One of the earliest descriptions of someone with cancer comes from the fourth century BC. Satyrus, tyrant of the city of Heracleia on the Black Sea, developed a cancer between his groin and scrotum. As the cancer spread, Satyrus had ever greater pains. He was unable to sleep and had convulsions.
Advanced cancers in that part of the body were regarded as inoperable, and there were no drugs strong enough to alleviate the agony. So doctors could do nothing. Eventually, the cancer took Satyrus’ life at the age of 65.
Cancer was already well known in this period. A text written in the late fifth or early fourth century BC, called Diseases of Women, described how breast cancer develops: hard growths form […] out of them hidden cancers develop […] pains shoot up from the patients’ breasts to their throats, and around their shoulder blades […] such patients become thin through their whole body […] breathing decreases, the sense of smell is lost […]
Other medical works of this period describe different sorts of cancers. A woman from the Greek city of Abdera died from a cancer of the chest; a man with throat cancer survived after his doctor burned away the tumor.
Where does the word ‘cancer’ come from?
The word cancer comes from the same era. In the late fifth and early fourth century BC, doctors were using the word karkinos – the ancient Greek word for crab – to describe malignant tumous. Later, when Latin-speaking doctors described the same disease, they used the Latin word for crab: cancer. So, the name stuck.
Even in ancient times, people wondered why doctors named the disease after an animal. One explanation was the crab is an aggressive animal, just as cancer can be an aggressive disease; another explanation was the crab can grip one part of a person’s body with its claws and be difficult to remove, just as cancer can be difficult to remove once it has developed. Others thought it was because of the appearance of the tumor.
The physician Galen (129-216 AD) described breast cancer in his work "A Method of Medicine to Glaucon," and compared the form of the tumor to the form of a crab: We have often seen in the breasts a tumor exactly like a crab. Just as that animal has feet on either side of its body, so too in this disease the veins of the unnatural swelling are stretched out on either side, creating a form similar to a crab.
Not everyone agreed what caused cancer
In the Greco-Roman period, there were different opinions about the cause of cancer.
According to a widespread ancient medical theory, the body has four humors: blood, yellow bile, phlegm and black bile. These four humors need to be kept in a state of balance, otherwise a person becomes sick. If a person suffered from an excess of black bile, it was thought this would eventually lead to cancer.
The physician Erasistratus, who lived from around 315 to 240 BC, disagreed. However, so far as we know, he did not offer an alternative explanation.
How was cancer treated?
Cancer was treated in a range of different ways. It was thought that cancers in their early stages could be cured using medications.
These included drugs derived from plants (such as cucumber, narcissus bulb, castor bean, bitter vetch, cabbage); animals (such as the ash of a crab); and metals (such as arsenic).
Galen claimed that by using this sort of medication, and repeatedly purging his patients with emetics or enemas, he was sometimes successful at making emerging cancers disappear. He said the same treatment sometimes prevented more advanced cancers from continuing to grow. However, he also said surgery is necessary if these medications do not work.
Surgery was usually avoided as patients tended to die from blood loss. The most successful operations were on cancers of the tip of the breast. Leonidas, a physician who lived in the second and third century AD, described his method, which involved cauterizing (burning): I usually operate in cases where the tumors do not extend into the chest […] When the patient has been placed on her back, I incise the healthy area of the breast above the tumor and then cauterize the incision until scabs form and the bleeding is stanched. Then I incise again, marking out the area as I cut deeply into the breast, and again I cauterize. I do this [incising and cauterizing] quite often […] This way the bleeding is not dangerous. After the excision is complete I again cauterize the entire area until it is dessicated."
Cancer was generally regarded as an incurable disease, and so it was feared. Some people with cancer, such as the poet Silius Italicus (26-102 AD), died by suicide to end the torment.
Patients would also pray to the gods for hope of a cure. An example of this is Innocentia, an aristocratic lady who lived in Carthage (in modern-day Tunisia) in the fifth century AD. She told her doctor divine intervention had cured her breast cancer, though her doctor did not believe her.
From the past into the future
We began with Satyrus, a tyrant in the fourth century BC. In the 2,400 years or so since then, much has changed in our knowledge of what causes cancer, how to prevent it and how to treat it. We also know there are more than 200 different types of cancer. Some people’s cancers are so successfully managed, they go on to live long lives.
But there is still no general “cure for cancer”, a disease that about one in five people develop in their lifetime. In 2022 alone, there were about 20 million new cancer cases and 9.7 million cancer deaths globally. We clearly have a long way to go.
Konstantine Panegyres is a McKenzie Postdoctoral Fellow, Historical and Philosophical Studies, University of Melbourne.
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4 Comments
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virusrex
A very interesting read on the history of the disease category and how it has shaped the development of medicine.
This is the same as other categories as well, there is no general cure for infection, or for deficiencies, or genetic diseases, It should be easy to understand the moment it is recognized we are not talking about single diseases but about categories, individual cases of course do have their own cures, specially in modern times.
Fortunately cures are not more and more common, and patients that 100 years ago were considered beyond salvation can now live long and prosper lives when their cancers are detected and treated on time so they can be cured. This is why now also more and more doctors are no longer afraid of calling these patients cured, something that brings an extra measure of ease to them and help with their mental health.
Laguna
Cancer took both of my wife's parents. And then it took her. My biracial kids have scattered, and I find myself among those few permanent residents with no Japanese spouse for anchor - but there is no "back" to which go back for, so I'll be here, single, til it's my time. It is a bitch of a disease. My wife came to terms with its terminality, and within days of her death, asked to be placed on her feet, perhaps for one last time to feel the earth (tatami) beneath her soles.
Our neighborhood came admirably together in supporting her care. If you are looking after one suffering from cancer, please be proactive in searching for such help. It is available in abundance, both private and public.
Strangerland
Wow, that's a difficult story Laguna. I hope you can find peace within that.
Laguna
Thank you, Strangerland. Recovery is day by day, though she still comes to me vividly in my dreams. My children support me as they can despite their distance. But I've spent over 30 years here in this house building an existence, and I'll be damned if I'll quit it, especially at retirement age. I love where I live, and someone has to look after the butsudan.