Delay in the Treatment of Cancer

Abstract

carotid artery, so that now, in the last few cases, in addition to fractional ligation I divide the artery. Six of the 8 cases were the result of fractured skull. One was a spontaneous pulsating exophthalmos in a woman of 73 and 1 case was due to gunshot wound from birdshot in which the other eye had been destroyed. Secondarily, ligation or division was carried out on an average of sixteen days after the first partial ligation.Dr. Alton Ochsner, New Orleans: There are two points that I should like to emphasize. Occasionally one will find persons whom ligation of either the internal carotid or the com¬ mon carotid will not help. In such instances it is necessary to combine ligation of the carotid with the intracranial clip, as suggested by Dandy. Recently Dr. DeBakey has shown that the gradual occlusion of the artery by cellophane does not work. In an extensive experimentation he was unable to verify Pierce's work concerning this. He has had 2 patients on whom, in an attempt to increase the intracranial vascularity, he has done a sympathectomy. One of these persons was greatly improved following the sympathectomy. This is based on the observations of Gage that in patients with peripheral arteriovenous aneu¬ rysms, by .decreasing the peripheral resistance and by increasing the vascularity, the aneurysm can be attacked with impunity. One of these patients was definitely improved following the sympathectomy, so that the ligation could be done safely. The other patient was cured by sympathectomy, simply indicating that by slowing the blood stream through the arteriovenous anastomosis, clotting was made possible, so that I think in the older person in whom hemiplegia is likely to occur, the use of cervicodorsal sympathectomy is of value and should be tried.Dr. James Rudolph Jaeger, Denver : It is obvious if we remember the anatomy concerned in the carotid-cavernous arteriovenous communications that a good many of these cases will not be cured by ligating the carotid in the neck or intra¬ cranially because the internal carotid has branches inside and near the cavernous sinus which connect up with the external carotid branches, and these branches enlarge to a tremendous extent in an attempt to feed this communication. Recently I had a case which had been treated conservatively without bene¬ fit, and there is no reason why these cases should not be treated first by the conservative ligations as mentioned by the speaker. This little 11 year old fellow had had the common carotid ligated in the neck. After three months I ligated the carotid proximal to the ophthalmic artery intracranially, and there remained a tremendous bruit and a pronounced exophthalmos. At a third operation I opened the internal carotid artery in the neck and placed a muscle strip with a silver clip on the end of it, as an embolus, and then ligated the external carotid. It progressed upward to the fistula, and x-ray examinations showed the silver clip in the cavernous sinus. Before the external carotid was ligated, and before I had inserted the muscle em...

The effects of symptoms and delay in seeking diagnosis on stage of disease at diagnosis among women with cancers of the ovary

“…Those who saw a physician because of their metrorrhagia (not associated with menopause) were more likely (P < 0.10) to have their disease detected at an earlier stage, but the problem was infrequently cited. (10) 20.0 18.5 (10) No other symptoms were significantly associated with stage. although a few conditions were cited more frequently in association with earlier compared with later stage (percentage is based on the number of patients who noticed the symptom in the stage category/number in that stage [N = 281, except when a woman could not recall whether the symptom occurred before diagnosis): irregular vaginal bleeding (29.6 versus 14.8%, respectively), urination problems (44.4 versus 29.5%, respectively), and fatigue (63.0 versus 48.2%.…”

Delay in Seeking Medical Advice and Late Presentation of Female Breast Cancer Patients in Most of the World. Could We Make Changes? The Experience of 23 Years in Port Said, Egypt

“…This study is compared to our previous studies carried out since 1987. The lagtime -time from initial onset of symptom to the time of seeking medical advice [6] -and the delay -the lapse of more than 3 months between the appearance of cancer symptoms and medical consultation [7] were studied by interviewing patients at least 4 times within 6 months of diagnosis. The findings were compared to previous studies [8][9][10][11] 35.7% of the 349 patients were in age group 50-59, and 27.1% were in age group 40-49.…”

The Cancer Patient Delay in Seeking Advice

“…7 s Sufficient stimulus in a large enough number of cases. Harms et al (1943), discussing causes for delay of cancer Af chance in patients attending an American hospital, say that it is noteient to seek worthy that fear of cancer played a minor part. "The waits.…”