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Probably no man has done more to save lives threatened by cancer than Greek-born Dr. George N. Papanicolaou. 76, of Cornell University Medical College, who devised a test for cancer of the uterus and cervix by smearing mucous secretion on a glass slide and examining the stained cells under a microscope. The "Pap smear" is nc' done routinely in hundreds of U.S. laboratories, for an estimated total of 3.000,000 tests a year—most of them for healthy women wisely having regular examinations. Vast ingenuity has gone into extensions of the Pap test: aerosols to make a smoker cough up deep mucus to reveal lung cancer; swallowed balloons and brushes to catch cells from stomach cancer; special washings to reveal disease in the large bowel and rectum.
Attempts to devise a blood test for cancer (other than "blood cancers" such as leukemia) have been unrewarding, though Sloan-Kettering now has high hopes based on high levels of a substance called cytolipin H in cancer victims' blood. But even if such a test was reliable, it would not tell the cancer's location. Physicians still rely mainly on traditional diagnostic methods: physical examination, visual inspection of accessible sites with such aids as the proctoscope and bronchoscope, Pap smears and X rays.
Knife & Rays. Treatment also is usually traditional: with surgery or X rays. For the most part, cancer specialists have to be content with five-or ten-year survival for their patients, and rate this as a substantial "cure."
Surgery by itself has made such strides that most authorities (including many surgeons) figure that it is nearing the end of the road. Thanks to advances in general surgical techniques and patient care, it is now possible to remove huge masses of tissue, including whole organs and limbs. Hence the grim jest: "They put the specimen to bed and sent the patient to the laboratory." For some cancers there is no doubt that "radical" (meaning drastic and extensive) surgery has pro longed useful life. (The University of Minnesota's famed Heart Surgeon C. Walton Lillehei's most productive years have followed removal of a lymphosarcoma and much related tissue in 1950.)
Almost daily, ways are found to give bigger radiation doses more safely to hard-to-reach parts of the body. Examples: cobalt-60 "bombs," a new cesium-137 unit at M. D. Anderson Hospital, higher-powered X-ray machines and linear-particle accelerators, ingeniously refined ways of implanting radioisotopes such as iridium 192 and yttrium 90 in tumors.
The one essentially new development in cancer treatment is chemotherapy's advance to the point where it gives relief from pain, and usually longer life, to 60% of patients with cancer of the lung, breast, ovary or prostate, as well as leukemia and Hodgkin's disease. From this has come a surge of confidence that increasingly potent drugs can be found that eventually will effect outright cures. So great is this confidence that the Cancer Chemotherapy National Service Center now gets the biggest single bite ($23 million) of NCI's budget, with $18 million going out in grants and contracts for development and screening of new drugs. In addition, almost $4,000,000 goes for testing screened drugs in patients.