A Report Of The Surgeon General: Fill & Download for Free

Cancer- As Old As HumanityMummy Had History's Second-Oldest Prostate CancerOctober is Breast Cancer Awareness MonthCancer, one of the world’s leading causes of death today, remains almost absent relative to other pathological conditions, in the archaeological record, giving rise to the conclusion that the disease is mainly a product of modern living and increased longevity. Few ancient skeletons bear evidence of cancer, but this may be because the victims died rapidly, before the disease could leave a mark on their bones. Recent finds indicate that the disease existed, and may even have been common, in antiquity.Human beings and other animals have had cancer for millions of years. So it’s no surprise that from the dawn of history people have written about cancer. Some of the earliest evidence of cancer is found among fossilized bone tumors, human mummies in ancient Egypt, and ancient manuscripts. Bony skull destruction as seen in cancer of the head and neck have been found, as well.Micro-CT image shows a tumor in an ancient toe bone from a human relative (Earliest Human Cancer Found in 1.7-Million-Year-Old Bone).A different view of the cancer-bearing bone ((Earliest Human Cancer Found in 1.7-Million-Year-Old Bone).In 2016, using 3-D imaging, researchers diagnosed an aggressive type of cancer called osteosarcoma in a foot bone belonging to a human relative who died in Swartkrans Cave between 1.6 and 1.8 million years ago.[1] The discovery—which has just been published in the South African Journal of Science—suggests that, while modern lifestyles have increased the incidences of cancer, especially in industrialized countries, the triggers for the disease are embedded deep within the human evolutionary past.In 2015, researchers found what is believed to be the oldest known case of cancer in humans. The cancer, leukemia, was identified in the skeletal remains of a woman who lived near present-day Stuttgart-Mühlhausen (Germany).[2]The 3,200-year-old skeleton ,Amara West site, Sudan (Oldest example of human cancer found on 3,000-year-old skeleton).An international team discovered the world's oldest known cases of breast cancer and multiple myeloma (a type of bone marrow cancer).[3] The discoveries were made by conducting CT scans of two mummies found in the pharaonic necropolis of Qubbet el-Hawa in Aswan, Egypt.[4]Currently, the earliest known case of cancer is attributed to the skeleton of a Siberian Bronze Age man. The remains of the man, dating from the Early Bronze Age, show he was 35 to 45 years of age at the time of his death.He had suffered from a cancer which spread throughout his body, the deterioration of his bones leaving him immobile. It was almost certain that those around him would have recognized he was ill.[5]4,500 year old bones of Siberian man reveal he died of cancer (Researchers find oldest known case of cancer in 4,500-year-old remains of Siberian man)The 4,500-year-old bones have significant marks and holes, alerting researchers to the devastating lung or prostate cancer that the ancient man had endured.[6] This new evidence of the illness in ancient bones demonstrates that cancer is not only a modern phenomenon, but also affected the ancient world. Researchers claim this is one of — if not the oldest — absolute cases of cancer in antiquity. Previous cases of cancer have been detected in remains up to 6,000 years old[7] , but those remained unconfirmed or with tumors that were benign.The first reference to the presence of a malignant tumor dates to the early Neolithic (4000-2000 BC) in Poland.[8] The earliest records of suspected cancer in the ancient world are documented in the Egyptian Ebers and Edwin Smith papyri. Both date to the early Eighteenth Dynasty (1550–1504 BC), but are most likely copies of earlier medical treatises from the Old Kingdom (c. 2600–2190 BC).[9] The Edwin Smith Papyrus (3000 BC) is a copy of part of an ancient Egyptian textbook on trauma surgery.[10]It describes 8 cases of tumors or ulcers of the breast that were removed by cauterization with a tool called the fire drill.[11] The writing says about the disease, “There is no treatment.”[12]Plates vi & vii of the Edwin Smith Papyrus (New York Academy of Medicine).One particularly gruesome remedy for what may have been cancer of the uterus states: “Break up a stone in water, leave it overnight, and then pour it into the vagina”.[13] Another treatment described was fumigation: “The patient would sit over something that was burning.”[14] Still, it's not certain that any of the maladies described were actually cancer.A male, young-adult individual from the archaeological site of Amara West in northern Sudan (c. 1200BC) displayed multiple, mainly osteolytic, lesions on the vertebrae, ribs, sternum, clavicles, scapulae, pelvis, and humeral and femoral heads.[15] Following radiographic, microscopic and scanning electron microscopic (SEM) imaging of the lesions, and a consideration of differential diagnoses, a diagnosis of metastatic carcinoma secondary to an unknown soft tissue cancer was suggested.