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The history of cancer describes the development of the field of oncology and its role in the history of medicine.
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The history of cancer describes the development of the field of oncology and its role in the history of medicine.
The earliest known descriptions of cancer appear in several papyri from ancient Egypt. The Edwin Smith Papyrus was written around 1600 BC (possibly a fragmentary copy of a text from 2500 BC) and contains a description of cancer, as well as a procedure to remove breast tumours by cauterization, stating that the disease has no treatment. [1] However, incidents of cancer were rare. In a study by the University of Manchester, only one case was found "in the investigation of hundreds of Egyptian mummies, with few references to cancer in literary evidence." [2] In 2016, a 1.7 million year old osteosarcoma was reported by Dr Edward John Odes (a doctoral student in Anatomical Sciences from the University of the Witwatersrand Medical School, South Africa) and colleagues, representing the oldest documented malignant hominin cancer.
Hippocrates (c. 460 BC – c. 370 BC) described several kinds of cancer, referring to them by the term καρκινος (carcinos), the Greek word for 'crab' or 'crayfish', as well as carcinoma. [3] This comes from the appearance of the cut surface of a solid malignant tumour, with "the veins stretched on all sides as the animal the crab has its feet, whence it derives its name". [4] Since it was against Greek tradition to open the body, Hippocrates only described and made drawings of outwardly visible tumours on the skin, nose, and breasts. Treatment was based on the humour theory of four bodily fluids (black and yellow bile, blood, and phlegm). According to the patient's humour, treatment consisted of diet, blood-letting, and/or laxatives. Celsus (c. 25 BC – 50 AD) translated carcinos into cancer, the Latin word for crab or crayfish.
In the 2nd century AD, the Greek physician Galen used oncos (Greek for 'swelling') to describe all tumours, reserving Hippocrates' term carcinos for malignant tumours. Galen also used the suffix -oma to indicate cancerous lesions. It is from Galen's usage that we derive the modern word oncology . [5]
Through the centuries it was discovered that cancer could occur anywhere in the body, but Hippocrates' humour-theory-based treatment remained popular until the 19th century.
In the 16th and 17th centuries, it became more acceptable for doctors to dissect bodies to discover the cause of death. The German professor Wilhelm Fabry believed that breast cancer was caused by a milk clot in a mammary duct. The Dutch professor Francois de la Boe Sylvius, a follower of Descartes, believed that all disease was the outcome of chemical processes, and that acidic lymph fluid was the cause of cancer. His contemporary Nicolaes Tulp believed that cancer was a poison that slowly spreads, and concluded that it was contagious. [6] In the 1600s, cancer was vulgarly called "the wolf[e]". [7]
The first cause of cancer was identified by British surgeon Percivall Pott, who discovered in 1775 that cancer of the scrotum was a common disease among chimney sweeps.[ citation needed ] The work of other individual physicians led to various insights, but when physicians started working together they could draw firmer conclusions.
With the widespread use of the microscope in the 18th century, it was discovered that the 'cancer poison' eventually spreads from the primary tumour through the lymph nodes to other sites ("metastasis"). This view of the disease was first formulated by the English surgeon Campbell De Morgan between 1871 and 1874. [8] The use of surgery to treat cancer had poor results due to problems with hygiene. The renowned Scottish surgeon Alexander Monro saw only 2 breast tumour patients out of 60 surviving surgery for two years. In the 19th century, asepsis improved surgical hygiene and as the survival statistics went up, surgical removal of the tumour became the primary treatment for cancer. With the exception of William Coley who in the late 19th century felt that the rate of cure after surgery had been higher before asepsis (and who injected bacteria into tumours with mixed results), cancer treatment became dependent on the individual art of the surgeon at removing a tumour. The underlying cause of his results might be that infection stimulates the immune system to destroy left tumour cells. During the same period, the idea that the body was made up of various tissues, that in turn were made up of millions of cells, laid rest the ancient belief in humor theory on chemical imbalances in the body.
