HP 330: Part One Review Continuation
HP 330: Part One Review Continuation HP 330
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This 2 page Class Notes was uploaded by Sydney Brummett on Sunday September 25, 2016. The Class Notes belongs to HP 330 at Wichita State University taught by Dr. Paul Danner in Fall 2016. Since its upload, it has received 26 views. For similar materials see Cancer: Perspectives and Controversies in Health Professions at Wichita State University.
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Date Created: 09/25/16
Part One Review • Surgical removal of cancer as a curative treatment was entertained only in the most extreme cases • When medicines and operations failed, doctors resorted to the only established treatment for cancer borrowed from Galen’s teachings: o An intricate series of bleeding and purging rituals to squeeze the humores • Galen’s humoral theory of disease – that all diseases were pathological accumulations of the four cardinal fluids. • Yellow bile in the liver • Black bile, Galen’s oozing carrier of cancer and depression – could not be found • If black bile doesn’t exist, then surgically removing the cancer may rid the body of the disease. • Surgery wasn’t ready, as disciple, wasn’t ready for such operations o Those who survived the operating table often died even more miserable deaths in their own beds soon afterward • Between 1846 and 1867 there were two significant discoveries: o Anesthesia – was publicly demonstrated in 1846 in Massachusetts General Hospital § Anesthesia: the disassociation of pain from surgery – allows surgeons to perform prolonged operations, often lasting for several hours o Joseph Lister, a Scottish surgeon in 1865, proposed that perhaps an antibacterial process or chemical could curb infection (pg. 57). • 1867, Theodor Billroth, launched a systematic study of methods to open the human abdomen to remove malignant masse o Task was to remove malignant tissue while leaving normal tissues and organs intact § But this task demanded a nearly godlike creative spirit • William Stewart Halstead’s name was to be inseparably attached to the concept of “radical” surgery (pg. 61). • In 1882, Halstead removed an infected gallbladder from his mother on the kitchen table, successfully performing one of the first operations in America • Charles Moore concluded that “mammary cancer requires the careful extirpation of then entire organ” and that “local recurrence of cancer after operations is due to the continuous growth of fragments of the principle tumor” • Halstead took that concept on step further • He decided to dig deeper into the breast cavity, cutting though the pectoralis major o He called this “radical mastectomy” using the Latin sense to mean “root • 1898 more radical, began to slice through the collarbone, reaching for lymph nodes just underneath o Reinforced that non-radical surgery left the breast somehow “unclean” • It seemed that Halstead and his disciples would rather evacuate the entire contents of the body than be faced with cancer recurrences • “The more radical the better’ o Physicians counted themselves lucky if patients merely survived the surgery o The question asked was “is the tumor removable?” and not “is the removal going to cure the patient?” § The patients interest was not kept in mind • The evidence of the effectiveness of this approach was disappointing • Survival didn’t come from how extensive the surgery was on the breast, but on how much the cancer had spread before the surgery • A new branch of cancer medicine, radiation oncology, was born from Emil Grubbe in 1896 using x-rays to treat cancer o Can be directed locally, radiation was at limited use for cancer that had metastasized • Second limitation that was far more insidious o Radiation produced cancers! • Wohler’s experiment demolished vitalism o Organic and inorganic chemicals, he proved, were interchangeable o Biology was chemistry § Could a molecule concocted in a flask affect the inner working of a biological organism § What is some chemical could discriminate bacterial cells from animal cells- and could kill the former without touching the host? o “Chemotherapy” the use of specific chemical to heal the diseased body, was conceptually born o Could cancer be cured by chemicals alone? Sidney Faber asked.