Abstract

EPITHELIOMA of the lip comprises, on the whole, about 2 per cent of all reported cases of malignancy, and —in conjunction with neoplastic growths in other parts of the body—its incidence is undoubtedly becoming more common, the frequency of its occurrence being out of proportion to the relative increase in population. As an increasing number of cases of epithelioma of the lip continually present themselves for treatment, the necessity for better technic and more competent handling of the condition becomes particularly evident. Hampered as we still are by the lack of definite knowledge regarding the etiology of these lesions, and, until recently, having no means of treatment which might be regarded as even reasonably reliable or satisfactory, progress has necessarily been slow. Those who have been most familiar with all phases of the condition, and who, therefore, were in a position to speak with greatest authority, have felt the need of caution in advancing along new lines, and, despite the most brilliant results in individual cases, these men have remained conservative in their attitude toward new methods. The wisdom of such a stand should meet with general approval, for the fact that they who had reason to believe they had “cured” a previously “incurable” disease were slow to blazon their success from the housetops, bespeaks the scientific spirit under which the investigations and experiments were undertaken, and, by the same token, enhances the value of the results obtained. The use of radium in the treatment of malignancy is now long past the experimental stage. Of this fact there can be no question. We no longer ask ourselves whether radium shall be employed, but rather how it shall be used, how much radium, how often, and especially whether it should be used alone or in conjunction with other curative measures. From the very outset radium has seemed peculiarly applicable to all malignant conditions of the lip. Even those who have remained skeptical as to its efficacy in all forms and stages of cancerous disease have admitted that radium is undoubtedly useful in the early stages of growth; and as a malignant condition of the lip is usually one of the earliest to be brought to the physician's attention, this fact may, to a certain extent, account for the marked success within this special area. The reason for reporting this condition at an earlier stage than is frequent with most malignancies can readily be understood. Any abnormality about the mouth is conspicuous and disfiguring, and moreover it constantly interferes with regular and important habits such as eating and talking, in consequence of which the person so afflicted will hasten in search of relief. If the case falls into the hands of a competent physician who is able to make a diagnosis, or, failing to do so, one who is willing to refer the patient to one who is qualified, the chances for ultimate relief are good.

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