The genetic basis of cancer was recognised in 1902 by the German zoologist Theodor Boveri, professor of zoology at Munich and later in Würzburg. [9] [10] He discovered a method to generate cells with multiple copies of the centrosome, a structure he discovered and named. He postulated that chromosomes were distinct and transmitted different inheritance factors. He suggested that mutations of the chromosomes could generate a cell with unlimited growth potential which could be passed on to its descendants. He proposed the existence of cell cycle checkpoints, tumour suppressor genes and oncogenes. He speculated that cancers might be caused or promoted by radiation, physical or chemical injuries, or by pathogenic microorganisms.
When Marie Curie and Pierre Curie discovered radiation at the end of the 19th century, they stumbled upon the first effective non-surgical cancer treatment. With radiation also came the first signs of multi-disciplinary approaches to cancer treatment. The surgeon was no longer operating in isolation but worked together with hospital radiologists to help patients. The complications in communication this brought, along with the necessity of the patient's treatment in a hospital facility rather than at home, also created a parallel process of compiling patient data into hospital files, which in turn led to the first statistical patient studies.
The American Cancer Society was founded in 1913 by 15 physicians and businessmen in New York City under the name American Society for the Control of Cancer (ASCC). The current name was adopted in 1945. [11]
A founding paper of cancer epidemiology was the work of Janet Lane-Claypon, who published a comparative study in 1926 of 500 breast cancer cases and 500 control patients of the same background and lifestyle for the British Ministry of Health. Her groundbreaking work on cancer epidemiology was carried on by Richard Doll and Austin Bradford Hill, who published "Lung Cancer and Other Causes of Death In Relation to Smoking. A Second Report on the Mortality of British Doctors" followed in 1956 (otherwise known as the British doctors study). Richard Doll left the London Medical Research Centre (MRC), to start the Oxford unit for Cancer epidemiology in 1968. With the use of computers, the unit was the first to compile large amounts of cancer data. Modern epidemiological methods are closely linked to current[ when? ] concepts of disease and public health policy. Over the past 50 years, great efforts have been spent on gathering data across medical practice, hospital, provincial, state, and even country boundaries to study the interdependence of environmental and cultural factors on cancer incidence.
Cancer patient treatment and studies were restricted to individual physicians' practices until World War II when medical research centres discovered that there were large international differences in disease incidence. This insight drove national public health bodies to enable the compilation of health data across practices and hospitals, a process found in many countries today. The Japanese medical community observed that the bone marrow of victims of the atomic bombings of Hiroshima and Nagasaki was completely destroyed. They concluded that diseased bone marrow could also be destroyed with radiation, and this led to the development of bone marrow transplants for leukemia. Since World War II, trends in cancer treatment are to improve on a micro-level the existing treatment methods, standardize them, and globalize them to find cures through epidemiology and international partnerships.
In 1968 Michael A. Epstein, Bert Achong, and Yvonne Barr identified the first human cancer virus, called the Epstein–Barr virus. [12]
The political 'war' on cancer began with the National Cancer Act of 1971, a United States federal law. [13] The act was intended "to amend the Public Health Service Act so as to strengthen the National Cancer Institute in order to more effectively carry out the national effort against cancer". It was signed into law by then U.S. President Richard Nixon on December 23, 1971. [14]
In 1973, cancer research led to a cold war incident, [15] where co-operative samples of reported oncoviruses were discovered to be contaminated by HeLa.
In 1984, Harald zur Hausen discovered first HPV16 and then HPV18 responsible for approximately 70% of cervical cancers. For discovery that human papillomaviruses (HPV) cause human cancer, zur Hausen won a 2008 Nobel Prize. [16]
Since 1971 the United States has invested over $200 billion on cancer research; that total includes money invested by public and private sectors and foundations. [17]
Despite this substantial investment, the country has seen just a five percent decrease in the cancer death rate (adjusting for size and age of the population) between 1950 and 2005. [18] Longer life expectancy may be a contributing factor to this, as cancer rates and mortality rates increase significantly with age, more than three out of five cancers are diagnosed in people aged 65 and over. [19]
Hippocrates of Kos, also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history of medicine. He is traditionally referred to as the "Father of Medicine" in recognition of his lasting contributions to the field, such as the use of prognosis and clinical observation, the systematic categorization of diseases, and the formulation of humoral theory. The Hippocratic school of medicine revolutionized ancient Greek medicine, establishing it as a discipline distinct from other fields with which it had traditionally been associated, thus establishing medicine as a profession.
