Antiquity & classical

c. 1.7 million years ago · Origin · Foundations

Earliest likely cancer in a human ancestor: Swartkrans foot bone

A fossil foot bone from Swartkrans Cave in South Africa, between roughly 1.6 and 1.8 million years old, carries a bony growth. In 2016 researchers used micro-CT scans to diagnose osteosarcoma, a bone cancer, which they call the earliest identifiable malignancy in a human ancestor. It is one bone, diagnosed from its structure.

Case report re-analysing SK 7923, a hominin left fifth metatarsal (genus and species indeterminate) from the Swartkrans Member 1 Hanging Remnant, South Africa, dated 1.8-1.6 million years. Micro-CT showed a 5.2 mm x 4.7 mm surface mass with a Codman triangle, subperiosteal invasion and medullary infilling. The authors diagnose osteosarcoma, possibly the parosteal variant, from morphology and differential diagnosis, and call it the earliest identifiable malignant neoplasm in a hominin.

c. 1600 BCE · Origin · Breast cancer

Edwin Smith Papyrus: Case 45, bulging breast tumours

An Egyptian surgical text, copied around 1600 BCE, describes a man with cool, bulging swellings on the breast. Its 1930 translator reads the treatment line as 'there is no treatment', with the word supplied in brackets. The text does not name the condition, so calling it cancer is an interpretation.

Case 45 of Breasted's 1930 translation of the Edwin Smith Surgical Papyrus describes a man with bulging tumours spreading over the breast: very cool, no fever, no granulation, no fluid or secretions. The verdict is 'an ailment with which I will contend' (doubtful). The treatment line reads 'There is no [treatment]', the bracket being Breasted's. Breasted dates the copy to the seventeenth century BCE and does not state that the disease is cancer.

c. 1600 BCE · Origin · Foundations

Edwin Smith Papyrus: Case 45, bulging tumours of the breast

An Egyptian surgical text, copied around 1600 BCE, describes a man with cool, bulging swellings on the breast. Its 1930 translator reads the treatment line as 'there is no treatment', with the word supplied in brackets. The text does not name the condition, so calling it cancer is an interpretation.

Case 45 of Breasted's 1930 translation of the Edwin Smith Surgical Papyrus describes a man with bulging tumours spreading over the breast: very cool, no fever, no granulation, no fluid or secretions. The verdict is 'an ailment with which I will contend' (doubtful). The treatment line reads 'There is no [treatment]', the bracket being Breasted's. Breasted dates the copy to the seventeenth century BCE and does not state that the disease is cancer.

5th-4th century BCE · Origin · Foundations

Hippocratic writings: karkinos and the first cancer vocabulary

Writings in the Hippocratic collection, from ancient Greece, use the word karkinos, Greek for crab, for non-healing swellings and ulcers, including tumours of the breast. They describe burning a throat tumour and advise leaving deep cancers untreated. The collection has many authors, and the word covered more conditions than cancer as defined today.

The Hippocratic Corpus uses karkinos and karkinoma for tumours; Papavramidou notes karkinos covered any non-healing swelling or ulcer, with karkinoma reserved for non-healing cancer. Retsas cites a woman from Abdera with breast cancer and a bloody nipple discharge, cautery of a pharyngeal carcinoma, fatal cancers in the elderly, and advice that deep cancers are better left untreated. No detailed surgical technique survives.

1st century CE · Understanding · Foundations

Celsus: carcinoma, its stages and a warning against treating it

The Roman writer Celsus, in the first century CE, described carcinoma as a fixed, uneven swelling with swollen veins, found mostly on the face and in women's breasts. He named stages from an early removable form to ulcerated and wart-like disease, and warned that treating the later stages made them worse.

In De Medicina (Book V, Loeb translation), Celsus describes carcinoma mostly of the face, lips and women's breasts: a fixed irregular swelling with dilated veins, progressing from cacoethes to non-ulcerated carcinoma, ulceration and a wart-like stage. Only cacoethes could be removed; later stages worsened with caustics, cautery or excision, and recurrence followed excision, while many patients with mild treatment lived to old age. He uses Latin cancer for a separate spreading ulcer.

2nd century CE · Understanding · Foundations

Galen: tumours against nature and the black-bile theory of cancer

In the second century CE the physician Galen wrote about tumours 'against nature'. He explained cancer as a build-up of residues of black bile, one of the four humours, and compared the swollen veins around breast tumours to the legs of a crab. The black-bile explanation is a historical theory, not a documented cause.

Galen (2nd century CE) wrote On Tumours Against Nature. Papavramidou summarises his humoral view: residues of black bile, left by a weak liver and spleen, accumulate to cause cancer. Retsas quotes his definition of carcinoma as a malignant, indurated tumour, ulcerated or not, named after the animal 'cancer' (crab), from distended veins around breast tumours. He saw cancer most often in the breast, treated early disease, and advised circular excision with cautery.

1700 · Understanding · Foundations

Ramazzini links breast cancer in nuns to celibacy

The Italian physician Bernardino Ramazzini, in his 1700 book on diseases of workers, noted that cancerous breast tumours seemed more frequent in nuns than in other women and suggested their celibate life as the reason. It was an observation without counts. Later writers read it as an early hint that childbearing affects breast cancer risk.

In De Morbis Artificum Diatriba (Modena, 1700), chapter XX on the diseases of wet-nurses, Ramazzini writes of a sympathy between the breasts and the uterus and says cancerous breast tumours are seen more often in nuns than in other women, attributing this not to absent menstruation but, as he thinks, to the celibate life. Horn and Vatten note he made no direct link between sexual inactivity and childbearing; later readers treated it as the first hint of a parity association.