How ancient people understood cancer thousands of years ago

Evidence of an operation or post-mortem examination on a skull from 4,000 years ago shows that ancient Egyptians may have tried to treat cancer with surgery. But how much did ancient people know about this ‘modern’ disease?

Most of us think that our understanding of cancer began in recent decades or centuries, but in fact, people not only understood what cancer was, but had begun to devise treatments for it thousands of years ago. Tellingly, even people thousands of years ago designated certain problems as ‘incurable’.

Dr Edgard Camaros, a professor at the University of Santiago de Compostela, Spain said that the Egyptian skull may show evidence of an operation to save a patient’s life, or a post-mortem examination, but in either case it was “the very first time that humanity was dealing surgically with what we nowadays call cancer".

What did Egyptians understand about cancer?

Various previously discovered Egyptian writings on papyrus dating from up to 3,000 years ago describe diseases that appear to be cancer: the Edwin Smith Papyrus describes various cancers – including one which seems to have spread through the body and for which there was no treatment.

Elsewhere in the Papyrus, surgeons describe cauterising what appear to be tumours with fire sticks.

The Ebers Papyrus, dated to 1,500BC, describes 'swelling of vessels' which may also describe cancers.

What did the ancient Greeks know?

In ancient Greece, Hippocrates described cancer as ‘karkinoma’ (Greek for crab) almost 2,500 years ago, which is believed to describe how a tumour clung on like a crab with its claws. The term evolved into the word 'cancer' thanks to Roman writers.

Hippocrates described using heat to treat tumours, writing: "Those diseases that medicine cannot cure are cured with the knife. Those that the knife cannot cure are cured by fire and those that fire does not cure are considered incurable."

Ancient Greek writers were aware of mastectomy as a treatment for breast cancer, and knew that cancer could spread to different parts of the body.

What about the rest of the world?

Classical Chinese works of medicine such as The Inner Canon of the Yellow Emperor (dating to around 100-200BC) classified different kinds of cancer affecting different parts of the body.

The Persian writer Ibn Sina (Avicenna) wrote The Canon of Medicine, which devoted a chapter to cancer, describing metastatic cancers and prescribing a herbal compound drug, Hindiba, which has since been identified as having anti-cancer properties.

When did our modern understanding of cancer begin?

Scottish surgeon John Hunter wrote in the 18th century that surgeons could operate to deal with certain cancers, writing that if a tumour had not invaded nearby tissue there is "no impropriety in removing it.”

The 18th and 19th centuries saw a series of rapid-fire breakthroughs which transformed our understanding of cancer.

In 1775, Percivall Pott identified a relationship between exposure to soot in chimneys and certain forms of cancer.

In 1886, Brazilian ophthalmologist Hilário de Gouveêa identified that cancer risk could be inherited.

The invention of X-rays by William Roentgen and Marie Curie’s discovery of radium paved the way for modern diagnosis and radiotherapy treatments.

The 20th century saw further breakthroughs including new understanding of how cancers can be caused by viruses and by chemicals in the environment.

In terms of treatment, radiotherapy and chemotherapy both evolved, alongside new understandings of how certain genes can trigger cancer. In 1984, researchers pinpointed the HER2 gene, associated with more aggressive disease.

In 2010, the first human cancer vaccine was approved for treatment of metastatic prostate cancer.

Cancer survival rates continue to improve: NHS statistics show an almost 10% improvement in one-year survival rates between 2005 and 2020, with three out of every four people surviving their first year after diagnosis.

In the future, treatments such as 'precision oncology', targeted precisely using genomic data from individual patients could mean personalised treatments - and fewer side effects.

Researchers hope that artificial intelligence (AI) and machine learning hold the potential to transform cancer care, with AI helping to analyse X-rays and scans and enable early diagnosis and treatment.