First recorded cases
The oldest description of cancer was in ancient Egypt and is found in the Edwin Smith Papyrus, the world’s oldest known surgical document, which dates to 1600 BCE. It describes eight cases of tumors or ulcers of the breast that were removed by cauterization with a tool called a ‘fire-stick.’ The writing says about the disease, “There is no treatment.”
Origin of the word
Hippocrates (460‐360 BCE), the father of medicine, used karkinos (Greek for crab) to describe ulcerating and non‐healing lumps and karkinoma for malignant tumors. Hippocrates believed that an imbalance of the main four body fluids or humors (blood, phlegm, yellow, and black bile) caused diseases. The Roman physician Celsus (28-50 BCE) later translated the Greek term into cancer, the Latin word for crab.
The dawn of surgery
By the 17th century, German surgeon Wilhelm Fabricius was publishing accounts of extensive operations on cancers. Over the next 200 years, a clinical approach became increasingly standard. By the 19th century, surgery, disinfection, and sterilization had become commonplace. The advent of anesthesia for surgery enabled surgeons like William Halsted to carry out increasingly radical surgeries, such as mastectomies, to prevent spreading.
Under the microscope
Microscopic study of tumors also provided deepening understanding of the nature of cancer. Scientists like Johannes Müller (1801–1858) and Robert Remak (1815–1865) noted that cancers were composed of particular types of cells and that metastasis was due to the spread of these cells. The genetic basis of cancer was recognized in 1902 by German zoologist Theodor Boveri, professor of zoology at Munich.
In November 1895, Wilhelm Röntgen discovered X-rays. It was found that the radiation caused by these rays could treat skin conditions and by the turn of the century, X-rays were used to treat cancers, but the side-effects could also cause cancer. Over the next century, advances in computers and radiation physics enabled small tumors to be accurately mapped and then precisely targeted with radiation beams.
The 20th century also saw the emergence of anti-cancer drugs, or chemotherapy. During the Second World War, the US Army discovered that nitrogen mustard – a poison used in WW1 – was effective in treating cancer of the lymph nodes (lymphoma). This served as the model for the cancer chemotherapy drugs that are generally based on the fact that tumor cells divide much faster than other cells in the body.
Surgery, radiation, and chemotherapy remain the principle weapons, but increasing knowledge of the molecular drivers are also providing insight. Genome editing and immunotherapy also hold promise of new individual treatments.
Researchers are seeking new ways to investigate medical and non-medical data to spot patterns which could detect cancer earlier. “Big data has long been a reality in medical practice,” says Jörg Lippert, head of the Department of Clinical Pharmacometry at Bayer. Researchers at the company are using cellular data, patient data, and population data to gain greater insights. The data of a single cancer cell are searched for patterns that suggest genetic biomarkers to better predict how individual tumors mutate and which drug treatment could be most effective based on a patient’s medical history and DNA.
Three significant initiatives
Three projects are enabling European researchers to pursue a collaborative approach. Public-private projects, such as the Innovative Medicines Initiative in Europe, are speeding up the development process and pooling various expertise. The Project Data Sphere Initiative enables historical cancer research data to be shared, integrated and analyzed. DREAM Challenges is an open science project that uses crowdsourcing and transparent data-sharing tools to evaluate existing analytical tools, suggest ways to improve them, and develop new solutions.
All these different modern approaches are helping to ensure that oncologists can one day offer each patient a tailored drug therapy that attacks their specific cancer cells and reduces the risk of serious side effects.