[16] This represents the earliest complete example in the world of a human who suffered metastatic cancer to date.1200 year old Nubian skeletal remains with indications of metastatic carcinoma (Ancient Oncology - Archaeology Magazine)Greek scholar, Herodotus, described a case of breast cancer in Persia that occurred around 520 BC. Herodotus records in The Histories that Atossa was troubled by a bleeding lump in her breast.[17] She wrapped herself in sheets and sought a self-imposed quarantine. Ultimately, a Greek slave, Democedes, persuaded her to allow him to excise the tumor.[18]From third century BC to the seventh century AD, numerous ancient scholars, such as Hippocrates, Aetius, Celsus, Dioscorides, Galen, and Paul of Aegina[19] wrote small treatises on cancer, containing information ranging from suspected causes of cancer to treatment and prevention strategies.The origin of the word cancer is credited to the Greek physician Hippocrates (460-370 BC), who is considered the “Father of Medicine.” Hippocrates used the terms carcinos and carcinoma to describe non-ulcer forming and ulcer-forming tumors.[20] In Greek, these words refer to a crab, most likely applied to the disease because the finger-like spreading projections from a cancer called to mind the shape of a crab.[21]The Roman physician, Celsus (28-50 BC), later translated the Greek term into cancer, the Latin word for crab.[22] Galen (130-200 AD), another Greek physician, used the word oncos (Greek for swelling) to describe tumors.[23] Although the crab analogy of Hippocrates and Celsus is still used to describe malignant tumors, Galen’s term is now used as a part of the name for cancer specialists – oncologists.Hippocrates was the first to publicly dispel the notion that diseases were caused by supernatural elements.[24] Although his understanding of anatomy and physiology was limited, Hippocrates’ detailed descriptions of medical symptoms included observable diagnostic features indicative of some types of cancer.[25] In addition to Hippocrates’ contribution to diagnostic methods, the Hippocratic Oath, a code of medical ethics, is still taken by medical practitioners to this day.Following Hippocrates’ method for medical observation, ancient physicians made attempts to understand the causes of tumors, swellings, and other abnormal growths by conducting their own research through trial and error. Examining the patient, ancient Greek physicians noticed that the cancer tumor was palpable and somewhat hard to the touch, irregular in shape, adherent to the surrounding tissue with dilatation of the veins, rather cool in temperature and sometimes sores would build up in the surrounding area of the body.[26] It also caused swelling and was not accompanied by fever. Another characteristic symptom of cancer was recorded to be acute pain and bleeding.(herodotus description of cancer)Greek physician, Galen, believed that ‘residues of black bile formed in the liver during hematosis’, and an excess of black bile (one of the four humors, or bodily substances) resulted in the development of cancer.[27] He believed that black bile was created when the liver was weak, and during this process the spleen attracted a large amount of thick black blood. This blood would accumulate in the veins and manifest in the formation of a tumor with projections like the legs of a crab.[28] It is from this description of malignant tumors that malignant neoplastic disease was named after the Latin word for crab, cancer. Later physicians, who largely adopted the concept of humoral imbalance as a cause of disease, adhered to Galen’s philosophy of cancer until the dark ages.[29]A text in the Hippocratic tradition, ascribed to an unidentified author, suggested that breast cancer was linked to the absence of menstruation after menopause.[30] According to this text, blood that normally flowed free every month stagnated in the body, and migrated to the breast tissue. Stagnated blood was often interpreted as black bile. This account indicates that Hippocratic physicians were aware that breast cancer, much like today, occurred in older women more often than younger women.[31]Ancient Greeks knew that a mastectomy would help a patient with a lump in her breast, but they also recognized that cancer can recur and spread to other parts of the body.[32] They recommended an unbelievable variety of potions, and plant extracts, and combinations to see if they couldn't kill the cancer in other places. None of those worked. It appears that the Greeks had a better knowledge and awareness of cancer than their predecessors, which is a more likely explanation than an increase in cancer.[33]Paul of Aegina (ca 625‐690 AD) was the first to describe an uncommon, rare malignancy of the breast skin, known today as BCC (Basal cell carcinoma of the breast), which presents spider‐like veins surrounding the growth, hyper pigmented, erythematous plaque combined with local ulceration.[34]Paul macroscopically described a female breast cancer as an uneven, swelling, rough, unseemly, ulcerative, darkish, and painful, having veins with a spreading similar to the legs of the sea crab (Greek: καρκίνος, carcinus, an ancient Greek word for sea crab). He had further suggested partial lumbectomy, ligation of the blood vessels, and cauterization to promote cicatrization and prevent any metastases.