Presentation

Documents from the Museum of Medicine in Brussels) Ritual : opening of the mouth Fragment of an Egyptian bas-relief -19th-20th dynasty

Surgery utensils - Roman period (1st century AC) - copper alloy

History

The History of Cancer

(Some History : until 1200 A.C.)

Some history !

Known cancer history began with the Egyptians and evolved very slowly in the following centuries. Thanks to numerous discoveries and inventions, namely the invention of the microscope in 1590, there was an accumulation of knowledge in the 17th century, which allowed the cellular theory to be set up. Modern and scientific medicine supplanted the early medicine, because it did away with all the former theories and because it was only based on the observation of facts.

For millenniums before this era

For millenniums before this era the notion of cancer was rare, but there are some ancient descriptions of so-called malignant tumours. However, these descriptions are not entirely reliable, because among them there are lesions that were obviously caused by a trauma or by injuries.
Some of the information comes from papyruses and describes tumours found on mummies. One papyrus, dating back to 3000 - 2000 BC, describes breast tumours and ulcers treated by cauterisation. Another papyrus, about medicine dates back to 1552 BC and advises not to remove a large tumour on the thigh because it can be lethal for the patient. However, until Hippocrates cancer descriptions were quite rare.

Antiquity

Hippocrates (460-370 BC),

a very famous Greek doctor. From his numerous and very detailed descriptions of various diseases, it clearly appears that he treated patients with cancer. In fact, he described lesions that affected the skin, the breast, the stomach, the cervix and the rectum and classified them. He observed that it was better not to apply any treatment in cases of "occult" cancers, for if treated, these patients died rapidly (the word "occult" Hippocrates uses here does not mean "early-stage cancer")
The only treatments available in those days were cauterisation and several ointments.
Little progress was made in the study of cancer in the three centuries after Hippocrates until :

 

Aulus Cornelius Celsus (25 BC - 50 AC),

a Roman doctor influenced by the Greek and Egyptian medicine. He explained that cancer mainly appeared in the upper parts of the body : in the area of the face, the nose, the ears, the lips, the beasts, but also in ulcers and in the spleen.
He described the different stages of the evolution of the disease : the first stage called "cacoethes" in Greek is followed by a carcinoma without ulcer and then by an exuberant lesion. He believed that only "cacoethes" could be treated by excision and advised not to apply any treatment for more advanced lesions : no ointment, no cauterisation, no excision.
In Antiquity already, cancer treatment is associated with the stage of the disease and like nowadays, relatively speaking, the treatment largely depends on a staging system of the disease.

 

Aretaeus,

of Cappadoce in Asia Minor, lived in Alexandria in the 2nd and the 3rd century BC. He described uterus cancer as superficial and deep ulcers, which later infiltrate the uterus. He also described another cancer type which does not present any ulcer, but which is rather a growth in the uterus.
He distinguished between the two lesions and acknowledged that the symptoms and the prognosis of cancers with ulcers were the most negative.

 

Leonides (180 AC) of Alexandria

identified the retraction of the nipple as a sign for cancer. With a scalpel he did a mastectomy, cutting off still healthy tissue around the nipple; he then cauterised the wound to avoid a haemorrhage and to destroy remaining cancerous tissues. He advised against a mastectomy in the case of advanced lesions.

 

Galen (130-201 AC. ),

was born in Asia Minor in Pergamon, studied in Alexandria and became a doctor in Rome. His theories were accepted for a millennium.
He believed that tumours were the result of an excess of "humor" or black bile that solidified in several parts of the body like the lips, the tongue or the breasts.
His treatment consisted in the administering of purges in order to dissolve the solidified bile. When the lesion did not recede, he made an excision.

This theory of "humors" was abandoned and for quite a long time there was no real progress.
Only clinical observations and the gathering of data about the evolution of different tumours allowed some very slow progress to be made. After Galen's death, the West underwent the Barbarian invasions : many Greek doctors took refuge in Constantinople, but there were no more great doctors except Oribase (325-400) and Paul d'Egine (7th century).

At the end of the 1st millennium

At the end of the 1st millennium, the Arab medicine became famous, particularly in the fight against cancer thanks to :

 

Avicenna (980-1037),

of Baghdad, who noticed that a tumour grows slowly and that it invades and destroys neighbouring tissues, which results in the absence of feeling in the affected part.

 

Albucasis (1013-1106),

of Cordoba in Spain, during the Arab domination. He also recommended an excision for early-stage cancers and if it was located in an accessible part: he recommended the cauterisation of the tissues around the area where the tumour was removed. As a pre-operative treatment, he purged the patient of his black bile and bled him afterwards when his veins were inflated, then he was positioned in the best possible way to undergo the operation. In case of a serious haemorrhage, Albucasis recommended the cauterisation of the vein or the artery.
He recommended not to apply any treatment in case of an advanced lesion.

 

Avenzoar (1070-1162),

of Cordoba, described oesophagus cancer and stomach cancer.

To access other sections of this text click on the links below :
Introduction : click here
History : until 1200 A.C. : see text above
History : from 1300 to 1600 A.C. : click here
History : from 1700 to 1900 A.C. : click here
Conclusion : click here

Main sources of the text are :
- "The Theory and Practice of Oncology - Historical evolution and present principles" by Ronald W. Raven - Edition : The Parthenon Publishing Group - 1990 (Lancs - England / Park Ridge, New Jersey - USA)
- "Histoire du Cancer" (review "Histoire" n°74) by Marie-José Imbault-Huart