History of the Cancer

Cancer as described by the ancient Egyptians (3000 BC to 1500 BC)

Human cancer is probably as old as the human race. It is obvious that cancer did not suddenly start appearing after modernization or industrial revolution. The oldest known description of human cancer is found in an Egyptian seven papyri or writing written between 3000-1500 BC. Two of them, known as the "Edwin Smith" and "George Ebers" papyri, contain details of conditions that are consistent with modern descriptions of cancer. The Edwin Smith Papyrus, describes 8 cases of tumors or ulcers of the breast. The document acknowledged that there is no treatment for this condition and recommended cauterization (the fire drill) as a palliative measure. The ancient Egyptian medicine typically mixed medicine and religion. These physicians treated patients for several forms of cancer. Hieroglyphic inscriptions and papyri manuscripts suggest that these ancient physicians were able to distinguish between benign and malignant tumors. They suggested that the surface tumors may be removed surgically much similar to the current medical practice. Compounds of barley, pigs ear and other indigenous materials were suggested as treatment for cancer of the stomach and the uterus. Other commonly dispensed medications included ointments, enemas, castor oil, suppositories, poultices and animal parts.

Oldest specimens of cancer (1900 BC to 1500 BC)

The oldest available specimen of a human cancer is found in the remains of skull of a female who lived during the Bronze Age (1900-1600 BC) The tumor in the womens skull was suggestive of head and neck cancer. The mummified skeletal remains of Peruvian Incas, dating back 2400 years ago, contained abnormalities suggestive of involvement with malignant melanoma. Cancer was also found in fossilized bones recovered from ancient Egypt. Louis Leakey found the oldest possible hominid malignant tumor in 1932 from the remains of a body, which could be either that of Homo erectus or an Australopithecus. This tumor had features suggestive of a Burkitts lymphoma.

Origin of the word carcinoma

Hippocrates, the great Greek physician (460-370 B.C), who is considered the father of medicine is though to be the first person to clearly recognize difference between benign and malignant tumors. His writings include description of cancers involving various body sites. Hippocrates noticed that blood vessels around a malignant tumor looked like the claws of crab. He named the disease karkinos (the Greek name for crab) to describe tumors that may or may not progress to ulceration. In English this term translates to carcinos or carcinoma. Works of Hippocrates and Galen, another Greek physician have revolutionized the practice of medicine by removing it from grips of superstitions and magic, to the era of observation and logical reasoning.

Constantinople in the history of cancer

Later in the course of history, Constantinople became the intellectual headquarters of medicine. The ancient teachings of Hippocrates and Galen continued to influence the physicians in Constantinople, Cairo, Alexandria, and Athens. During this period the cause of cancer was explained as the result of an excess of black bile.

Renaissance period

During the Renaissance, beginning in the 15th century, physicians acquired greater knowledge of the anatomy and physiology of the human body. This started an era, which has seen the advancement of surgery and development of rational therapies based on clinical observations. The theory that cancer is caused by excess of black bile continued to prevail through the 16th century. At this time cancer was considered incurable, however a variety of temporary measures were available including creams and pastes containing arsenic. Autopsies, performed by Harvey in the 17th century, gave an insight in to the circulation system. By about the same period Gaspare Aselli discovered the lymphatic system and this led to the end of the old theory of black bile as the cause of cancer. The new theory suggested that abnormalities in the lymph and lymphatic system as the primary cause of cancer. A French physician, Claude Gendron suggested that cancer arises locally as a hard, growing mass, untreatable with drugs, and must be removed with all its "filaments."

Eighteenth century to modern era

Jean Astruc and chemist Bernard, two 18th century physicians conducted research to confirm or disprove then current theories related to the origin of cancer. These efforts were the very first steps of experimental oncology. The art and science of seeking better diagnosis, treatments and understanding of the causes of cancer evolved from many who followed their path. In 1761, Giovanni Morgagni of Padua was the first to do an autopsy to look for the pathological findings in a patient after death. This and the efforts of many great physicians who followed them laid the foundation for scientific oncology, the study of cancer. John Hunter (1728-1793), a famous Scottish surgeon suggested that some cancers might be cured by surgery and described methods by which we can distinguish the surgically removable tumors. He suggested that, if tumor has not encroached to the nearby tissue and was still moveable, "There is no impropriety in removing it."

Discovery of anesthesia in 1844 by Wells allowed surgery to flourish and the classic cancer operations such as radical mastectomy were developed. The discovery of microscope by Leeuwenhoek in the late 17th century added momentum to the quest for the cause of cancer. By late19th century, with the development of better microscopes to study cancer tissues scientists gained more knowledge about the cancer process. These studies showed that cancer cells are markedly different in appearance compared to the surrounding normal cells from which they originated. Rudolf Virchow, who is often called the founder of cellular pathology, provided the scientific basis for the modern pathologic study of cancer and correlated the clinical course of illness with microscopic findings. This approach led to the development of modern cancer surgery. Tissues removed by the surgeons were examined under the microscope to make a precise diagnosis of cancer. By looking at the cut margin of surgery the pathologist were able to tell the surgeon if the cooperative procedure had completely removed the tumor.

The early 20th century saw great progress in our understanding of microscopic structure and functioning of the living cells. Researchers pursued different theories to the origin of cancer, subjecting their hypotheses to systematic research and experimentation. A virus causing cancer in chickens was identified in 1911. Existence of many chemical and physical carcinogens were conclusively identified during later part of the 20th century. Later part of the 20th century showed tremendous improvement in our understanding of the cellular mechanisms related to cell growth and division. Many factors that suppress and activate the cell growth and division were identified.