[35]12th-century manuscript of the Canon, kept at the Azerbaijan National Academy of Sciences (Avicenna - Wikipedia).Avicenna (980–1037AD), a prominent Islamic physician of Persian origin, gave a detailed description of cancer symptoms, and treatments and prevention strategies in his work Canon of Medicine, which continued to be an authoritative medical reference until the late eighteenth century.[36] He detailed a case of breast cancer and metastatic conditions, which is considered a very early report of metastatic or stage IV breast cancer.[37] He underlined that cancer should be diagnosed and cured in the early stages. With views of Avicenna, cancer is an atrabilious (black bile) swelling (tumor) which sometimes may be accompanied by pain or swelling. He also mentioned that some vessels may be appeared around the cancerous part.Moses Maimonides was a prominent physician, scientist, and philosopher, wrote ten medical treatises. His fifth treatise contains surgical aphorisms, some of which pertain to his treatment of cancer. His treatment of large tumors, as he wrote, involves "excis[ing] the tumor and uproots the entire tumor and its surroundings up to the point of healthy tissue, except if the tumor contains large vessels & [or] the tumor happens to be situated in close proximity to any major organ, excision is dangerous”[38]Although these literary works are important sources of information on the history of cancer, they should be consulted within the context of the medical philosophies of the time and region.[39] From about A.D. 500 to 1500 there was little advancement in understanding. Then, in the 17th century, Wilhelm Fabricus (also William Fabry, Guilelmus Fabricius Hildanus, or Fabricius von Hilden) (June 25, 1560 − February 15, 1634), often called the "Father of German surgery", was the first educated and scientific German surgeon.[40] He is one of the most prominent scholars in the iatromechanics school and author of 20 medical books.[41] His Observationum et Curationum Chirurgicarum Centuriae, published posthumously in 1641, is the best collection of case records of the century and gives clear insight into the variety and methods of his surgical practice, detailing operations for breast and other cancers.The history of cancer in the College collectionsCancer begins when cells in a part of the body start to grow out of control. There are many kinds of cancer, but they all start because of out-of-control growth of abnormal cells. Cancer is the second leading cause of death in the United States. About one-third of all people in the US will develop cancer during their lifetimes.Today, millions of people are living with cancer or have had cancer.[42]The general opinion about the occurrence of malignant tumors in antiquity was that they were nonexistent or extremely rare. Paleooncologists still strongly disagree about the prevalence of cancer in the past, sometimes almost reaching the point of denying their existence, other times admitting a very low prevalence compared to the present. Therefore, cancer seems to have been rare in the past and the calculated prevalence might be either real or it might only reflect an underdetection of cancer.Aeschylus healing a patient (The Ancient Greek Healing Tradition - The National Herald)Some of the reasons given as an explanation for the rarity of cancer in antiquity are as follows: 1) the average life span was shorter (individuals died earlier and more frequently from injuries or infections rather than from a complication of the malignant tumor);[43] 2) certain chemical substances or physical agents known to being cancer promoters were rare in the past ; 3) as far as primary soft tissue tumors are concerned, the tendency to spread to the bones is not always the same for all types of tumors;[44] 4) bone metastases appear first in the marrow cavity and the simple inspection of bones may fail to reveal inner growths which might instead become apparent, were recovered bones sistematically radiographed;[45] 5) malignant tumors might have been scarcely reported in older literature also because anthropologists in charge, being not medically trained, simply did not look for tumors.[46]Historical Cancer HighlightsUnfortunately, direct diagnosis of malignant soft tissue tumors is exceptional in paleopathology.[47] In fact, with the exception of primary bone tumors (which for that matter are rare in modern medical records as much as they are in archeological specimens), the diagnosis is generally indirect, through osseous destruction by metastases. Studying tumour palaeoepidemiology is uniquely challenging. A recent meta-analysis of all published palaeopathological studies of Egyptian mummies demonstrated how diagnostic uncertainty was a general problem in palaeopathological research and explained why clinical standards of diagnostic sensitivity and specificity were rarely applied.