Hippocrates was the first to use the word cancer (from the term carcinos, which in Greek mythology was a giant crab). Around the year 400 BC, the considered father of Medicine defined it as “a hard subcutaneous mass like a crab shell”, hence the name he coined. Two millennia before, this group of diseases that we call cancer was already known by the ancient Egyptians, who called it aat (tumor) and They considered it incurable. However, analysis of a skull from more than 4,300 years ago suggests they also attempted to treat it.
These are the remains of a man who suffered from cancer and died when he was about 30 years old. His skull was found at the beginning of the 20th century in the Egyptian necropolis of Giza and is preserved at the University of Cambridge, in the United Kingdom, so it was analyzed again within the framework of research on the evolution of cancer in history. by Tatiana Tondini, researcher at the University of Tübingen, and by the Spanish Edgard Camaros, archaeologist and paleopathologist, and Albert Isidro, oncologist. His conclusions are published this Wednesday in the magazine Frontiers in Medicine.
As Edgard Camarós, who is currently a researcher at the University of Santiago de Compostela and until a year ago was at the University of Cambridge, explains in a telephone interview, “Egyptian medicine was one of the most advanced and sophisticated that has existed in ancient times. They treated many ailments, not only with medications but also with surgical interventions. They performed amputations, dental interventions and placed wooden prostheses, for example, after amputating the big toe due to an infection. It was so advanced that It not only sought to cure the patient but also to improve their quality of life.. And we know all this thanks to human remains, sculptures, hieroglyphs and specific papyri.”
Specifically, he mentions the Edwin Smith Papyrus, dating back to 1600 BC “This is a compilation of 48 cases in which the case is described, a diagnosis and treatment are suggested. That is, the interesting thing is that For 3,600 years now, the observation-diagnosis-treatment scheme has been followedwhich is something very modern,” he reviews.
Case number 48, he continues, “describes breast cancer, and the interesting thing is that when talking about the treatment he says that there is no treatment, that it is an incurable disease. Despite having very advanced medicine, cancer was at the frontier of their knowledge.
The new research is based on two skulls preserved in the Duckworth Collection at the University of Cambridge, both belonging to two individuals who suffered from cancer. The skull of the man who died when he was about 30 years old, between approximately 2687 BC and 2,345 BC, and that of a woman over 50, with an estimated chronology of between 663 BC and 343 BC
As Edgard Camarós details, The man suffered from nasopharyngeal carcinoma, a type of cancer that appears in the nasopharynx, at the base of the skull. “That was the primary tumor that advanced in such a way that it metastasized. His skull has some cut marks on the metastasis, an oncological intervention. But it must be clarified that these marks, which are like incisions, could have occurred in two scenarios. No We can distinguish whether they were done days before his death, or a few hours after his death. If they did it while he was alive, it was an intervention linked to the treatment, and if they did it once he died, it was more of an exploratory type, to investigate the tumors. with the aim of understanding them to treat them,” suggests the scientist.
“The marks around two of the injuries are perimortem, That is, they indicate the actions of a person while they were alive or very shortly after death, when the bone is surrounded by soft tissues and still has the capacity to respond. Therefore, we can consider it as an attempt at treatment, we do not know if to try to save his life, or together with the magical rituals that were also performed by people who practiced medicine in Ancient Egypt”says Albert Isidro, who in addition to being head of the Locomotor Tumor Unit at the Sagrat Cor University Hospital, has been investigating cancerous lesions in archaeological remains, mainly in mummified remains, for three decades.
“In the 12 years I have been going to Egypt, I have never seen marks like these on human remains,” says Isidro in a telephone conversation, who is also president of the Catalan Society of Paleopathology and next month will present at the Congress of Bone Tumors in Poland an investigation on 16 individuals from Ancient Egypt who suffered from cancer and who were found on Spanish expeditions.
Regarding the type of tumor that this man had, this specialist states that “Nasopharyngeal cancer was the most common cancer in Ancient Egypt, and it has been quite common in that country in all periods due to the aspiration of sand, dirt and smoke, which cause continuous irritation that causes the nasopharyngeal mucosa to react, make mistakes and mutate, forming cancer. What is not so common is that it causes metastases in the rest of the skull, as happened with this man who, due to the destruction that occurs in him, must have lived for a long time with the cancer.” In Spain, this cancer is not very prevalent in the current population because it is also usually detected quickly.
