The History of Cancer: Everything there is to know!

Where does the name "cancer" come from?

The word "cancer" is a Latin word meaning "crab". Hippocrates (460-377 BCE) was the first to compare cancer to a crab, using an analogy to described the appearance of breast tumours when they spread over the skin. Indeed, the tumour is centred by a rounded shape surrounded by radiating extensions similar to the legs of a crab.

The comparison to the crab was later taken up by Galen (131-201 CE) who wrote a treatise on tumours and described breast cancer with great precision:

"Many times we have seen a tumour in the breast exactly like a crab. Indeed, as the crab has legs spreading around its body, in the same way are the veins in this illness; they are spread by the abnormal tumour in a shape of crab. We have often cured this condition in its early stages. When it has grown to a considerable extent, no one has cured it without an operation."

What are some of the main theories about cancer?

There have been many theories about the causes of cancer throughout the ages:

• Humoural theory: The theory of humours, popularised by the Hippocratic Corpus, is one of the foundational works of ancient European medicine. According to this theory, the body is made up of the four fundamental elements: air, fire, water and earth. These elements possess four qualities: hot, cold, dryness or humidity. These antagonistic elements must coexist in balance for a person to be healthy. A minor imbalance leads to "mood swings" and a major imbalance threatens the patient's health.
  Subsequent discoveries discredited the humoral theory for several reasons: lack of understanding of the role of organs, failure to take into account blood circulation, lack of knowledge of basic chemistry... Numerous outlandish diagnoses and treatments were developed as a result of this theory.
• Lymph theory: Following the humoural theory of cancer, this theory puts forward that cancer is caused by another body fluid: lymph. According to this theory, life consists of a continuous and appropriate movement of the fluid parts of the body through the solid parts. Of all the fluids, the most important were lymph and blood. Stahl and Hoffman theorised that cancer was composed of degenerating and fermenting lymph, varying in acidity, alkalinity and density. John Hunter, the Scottish surgeon of the 1700s, agreed that tumours developed from the lymph that was constantly rejected by the blood. 
• Blastema theory: In 1838, Johannes Muller, a German pathologist, demonstrated that cancer consists of cells and not lymph. He believed that cancer cells did not come from normal cells and proposed that cancer cells developed from budding elements (blastema) between normal tissues. 
• Chronic irritation theory: Rudolph Virchow (1821-1902), a famous German pathologist, proposed that chronic irritation was the cause of cancer. However, he believed that cancers spread "like a liquid". In the 1860s, the German surgeon Karl Thiersch showed that cancers metastasise through the spread of malignant cells and not through an unidentified fluid. 
• Trauma theory: From the late 1800s to the 1920s, despite the progress made in understanding cancer, some people believed that the origin of cancer was due to trauma. This belief was maintained for a long time despite numerous studies carried out on animals in laboratory settings. 
• Infectious disease theory: Two Dutch doctors, Zacutus Lusitani (1575-1642) and Nicholas Tulp (1593-1674), concluded almost simultaneously that cancer was contagious. They drew their conclusion on the basis of their knowledge of breast cancer among members of the same household. They then proposed that cancer patients should be isolated in order to prevent the spread of cancer.

When was the first recorded case of cancer?

The first case of cancer was recorded in ancient Egypt. It is described in the oldest known surgical document, the Edwin Smith Papyrus, dating from around 1600 BCE. 

Fragment of the Edwin Smith surgical papyrus addressing facial trauma.
Source: Jeff Dahl, Wikimedia Commons

It contains a reference to breast cancer:

"Presence on the breast of spherical protruding tumours, cold to the touch."
First recorded case of cancer, Edwin Smith Papyrus

The papyrus mentions that the unidentified tumours were burned or cauterised with an "inflamed stick". 

When did the various treatments for cancer first emerge?

With the increasingly widespread use of sterilisation and disinfection, as well as the use of anaesthesia (William Morton in 1846) for surgery, surgery had its golden age in the 19th century. This allowed the pioneers of surgery to perform operations on tumours such as mastectomies to prevent the spread of cancer.

Wilhelm Conrad Roentgen, a German physics professor, discovered the properties of X-rays in 1896.
Several hospitals around the world then acquired an imaging machine which they used to make diagnoses. It was thus discovered that the radiation emitted by X-rays could treat several skin diseases.

This led to the birth of radiotherapy for treating cancer. However, the side effects quickly outweighed the benefits of this technique. 

It wasn't until the end of the 20th century that advances in computer science and physics enabled scientists to map the shape and location of small tumours with accuracy in order to target them more precisely with X-rays.

The 20th century also saw the development of anti-cancer drugs or chemotherapy. 

The first of these drugs was mustard gas (nitrogen mustard), which wreaked havoc in the trenches of the First World War.

During the Second World War, the American army found that this product caused a decrease in the number of white blood cells (or lymphocytes) in exposed soldiers. While searching for protective measures against these effects, scientists discovered that nitrogen mustard is effective in the treatment of lymph node cancer (lymphoma) because it attacks these white blood cells.

This product would serve as a model for the chemotherapy drugs that would soon follow.

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