[48]More than 176 confirmed malignancies have been documented in the archaeological record providing ample evidence that cancer is an ancient natural phenomenon and is not solely a by-product of carcinogens that are abundant in today's industrial society.[49]In their review of texts documenting supposed cancer symptoms and cures, Susanna Gamba and Gino Fornaciari documented that most cases of cancer are concentrated in the age range between 21 and 40 years, while modern medical records show that the highest incidence of cancer occurs beyond age 40.[50] This might be explained by taking into consideration that the modern life span has expanded compared to the past. In addition, certain tumors have a tendency to develop and manifest themselves later in life, at an age when the same individual in the past might have already been dead from an infection or an injury.[51]It can be argued that since life expectancy was lower in the ancient world, most people didn't live long enough to develop cancer.But the lack of evidence of childhood bone cancer suggests that perhaps overall rates were lower as well.Recently, more carefully designed and methodologically sound palaeoepidemiological studies show that malignant tumours in the past were as prevalent as in modern populations. A recent study by Nerlich et al. examined the preserved skeletal remains of 905 individuals from two major ancient Egyptian necropolises spanning 3,200–500 BCE and also those of 2,547 individuals in ancient Germany dating back to 1400–1800 CE.[52] This study established the presence of malignant tumours in spatially and temporarily different populations over the past 4,000 years with an age- and gender-adjusted frequency.[53] Evidence from several studies indicates that distinct types of malignant tumours such as multiple myeloma and nasopharyngeal carcinoma occurred at rates that are much higher than those in modern populations.[54]In summary, cancer is an ancient disease and is not 'man-made'. There is strong evidence from palaeoepidemiological studies that cancer was at least as prevalent in ancient human populations as it is in our modern societies. More studies designed specifically to establish the epidemiology of cancer in ancient populations are needed to corroborate these findings.Footnotes[1] Earliest Human Cancer Found in 1.7-Million-Year-Old Bone[2] Historical Cancer Highlights[3] Ancient History: Two Mummies Discovered With Cancer[4] Breast cancer dates back as far as 4,200 years ago, research team led by the UGR reveals[5] Ancient Egyptian had earliest cancer[6] Researchers find oldest known case of cancer in 4,500-year-old remains of Siberian man[7] On the Antiquity of Cancer: Evidence for Metastatic Carcinoma in a Young Man from Ancient Nubia (c. 1200BC)[8] The treatment of cancer in Greek antiquity[9] https://www.google.com/url?sa=t&source=web&rct=j&url=https://oi.uchicago.edu/sites/oi.uchicago.edu/files/uploads/shared/docs/oip3.pdf&ved=2ahUKEwj-t8_TyYHlAhWHsZ4KHbsWD_4QFjAOegQIBhAC&usg=AOvVaw0eZKFLsIbVMm7HJ6fchRcV&cshid=1570156741531[10] A note from history: Landmarks in history of cancer, part 1[11] A comprehensive history of cancer treatment[12] A Brief History of Breast Cancer: Part I: Surgical domination reinvented[13] Oncology and Infectious Diseases in Ancient Egypt[14] How the ancient world dealt with cancer[15] Ancient Oncology - Archaeology Magazine[16] On the Antiquity of Cancer: Evidence for Metastatic Carcinoma in a Young Man from Ancient Nubia (c. 1200BC)[17] THE FIRST RECORDED CASE OF INFLAMMATORY MASTITIS— QUEEN ATOSSA OF PERSIA AND THE PHYSICIAN DEMOCÊDES[18] http://(Mukherjee, The Emperor of All Maladies, p.41 [19] Paul of Aegina (ca 625‐690 AD): an early description of a rare basal cell carcinoma of the breast[20] What Ancient Greek Physicians Knew About Cancer[21] http://www.bordet.be/en/presentation/history/cancer_e/cancer1.htm[22] Greco‐Roman thought about cancer[23] Science Diction: The Origin Of The Word 'Cancer'[24] https://www.google.com/url?sa=t&source=web&rct=j&url=https://pdxscholar.library.pdx.edu/cgi/viewcontent.cgi%3Farticle%3D1029%26context%3Dyounghistorians&ved=2ahUKEwiOjr3_yYPlAhVLgp4KHc1yAwYQFjANegQIBxAB&usg=AOvVaw2CIjIhyniBVL52qAuvcIIV[25] [Hippocrates' viewpoint on cancer].[26] How Was Cancer Treated in Ancient Greece?[27] Evolution of Cancer Treatments: Surgery | American Cancer Society[28] Cancer: We Should Not Forget The Past[29] Ancient Greek and Greco–Roman Methods in Modern Surgical Treatment of Cancer[30] Menopause and Cancer Risk[31] Bile, Cauterization, and Exercise: Cancer Treatment Was a Very Different Story in Ancient Greece[32] The history of breast cancer treatment, from ancient times onward[33] THE PROBLEM OF CANCER IN ANTIQUITY : BRIEF REVIEW OF 94 CASES[34] https://www.google.com/url?sa=t&source=web&rct=j&url=https://pdfs.semanticscholar.org/8c41/d2c2291d95a85d6069895bd49ec7d0ffb19c.pdf&ved=2ahUKEwiwrKLzxYPlAhXFup4KHexYAFUQFjARegQICBAB&usg=AOvVaw21LmeNc4IXOcwMlfx8gAac&cshid=1570225194695[35] Paul of Aegina (ca 625‐690 AD): an early description of a rare basal cell carcinoma of the breast[36] A medieval description of metastatic breast cancer; from Avicenna's view point.