A brain tumor occurs when abnormal cells form within the brain. There are two main types of tumors: malignant (cancerous) tumors and benign (non-cancerous) tumors. These can be further classified as primary tumors, which start within the brain, and secondary tumors, which most commonly have spread from tumors located outside the brain, known as brain metastasis tumors. All types of brain tumors may produce symptoms that vary depending on the size of the tumor and the part of the brain that is involved. Where symptoms exist, they may include headaches, seizures, problems with vision, vomiting and mental changes. Other symptoms may include difficulty walking, speaking, with sensations, or unconsciousness.
The lymphatic system, or lymphoid system, is an organ system in vertebrates that is part of the immune system, and complementary to the circulatory system. It consists of a large network of lymphatic vessels, lymph nodes, lymphoid organs, lymphatic tissue and lymph. Lymph is a clear fluid carried by the lymphatic vessels back to the heart for re-circulation. The Latin word for lymph, lympha, refers to the deity of fresh water, "Lympha".
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal bleeding, prolonged cough, unexplained weight loss, and a change in bowel movements. While these symptoms may indicate cancer, they can also have other causes. Over 100 types of cancers affect humans.
Metastasis is a pathogenic agent's spread from an initial or primary site to a different or secondary site within the host's body; the term is typically used when referring to metastasis by a cancerous tumor. The newly pathological sites, then, are metastases (mets). It is generally distinguished from cancer invasion, which is the direct extension and penetration by cancer cells into neighboring tissues.
A bone tumor is an abnormal growth of tissue in bone, traditionally classified as noncancerous (benign) or cancerous (malignant). Cancerous bone tumors usually originate from a cancer in another part of the body such as from lung, breast, thyroid, kidney and prostate. There may be a lump, pain, or neurological signs from pressure. A bone tumor might present with a pathologic fracture. Other symptoms may include fatigue, fever, weight loss, anemia and nausea. Sometimes there are no symptoms and the tumour is found when investigating another problem.
Humorism, the humoral theory, or humoralism, is a system of medicine detailing a supposed makeup and workings of the human body, adopted by Ancient Greek and Roman physicians and philosophers.
Malignancy is the tendency of a medical condition to become progressively worse; the term is most familiar as a characterization of cancer.
Hybridoma technology is a method for producing large numbers of identical antibodies. This process starts by injecting a mouse with an antigen that provokes an immune response. A type of white blood cell, the B cell, produces antibodies that bind to the injected antigen. These antibody producing B-cells are then harvested from the mouse and, in turn, fused with immortal myeloma cancer cells, to produce a hybrid cell line called a hybridoma, which has both the antibody-producing ability of the B-cell and the longevity and reproductivity of the myeloma. The hybridomas can be grown in culture, each culture starting with one viable hybridoma cell, producing cultures each of which consists of genetically identical hybridomas which produce one antibody per culture (monoclonal) rather than mixtures of different antibodies (polyclonal). The myeloma cell line that is used in this process is selected for its ability to grow in tissue culture and for an absence of antibody synthesis. In contrast to polyclonal antibodies, which are mixtures of many different antibody molecules, the monoclonal antibodies produced by each hybridoma line are all chemically identical.
The era of cancer chemotherapy began in the 1940s with the first use of nitrogen mustards and folic acid antagonist drugs. The targeted therapy revolution has arrived, but many of the principles and limitations of chemotherapy discovered by the early researchers still apply.
A malignant peripheral nerve sheath tumor (MPNST) is a form of cancer of the connective tissue surrounding nerves. Given its origin and behavior it is classified as a sarcoma. About half the cases are diagnosed in people with neurofibromatosis; the lifetime risk for an MPNST in patients with neurofibromatosis type 1 is 8–13%. MPNST with rhabdomyoblastomatous component are called malignant triton tumors.
