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George Crile Jr., M.D.
AMA Arch Surg. 1956;73(5):884. doi:10.1001/archsurg.1956.01280050152027.
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DISTRESSING experiences with some of the more malignant types of cancer often cause surgeons to make unwarranted generalizations about the natural course of the disease. They may believe that unless a cancer can be eradicated, the patient is doomed to death. In such cases they assume that if a radical operation can be done the patient has everything to gain, and that if he dies as a result of treatment he has lost nothing. In the light of this philosophy any risk or any disability seems justified. But is it?

In the natural history of cancers, some grow very slowly, give few if any symptoms, and show little tendency to systemic dissemination, even over a period of years. These are the same cancers that usually are cured by radical surgery. Many of them are equally curable by simple eradication of the local lesion. Many of them, even if untreated, may


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