[37] http://A medieval description of metastatic breast cancer; from Avicenna's view point. The Breast Volume 31, February 2017, Pages 20-21[38] Historical Cancer Highlights[39] Paleo-oncology Research Organization (PRO)[40] The history of cancer in the College collections[41] http://iatromechanics [42] Early History of Cancer | American Cancer Society[43] http://www.bordet.be/en/presentation/history/cancer_e/cancer1.htm[44] Bone metastases in soft tissue sarcoma: a survey of natural history, prognostic value and treatment options[45] Understanding the Progression of Bone Metastases to Identify Novel Therapeutic Targets[46] http://Moss, Ralph W. (2004). "Galen on Cancer". CancerDecisions. [47] Soft Tissue Tumors in Palaeopathology: A Review[48] Cancer is an ancient disease: the case for better palaeoepidemiological and molecular studies[49] Cancer is an ancient disease: the case for better palaeoepidemiological and molecular studies[50] THE PROBLEM OF CANCER IN ANTIQUITY : BRIEF REVIEW OF 94 CASES[51] The Development and Causes of Cancer[52] https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.researchgate.net/publication/6998168_Malignant_tumors_in_two_ancient_populations_An_approach_to_historical_tumor_epidemiology&ved=2ahUKEwjuxcDPtIHlAhWW_J4KHUIbCNsQFjACegQIBRAB&usg=AOvVaw1GlmCxqb7H9ouB3SL78nP7[53] http://(Nerlich, A. G., Rohrbach, H., Bachmeier, B. & Zink, A. Malignant tumors in two ancient populations: An approach to historical tumor epidemiology. Oncol. Rep. 16, 197–202 (2006).[54] http://(Capasso, L. L. Antiquity of cancer. Int. J. Cancer 113, 2–13 (2005

Vivek Hallegere Murthy (Kannada: ವಿವೇಕ ಹಲ್ಲೆಗೆರೆ ಮೂರ್ತಿ, born July 10, 1977) is an American physician and former vice admiral in the Public Health Service Commissioned Corps who served as the nineteenth Surgeon General of the United States.Murthy, who founded the nonprofit Doctors for America in 2008, was the first Surgeon General of Indian descent and was the youngest active duty flag officer in federal uniformed service while serving in office.On November 9, 2020, President-elect of the United States Joe Biden announced that Murthy would co-chair his COVID-19 Advisory Board, alongside former Food and Drug Administration commissioner David A. Kessler and Yale public health professor Marcella Nunez-Smith.On December 3, Politico reported that Murthy would return to the role of Surgeon General in the Biden administration.On December 7, President-elect of the United States Joe Biden announced Murthy would be his nominee for Surgeon General of the United States.Murthy was born in Huddersfield, Yorkshire to immigrants from Karnataka, India. In 1978 the family crossed the Atlantic to Newfoundland, where his father worked as a District Medical Officer. When he was three years old, the family relocated to Miami, and his parents established their medical practice.Murthy was raised and completed his early education in Miami, graduating as valedictorian from Miami Palmetto Senior High School in 1994.He then attended college at Harvard University and graduated magna cum laude in 1997 with a bachelor of arts in biochemical sciences.In 2003, Murthy earned an MD from Yale School of Medicine and an MBA from Yale School of Management, where he was a recipient of The Paul & Daisy Soros Fellowships for New Americans

Written in honor of those who have fought until their last breath, those fighting the good fight daily and those who won.Cancer, one of the world’s leading causes of death today, remains almost absent relative to other pathological conditions, in the archaeological record, giving rise to the conclusion that the disease is mainly a product of modern living and increased longevity. Few ancient skeletons bear evidence of cancer, but this may be because the victims died rapidly, before the disease could leave a mark on their bones. Recent finds indicate that the disease existed, and may even have been common, in antiquity.Human beings and other animals have had cancer throughout recorded history. So it’s no surprise that from the dawn of history people have written about cancer. Some of the earliest evidence of cancer is found among fossilized bone tumors, human mummies in ancient Egypt, and ancient manuscripts. Bony skull destruction as seen in cancer of the head and neck have been found, as well.This micro-CT image shows a tumor in an ancient toe bone from a human relative.PHOTOGRAPH BY PATRICK RANDOLPH-QUINNEY, UCLAN (Earliest Human Cancer Found in 1.7-Million-Year-Old Bone).In 2016, using 3-D imaging, researchers have diagnosed an aggressive type of cancer called osteosarcoma in a foot bone belonging to a human relative who died in Swartkrans Cave between 1.6 and 1.8 million years ago. The discovery—which has just been published in the South African Journal of Science—suggests that, while modern lifestyles have increased the incidences of cancer, especially in industrialized countries, the triggers for the disease are embedded deep within the human evolutionary past.An international team discovered the world's oldest known cases of breast cancer and multiple myeloma (a type of bone marrow cancer) (Ancient History: Two Mummies Discovered With Cancer). The discoveries were