Phyllodes tumors, are a rare type of biphasic fibroepithelial mass that form from the periductal stromal and epithelial cells of the breast. They account for less than 1% of all breast neoplasms. They were previously termed cystosarcoma phyllodes, coined by Johannes Müller in 1838, before being renamed to phyllodes tumor by the World Health Organization in 2003. Phullon, which means 'leaf' in Greek, describes the unique papillary projections characteristic of phyllodes tumors on histology. Diagnosis is made via a core-needle biopsy and treatment is typically surgical resection with wide margins (>1 cm), due to their propensity to recur.
Adjuvant therapy, also known as adjunct therapy, adjuvant care, or augmentation therapy, is a therapy that is given in addition to the primary or initial therapy to maximize its effectiveness. The surgeries and complex treatment regimens used in cancer therapy have led the term to be used mainly to describe adjuvant cancer treatments. An example of such adjuvant therapy is the additional treatment usually given after surgery where all detectable disease has been removed, but where there remains a statistical risk of relapse due to the presence of undetected disease. If known disease is left behind following surgery, then further treatment is not technically adjuvant.
Spinal cord compression is a form of myelopathy in which the spinal cord is compressed. Causes can be bone fragments from a vertebral fracture, a tumor, abscess, ruptured intervertebral disc or other lesion.
An eye neoplasm is a tumor of the eye. A rare type of tumor, eye neoplasms can affect all parts of the eye, and can either be benign or malignant (cancerous), in which case it is known as eye cancer. Eye cancers can be primary or metastatic cancer. The two most common cancers that spread to the eye from another organ are breast cancer and lung cancer. Other less common sites of origin include the prostate, kidney, thyroid, skin, colon and blood or bone marrow.
Medicine in ancient Rome was highly influenced by ancient Greek medicine, but also developed new practices through knowledge of the Hippocratic Corpus combined with use of the treatment of diet, regimen, along with surgical procedures. This was most notably seen through the works of two of the prominent Greek physicians, Dioscorides and Galen, who practiced medicine and recorded their discoveries. This is contrary to two other physicians like Soranus of Ephesus and Asclepiades of Bithynia, who practiced medicine both in outside territories and in ancient Roman territory, subsequently. Dioscorides was a Roman army physician, Soranus was a representative for the Methodic school of medicine, Galen performed public demonstrations, and Asclepiades was a leading Roman physician. These four physicians all had knowledge of medicine, ailments, and treatments that were healing, long lasting and influential to human history.
An adrenal tumor or adrenal mass is any benign or malignant neoplasms of the adrenal gland, several of which are notable for their tendency to overproduce endocrine hormones. Adrenal cancer is the presence of malignant adrenal tumors, and includes neuroblastoma, adrenocortical carcinoma and some adrenal pheochromocytomas. Most adrenal pheochromocytomas and all adrenocortical adenomas are benign tumors, which do not metastasize or invade nearby tissues, but may cause significant health problems by unbalancing hormones.
Surgery is the branch of medicine that deals with the physical manipulation of a bodily structure to diagnose, prevent, or cure an ailment. Ambroise Paré, a 16th-century French surgeon, stated that to perform surgery is, "To eliminate that which is superfluous, restore that which has been dislocated, separate that which has been united, join that which has been divided and repair the defects of nature."
The following outline is provided as an overview of and topical guide to medicine:
Cancer cells are cells that divide continually, forming solid tumors or flooding the blood or lymph with abnormal cells. Cell division is a normal process used by the body for growth and repair. A parent cell divides to form two daughter cells, and these daughter cells are used to build new tissue or to replace cells that have died because of aging or damage. Healthy cells stop dividing when there is no longer a need for more daughter cells, but cancer cells continue to produce copies. They are also able to spread from one part of the body to another in a process known as metastasis.
19. Odes EJ, Randolph-Quinney PS, Steyn M, Throckmorton Z, Smilg JS, Zipfel B, et al. (2016). "Earliest hominin cancer: 1.7-million-year-old osteosarcoma from Swartkrans Cave, South Africa". South African Journal of Science. 112 (7/8): 5. doi:10.17159/sajs.2016/20150471. ISSN 1996-7489. Archived from the original on 2016-08-01. Retrieved 2016-08-01.
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