The history of cancer
Cancer has plagued humankind from our very beginnings. A short history now from Jane Pauley:
When life began, so did cancer.
Prehistoric animals had cancer, said physician and scientist Siddhartha Mukherjee. "In humans, you can find signs of cancer in ancient specimens," he said.
Mukherjee calls cancer "The Emperor of All Maladies" in his Pulitzer Prize-winning history of the disease. Around 400 B.C., Hippocrates, the Greek physician known as the father of medicine, is said to have first given it a name: karkinos.
Why that word? "The word comes from crab, and there was something about tumors as they sent their fingers or fingerlings into the body that looked like the legs of a crab that had dug underneath the sand," Mukherjee said.
But the earliest reference to cancer can be found about a thousand years earlier, on an ancient Egyptian papyrus.
As for treatment, it says, "There is none."
In fact, it was not until the arrival of anesthesia in the mid-19th century that surgery became a viable option. "Who would've thought that you could open up a human being, take out an ovary that may have been involved with cancer, and sew that human being up again, and they will come back to life?" Mukherjee said. "That was an amazing advancement."
Mukherjee, who conducts research and treats patients at New York's Columbia University Medical Center, says that by the beginning of the 20th century, X-ray technology would give rise to the very earliest form of radiation treatment.
The use of toxic chemicals to kill cancer cells -- what's commonly called chemotherapy -- was a 1940s development.
"The dream was to invent a chemical that would kill the cancer cell but spare the normal cell," Mukherjee said. "The problem is that cancers evolve out of normal cells. They are very close cousins."
Still, given that potential therapies were often as fearsome as the disease itself, a cancer diagnosis came to be cloaked in secrecy, even shame.
"When my mother was surviving cancer, it was literally unspeakable," Pauley said. "What changed that?"
"You couldn't shove it under the carpet anymore," Mukherjee replied. "We saw our children dying from it. We saw our parents dying from it. It had to be a public word, because otherwise we couldn't have a conversation. How can there be a war on something you can't name?"
Which brings us to 1971, when President Richard Nixon did in fact declare "war" on cancer.
"The war on cancer grew out of a particular optimism around cancer in the late 1960s, early 1970s. Remember that human beings had just walked on the moon. Why don't we cure cancer in ten years? It was thought very doable."
It turns out that optimism was premature. Key was the realization that a patient's genes could in effect be calling the shots.
"What tells a cell to stop growing or start growing in the first place?" said Mukherjee. "The idea that sitting at the center of the puzzle was genes, that was a huge leap because all of a sudden you had a framework to understand cancer."
Once researchers began to understand cancer's mechanism, more clues started to fall into place. And the human genome project, completed in 2003, led to the development of still more treatments -- among them, individually-targeted immunotherapy techniques.
Pauley asked, "Where are we in the timeline and arc?"
"The problem remains, how do you target, how do you kill the cancer cell while sparing normal cells?" Mukherjee replied. "That was a puzzle in 1920. It was a puzzle in 1970. It's a puzzle in 2017."
"But you have more tools now."
"Many, many more tools."
For more info:
- "The Emperor of All Maladies: A History of Cancer" by Siddhartha Mukherjee (Scribner); Also available in eBook and Digital Audio Download formats
- siddharthamukherjee.com
- Dr. Siddhartha Mukherjee, New York-Presbyterian Hospital/Columbia University Medical Center
Herbert Irving Comprehensive Cancer Center, Columbia University