made by conducting CT scans of two mummies found in the pharaonic necropolis of Qubbet el-Hawa in Aswan, Egypt.The earliest known case of cancer has been identified in the skeleton of a Siberian Bronze Age man. The 4,500-year-old bones have significant marks and holes, alerting researchers to the devastating lung or prostate cancer that the ancient man had endured. This new evidence of the illness in ancient bones demonstrates that cancer is not only a modern phenomenon, but also affected the ancient world (Researchers find oldest known case of cancer in 4,500-year-old remains of Siberian man).Researchers claim this is one of — if not the oldest — absolute cases of cancer in antiquity. Previous cases of cancer have been detected in remains up to 6,000 years old, but those remained unconfirmed or with tumors that were benign.4,500 year old bones of Siberian man reveal he died of cancer. Researchers have found what may be the oldest case of human cancer in the world. Credit: Angela R. Lieverse et al. (Researchers find oldest known case of cancer in 4,500-year-old remains of Siberian man).The remains of the man, dating from the Early Bronze Age, show he was 35 to 45 years of age at the time of his death. He had suffered from a cancer which spread throughout his body, the deterioration of his bones leaving him immobile. It was almost certain that those around him would have recognized he was ill.The first reference to the presence of a malignant tumor in Poland dates back as early as the Neolithic Period (4000-2000 BC). (The treatment of cancer in Greek antiquity).Plates vi & vii of the Edwin Smith Papyrus at the Rare Book Room, New York Academy of Medicine.Thee earliest records of suspected cancer in the ancient world are documented in the Egyptian Ebers and Edwin Smith papyri. Both date to the early Eighteenth Dynasty (1550–1504 BC), but are most likely copies of earlier medical treatises from the Old Kingdom (c. 2600–2190 BC). The Edwin Smith Papyrus (3000 BC) is a copy of part of an ancient Egyptian textbook on trauma surgery (A note from history: Landmarks in history of cancer, part 1). It describes 8 cases of tumors or ulcers of the breast that were removed by cauterization with a tool called the fire drill. The writing says about the disease, “There is no treatment.”One particularly gruesome remedy for what may have been cancer of the uterus states: “Break up a stone in water, leave it overnight, and then pour it into the vagina” (Ebers Papyrus - Wikipedia). Another treatment described was fumigation: “The patient would sit over something that was burning. Still, it's not certain that any of the maladies described were actually cancer” (How the ancient world dealt with cancer).The 3,200-year-old skeleton was found in its original burial position in a tomb close to the River Nile in the Amara West site, Sudan (British Museum ) (Oldest example of human cancer found on 3,000-year-old skeleton).A male, young-adult individual from the archaeological site of Amara West in northern Sudan (c. 1200BC) displayed multiple, mainly osteolytic, lesions on the vertebrae, ribs, sternum, clavicles, scapulae, pelvis, and humeral and femoral heads (Ancient Oncology - Archaeology Magazine).Ancient Oncology - Archaeology MagazineFollowing radiographic, microscopic and scanning electron microscopic (SEM) imaging of the lesions, and a consideration of differential diagnoses, a diagnosis of metastatic carcinoma secondary to an unknown soft tissue cancer was suggested. This represents the earliest complete example in the world of a human who suffered metastatic cancer to date (On the Antiquity of Cancer: Evidence for Metastatic Carcinoma in a Young Man from Ancient Nubia (c. 1200BC).The Greek scholar, Herodotus, later described a case of breast cancer in Persia that occurred around 520 BC (Atossa - Wikipedia). Herodotus records in The Histories that Atossa was troubled by a bleeding lump in her breast. She wrapped herself in sheets and sought a self-imposed quarantine. Ultimately, a Greek slave, Democedes, persuaded her to allow him to excise the tumor (Mukherjee, The Emperor of All Maladies, p.41. See Herodotus, The Histories, OUP, 1998, pt. VIII).Other ancient scholars, such as Hippocrates, Aetius, Celsus, Dioscorides, Galen, and Paul of Aegina all wrote small treatises on cancer, containing information ranging from suspected causes of cancer to treatment and prevention strategies. The medical works of these early physicians date from the third century BC to the seventh century ADThe origin of the word cancer is credited to the Greek physician Hippocrates (460-370 BC), who is considered the “Father of Medicine.” Hippocrates used the terms carcinos and carcinoma to describe non-ulcer forming and ulcer-forming tumors (What Ancient Greek Physicians Knew About Cancer). In Greek, these words refer to a crab, most likely applied to the disease because the finger-like spreading projections from a cancer called to mind the shape of a crab.Hippocrates was the first to publicly dispel the notion that diseases were caused by supernatural elements. Although his understanding of anatomy and physiology was