Löwy Ilana
INSERM-Institut National de la Santé et de la Récherche Médicale, France.
Bull Hist Med. 2011 Fall;85(3):356-83. doi: 10.1353/bhm.2011.0058.
The birth of the "do not delay" principle in cancer treatment has often been linked with developments in late nineteenth century: the rise of histology and cellular theory of malignancy that favored the definition of cancer as a local pathology, then the development of radical surgical techniques that transformed malignant tumors into a potentially curable condition. This text seeks to nuance this view. It points out important continuities in the understanding of the natural history of uterine cancers. At its center, the wish, already present in early nineteenth century, is to detect "early," that is, small and localized malignant lesions, then to extirpate or destroy these lesions before they become fully blown cancer. The long history of this particular regime of hope helps demonstrate why it is so difficult today to promote more nuanced views of the efficacy of early detection of malignant tumors.
癌症治疗中“不要延误”原则的诞生常常与19世纪晚期的发展联系在一起:组织学的兴起以及恶性肿瘤的细胞理论,这使得癌症被定义为一种局部病理学;随后是根治性手术技术的发展,将恶性肿瘤转变为一种有可能治愈的疾病。本文旨在细化这一观点。它指出了在子宫癌自然史理解方面的重要连续性。其核心是早在19世纪早期就已存在的愿望,即检测出“早期”,也就是小的、局限的恶性病变,然后在这些病变发展成完全成熟的癌症之前将其切除或摧毁。这种特定希望模式的悠久历史有助于说明为何如今要推广对恶性肿瘤早期检测疗效更细致入微的观点如此困难。