(1) Cancer of the stomach is at once the commonest and causes the highest mortality of all forms of carcinoma.
(2) Failure to make an early diagnosis is the
factor chiefly responsible for the continued high
mortality. Improvement does not lie in more extensive operations.
(3) This failure is due to:-
(a) Time lost by the patient, i.e., delay
between the onset of vague symptoms
and the consulting of a doctor.
(b) Time lost by the doctor in the treatment
of symptoma without investigating their cause.
(4) Patients must therefore be educated against
the danger of treating themselves for indigestion or for vague ill-health. This can be done by the family doctor.
(5) The doctor must investigate first and treat
last. This implies that in every case of dyspepsia
or of vague ill -health the possibility of cancer of
the stomach must be thought of and steps taken at once to exclude it by the use of clinical methods.
(6) Early diagnosis can be made by the joint
use of clinical, radiological and if necessary
(7) The greatest of these are the clinical, because
they are the earliest. It follows, therefore, that in the fight against cancer the general practitioner
must play a leading part.
(8) Investigation by means of gastric analysis
is an invaluable aid to the diagnostician and is
within the scope of every general practitioner.
(9) The routine investigation of all suspicious
cases by this method would at least lead to a correct diagnosis being made, or a strong probability being aroused, within two weeks of the patient consulting.
(10) Cases would, as a result, be sent oftener
and earlier for X -ray investigation, which, in the
hands of the expert, is capable of making a correct diagnosis in 96 per cent of cases.
(11) Modern surgery has proved that it can
cure; the above routine of investigation would afford it the opportunity. Mortality would be reduced and life prolonged.