limited, Hippocrates’ detailed descriptions of medical symptoms included observable diagnostic features indicative of some types of cancer (Hippocrates - Wikipedia). In addition to Hippocrates’ contribution to diagnostic methods, the Hippocratic Oath, a code of medical ethics, is still taken by medical practitioners to this day.Following Hippocrates’ method for medical observation, ancient physicians made attempts to understand the causes of tumors, swellings, and other abnormal growths by conducting their own research through trial and error.Greek physician, Galen, believed that ‘residues of black bile formed in the liver during hematosis’, and an excess of black bile (one of the four humors, or bodily substances) resulted in the development of cancer (Evolution of Cancer Treatments: Surgery | American Cancer Society). He believed that black bile was created when the liver was weak, and during this process the spleen attracted a large amount of thick black blood. This blood would accumulate in the veins and manifest in the formation of a tumor with projections like the legs of a crab. It is from this description of malignant tumors that malignant neoplastic disease was named after the Latin word for crab, cancer. Later physicians, who largely adopted the concept of humoral imbalance as a cause of disease, adhered to Galen’s philosophy of cancer until the dark ages.A text in the Hippocratic tradition, ascribed to an unidentified author, suggested that breast cancer was linked to the absence of menstruation after menopause (Menopause and Cancer Risk). According to this text, blood that normally flowed free every month stagnated in the body, and migrated to the breast tissue. Stagnated blood was often interpreted as black bile. This account indicates that Hippocratic physicians were aware that breast cancer, much like today, occurred in older women more often than younger women.Ancient Greeks knew that a mastectomy would help a patient with a lump in her breast, but they also recognized that cancer can recur and spread to other parts of the body (The history of breast cancer treatment, from ancient times onward). They recommended an unbelievable variety of potions, and plant extracts, and combinations to see if they couldn't kill the cancer in other places. None of those worked. It appears that the Greeks had a better knowledge and awareness of cancer than their predecessors, which is a more likely explanation than an increase in cancer (THE PROBLEM OF CANCER IN ANTIQUITY : BRIEF REVIEW OF 94 CASES).The Roman physician, Celsus (28-50 BC), later translated the Greek term into cancer, the Latin word for crab. Galen (130-200 AD), another Greek physician, used the word oncos (Greek for swelling) to describe tumors. (Evolution of Cancer Treatments: Surgery | American Cancer Society). Although the crab analogy of Hippocrates and Celsus is still used to describe malignant tumors, Galen’s term is now used as a part of the name for cancer specialists – oncologists.12th-century manuscript of the Canon, kept at the Azerbaijan National Academy of Sciences (Avicenna - Wikipedia).Avicenna (980–1037AD), a prominent Islamic physician of Persian origin, gave a detailed description of cancer symptoms, and treatments and prevention strategies in his work Canon of Medicine, which continued to be an authoritative medical reference until the late eighteenth century (A medieval description of metastatic breast cancer; from Avicenna's view point). He detailed a case of breast cancer and metastatic conditions, which his is considered a very early report of metastatic or stage IV breast cancer ( A medieval description of metastatic breast cancer; from Avicenna's view point. The Breast Volume 31, February 2017, Pages 20-21). He underlined that cancer should be diagnosed and cured in the early stages. With views of Avicenna, cancer is an atrabilious (black bile) swelling (tumor) which sometimes may be accompanied by pain or swelling. He also mentioned that some vessels may be appeared around the cancerous part.Although these literary works are important sources of information on the history of cancer, they should be consulted within the context of the medical philosophies of the time and region (Paleo-oncology Research Organization (PRO) | A Brief History of Cancer). From about A.D. 500 to 1500 there was little advancement in understanding. Then, in the 17th century, Wilhelm Fabricus (also William Fabry, Guilelmus Fabricius Hildanus, or Fabricius von Hilden) (June 25, 1560 − February 15, 1634), often called the "Father of German surgery", was the first educated and scientific German surgeon. He is one of the most prominent scholars in the iatromechanics school (Iatrophysics - Wikipedia) and author of 20 medical books. His Observationum et Curationum Chirurgicarum Centuriae, published posthumously in 1641, is the best collection of case records of the century and gives clear insight into the variety and methods of his surgical practice. He detailed operations for breast and other cancers (Wilhelm Fabry - Wikipedia).Cancer begins when cells in a part of the body start to grow out of control. There are many