Cancer may seem like a modern disease, but it has been affecting people for ages. Scientists have discovered many prehistoric human remains that indicate the presence of cancer. So, what is the earliest case of cancer that has been recorded? And what is the first time that people wrote about it in medical texts?
The earliest evidence of cancer in humans comes from an early human relative that lived about 1.7 million years ago. This individual, probably of the species Paranthropus robustus or Homo ergaster, lived with a malignant tumor in his left toe. Archaeologists discovered the skeletal remains inside Swartkran Cave, a limestone deposit in South Africa often called the Cradle of Humankind for being home to the largest concentration of human relatives in the world.
When researchers compared computed tomography (CT) scans of the toe bone fossil with images of modern cases of osteosarcoma, an aggressive form of cancer which begins in the cells that form bone, they immediately recognized the distinctive cauliflower-like appearance of an osteosarcoma, according to a 2016 study of the case published in South African Journal of Science (opens in new tab).
Today, osteosarcoma is one of the most common bone cancers in humans and can occur at any age, although it is most often seen in children, teenagers and young adults who are still growing, according to American Cancer Society (opens in new tab). But although the age of this prehistoric individual is unknown, it appears that they were adults, the researchers said.
An even older benign tumor was found in a 1.9-million-year-old human relative known as Australopithecus sediba found in South Africa, according to a separate 2016 study i South African Journal of Science (opens in new tab).
It is not surprising that the oldest known case of cancer was in a bone, as organs, skin and other soft tissues are more prone to decay than bones.
“Bone is one of the few tissues that can survive in the fossil record,” Bruce Rothschild (opens in new tab)a vertebrate paleontologist at the Carnegie Museum of Natural History in Pittsburgh who was not involved in the study, told Live Science.
However, even if cancer is present in a fossil, it is often not visible to the naked eye and requires further investigation to find – as was the case with the toe bone.
“About a third of cancers will show up,” Rothschild said. “But you would have to do an X-ray to determine if something was hidden inside the bone. Most pathologists [today] look at an X-ray before making a diagnosis of a tumor when it involves the bone.”
First written documents on cancer
Although the 1.7-million-year-old toe bone is the earliest known case of cancer in a hominin, a group that includes modern humans, the first written record of cancer does not appear until much, much later.
Year 3000 BC wrote Imhotep – an ancient Egyptian mathematician, physician and architect – what came to be known Edwin Smith Papyrus (opens in new tab), a textbook on bodily injury and surgical procedures. In the text, he described 48 medical cases, including several case studies on breast cancer.
The text was written in hieratic, an ancient Egyptian writing system, and was later translated into an English text in two volumes by the American archaeologist James Henry Breasted. In it, Imhotep described characteristics of different types of tumors, including “oily tumors” and “solid tumors.” He also included descriptions of a breast tumor — describing it as a “bulging mass in the breast” that is cool, hard and as dense as an “unripe haematocarp” spreading under the skin, according to the book “The Emperor of All Maladies: A Biography of Cancer (opens in new tab)” (Scribner, 2010).
While Imhotep gives a number of treatments for the other medical conditions in the text, under “therapy” for the breast tumor he wrote: “There is none.” However, he noted the best methods for binding other types of tumors, which involved creating an ointment made from fat, honey and lint, according to The cancer letter (opens in new tab)who published an extract from the historical text.
The papyrus not only provides a glimpse of how surgical medicine was practiced thousands of years ago by ancient Egyptians, but undoubtedly some of the the world’s first surgeonsbut also provides some of the earliest evidence of cancer ever recorded, according to a 2016 study published in the journal Cancer (opens in new tab).
It is unclear how these cases of prehistoric cancer developed. Like the people who came before us, we are still trying to figure out what causes many cancers and the best ways to treat them.
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