When a patient has been cured of extensive cancer of the skin, so far as concerns the removal of the disease, there is often much to be done to replace the deformity. Plastic surgery can do wonders. A new nose can be built up from a finger, new lips can be made from flaps from the cheeks, and many hideous deformities can be made much less noticeable by some similar means. This is not the proper place to dwell on such possibilities, for the subject is treated thoroughly in various text-books on operative surgery. It should, however, be pointed out that no plastic operation should be attempted until the cancer has been well for at least three years, as an operation may light up latent cells.
If necessary, artificial .parts can be supplied by various manufacturers. Artificial ears or noses can be procured, and, when properly tinted, to some extent are acceptable to the patient, although never as good as the manufacturers would have us believe.
In concluding this chapter, we must say that the time to treat a cancer is in its early stage ;26 if it be of the nonmetastasizing type, complete local removal will suffice, but, if it be of the prickle-celled type, the neighboring lymph glands should be removed at the onset. The one object in the treatment of cancer is to wipe out every last cancer cell-not one must be left. To do this means the sacrifice of apparently healthy tissue, and the surgeon must school himself to do this, making the question of deformity an entirely secondary consideration. It is better to learn a few modes of treatment and practice them well rather than to have a superficial knowledge of all the varieties of attack; and, above all, tissue from each tumor should be submitted to competent histological examination, for in no other way can we increase our knowledge of the relationship between the pathology and the clinical course of the disease.
*Bloodgood: Jour. Amer. Med. Assn., 1910, lv, 1615.