kinds of cancer, but they all start because of out-of-control growth of abnormal cells. Cancer is the second leading cause of death in the United States. About one-third of all people in the US will develop cancer during their lifetimes (Early History of Cancer | American Cancer Society). Today, millions of people are living with cancer or have had cancer.The general opinion about the occurrence of malignant tumors in antiquity was that they were nonexistent or extremely rare. Paleooncologists still strongly disagree about the prevalence of cancer in the past, sometimes almost reaching the point of denying their existence, other times admitting a very low prevalence compared to the present. Therefore, cancer seems to have been rare in the past and the calculated prevalence might be either real or it might only reflect an underdetection of cancer.Some of the reasons given as an explanation for the rarity of cancer in antiquity are as follows (History of cancer - Wikipedia): 1) the average life span was shorter (individuals died earlier and more frequently from injuries or infections rather than from a complication of the malignant tumor) ; 2) certain chemical substances or physical agents known to being cancer promoters were rare in the past ; 3) as far as primary soft tissue tumors are concerned, the tendency to spread to the bones is not always the same for all types of tumors ; 4) bone metastases appear first in the marrow cavity and the simple inspection of bones may fail to reveal inner growths which might instead become apparent, were recovered bones sistematically radiographed ; 5) malignant tumors might have been scarcely reported in older literature also because anthropologists in charge, being not medically trained, simply did not look for tumors.Unfortunately, direct diagnosis of malignant soft tissue tumors is exceptional in paleopathology. In fact, with the exception of primary bone tumors (which for that matter are rare in modern medical records as much as they are in archeological specimens), the diagnosis is generally indirect, through osseous destruction by metastases. Studying tumour palaeoepidemiology is uniquely challenging. A recent meta-analysis of all published palaeopathological studies of Egyptian mummies demonstrated how diagnostic uncertainty was a general problem in palaeopathological research and explained why clinical standards of diagnostic sensitivity and specificity were rarely applied (Cancer is an ancient disease: the case for better palaeoepidemiological and molecular studies).More than 176 confirmed malignancies have documented in the archaeological record providing ample evidence that cancer is an ancient natural phenomenon and is not solely a by-product of carcinogens that are abundant in today's industrial society (Cancer is an ancient disease: the case for better palaeoepidemiological and molecular studies).In their review, (THE PROBLEM OF CANCER IN ANTIQUITY : BRIEF REVIEW OF 94 CASES), Susanna Gamba and Gino Fornaciari documented that most cases of cancer are concentrated in the age range between 21 and 40 years, while modern medical records show that the highest incidence of cancer occurs beyond age 40 ; this might be explained by taking into consideration that the modern life span has expanded compared to the past. In addition, certain tumors have a tendency to develop and manifest themselves later in life, at an age when the same individual in the past might have already been dead from an infection or an injury.It can be argued that since life expectancy was lower in the ancient world, most people didn't live long enough to develop cancer.But the lack of evidence of childhood bone cancer suggests that perhaps overall rates were lower as well.Recently, more carefully designed and methodologically sound palaeoepidemiological studies show that malignant tumours in the past were as prevalent as in modern populations. A recent study by Nerlich et al. examined the preserved skeletal remains of 905 individuals from two major ancient Egyptian necropolises spanning 3,200–500 BCE and also those of 2,547 individuals in ancient Germany dating back to 1400–1800 CE. This study established the presence of malignant tumours in spatially and temporarily different populations over the past 4,000 years with an age- and gender-adjusted frequency (Nerlich, A. G., Rohrbach, H., Bachmeier, B. & Zink, A. Malignant tumors in two ancient populations: An approach to historical tumor epidemiology. Oncol. Rep. 16, 197–202 (2006).Evidence from several studies indicate that distinct types of malignant tumours such as multiple myeloma and nasopharyngeal carcinoma occurred at rates that are much higher than those in modern populations (Capasso, L. L. Antiquity of cancer. Int. J. Cancer 113, 2–13 (2005).In summary, cancer is an ancient disease and is not 'man-made'. There is strong evidence from palaeoepidemiological studies that cancer was at least as prevalent in ancient human populations as it is in our modern societies. More studies designed specifically to establish the epidemiology of cancer in ancient populations are needed to corroborate these findings.