do About It

by Larry Agran
Houghton Mifflin, 220 pp., $8.95

X-Rays: More Harm Than Good

by Priscilla Laws
Rodale Press, 258 pp., $8.95

You Can Fight For Your Life: Emotional Factors in the Causation of Cancer

by Lawrence LeShan
M. Evans, 192 pp., $7.95

You Can Fight Cancer and Win

by Jane E. Brody, by Arthur I. Holleb MD.
Quadrangle/New York Times Book Company, 338 pp., $12.50

Although cancer is much more often curable than its popular reputation leads one to expect, the number of its victims and the sometimes morbid dread (oncophobia) of being among them make cancer a source of human distress that is reason enough for the fear it arouses.

In Latin, French, Italian, German, and English cancer is the crab—so-called, perhaps, because of the growth pattern of the most easily visible of all tumors: the rodent ulcer. Some purists (others would say pedants) confine the use of “cancer” to malignant growths of epithelial tissues, i.e., of the tissues that bound surfaces, using “sarcoma” for malignant growths of connective and supportive tissues and of the white cells of the blood. To laymen these niceties mean nothing. For them a cancer is any threateningly malignant growth.

Dr. Thelma Dunn declares that there is an urgent need for an exact definition of cancer that will include all examples of cancer and “exclude all other abnormal growths or diseases,” and she makes much of the admission of Virchow (one of the founders of pathology) that “no man, even under torture, could say exactly what cancer is.” But in this context, as in so many others, altogether too much fuss is made of matters of definition—for the very ambition to draw a dividing line such as Dr. Dunn proposes takes for granted the pre-existence of a working distinction between growths acknowledged to be malignant and others classifiable as benign. My experience as a scientist has taught me that the comfort brought by a satisfying and well-worded definition is only short-lived, because it is certain to need modification and qualification as our experience and understanding increase; it is explanations and descriptions that are needed—and these Dr. Dunn provides in abundance.

Hers is not a textbook, though; it could be thought of as a detailed invoice for the expenditure of the very large sums of money allotted to laboratory research—in 1976 a governmental grant of $396 million was spent on basic research, a fourfold increase over the grant in 1970. In its report to the president, the President’s Cancer Panel, presided over by Benno C. Schmidt, has already argued most cogently in defense of the expenditure of these very large sums of public money. Dr. Dunn’s book, which she describes as an informal report, and not for the cancer specialist, might be read as a series of appendices to this report. She writes with the unmistakable air of an insider—a professional who spent the greater part of her working life as a biologist and pathologist at the National Cancer Institute.

Dr. Dunn pours scorn on the idea that cancer is essentially a disease of civilization and the satellite notion that cancer develops in lower animals only after contact with man, but she goes on to explain the demographic circumstances that have nourished this illusion: in most backward societies and in most non-domesticated animals, early death deprives their members of candidature for cancer …

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Letters

Cancer September 15, 1977