Currently, this oncologist adds, “the most common cancer in Egypt is lung cancer because they smoke a lot.”
According to Alberto Isidro, this would be the oldest published evidence of an attempted cancer treatment, but he is cautious because he does not rule out that there may have been older attempts to treat or manipulate a cancerous lesion in Sumeria, or even in the predynastic periods. Chinese.
The frontier of knowledge
Regarding the second skull analyzed in the study published in Frontiers in Medicine, It belonged to a woman who died when she was over 50 years old, so in Ancient Egypt she was already an old woman. Two types of cancer are considered that she could have suffered: “He could have had sarcoma-type bone cancer, but I’m leaning towards meningosarcoma, a malignant lesion of the meninges that causes the bone to form a kind of crater because it protrudes outwards. It is very rare,” says Albert Isidro.
The case of this woman, highlights the oncologist, “is striking becausesurvived a very severe injury due to violence which was probably made with a sword or knife, at least a year before his death. He actually has two traumatic injuries. And something like this had not been seen in the same individual, that trauma and then the injury caused by the tumor.”
“It is a different case that allows us to understand that frontier of knowledge that existed in Ancient Egypt,” explains Edgard Camarós. “On the left side of the skull there is a craniocerebral fracture that was treated successfully, otherwise he would have died. In paleopathology we link this attack with interpersonal violence, it is usually related to war contexts but knowing the framework of that violence is more complex,” admits. What they do know is that “care was applied, the bone plate was replaced, which healed him and he was able to survive for several years. Years later he developed a massive tumor that caused his death.”
For this reason, he adds, “this skull allows us to demonstrate how Egyptian medicine was advanced enough to treat a very complex skull fracture but When cancer arrives there is no cure nor is there treatment because cancer treatment is something very modern and we continue working on it. In fact, he emphasizes, “the common denominator of what we call cancer is that it is a genetic and cellular disease but there are many diseases.”
What they should have, according to Isidro, “were palliative analgesics to relieve pain based on plants and the bark of various trees, which they crushed.
Social class
Because the skulls were transferred to the United Kingdom at a time when excavations were carried out without taking into account the context of the excavation as is done today, they only have these remains so they do not have direct information about who the skulls were. deceased or to what social class they belonged. However, the analysis of the skulls does provide information. In the case of the 30-year-old man, he reveals that “His dental health was very good, and his diet was not very abrasive., so it could be a good and rich diet compared to lower strata. Furthermore, taking into account that they had received differential care or some type of treatment, and he was buried in Giza, which was a very important necropolis, with emblematic funerary monuments, we can think that he belonged to a social class that was not low.”
The woman’s teeth also suggest that He belonged to a wealthy class. “If we had the rest of the body we could clarify the age much more and know many more things,” says Camarós.
FROM TURTLES TO HUMANS
The paleoanthropologist Miguel Botelladirector of the Anthropology laboratory at the University of Granada and member of the team of Egyptologists excavating Qubbet el Hawa, discovered in Aswan, southern Egypt, the first evidence of breast cancer in Ancient Egypt in a mummy of a woman who died around 2200 BC According to Albert Isidro, older cases of cancer have been discovered in Ancient Egypt which they will present at the Polish congress in mid-June.
As Edgard Camarós highlights, “cancer has been in the history of humanity since day zero, since it has also been found in hominids from almost two million years ago.” “If we do not see more cases in archaeological remains it is because the further we go back in time, the fewer fossilized remains we find, and furthermore, “There are many cancers that do not leave a mark on the bones.”Albert Isidro agrees.
If we go further back in time, “The oldest cancer known so far is a turtle from about 320 million years ago. And it has also been found in many dinosaurs, in many extinct mammals,” says Albert Isidro, who states that “the capacity of mutation to cause cancer is inherent to the complexity of life. “Organisms like jellyfish and the simplest beings are those that do not have cancer because their cells only have one function and cannot make mistakes, as happens with other living beings and with humans.”
If there are more cases of cancer today, the oncologist adds, it is due to environmental issues and survival: “In Ancient Egypt, people used to live to be about 35 or 50 years old, and now they play tennis at 85 years old, which means that doubles the capacity for any organ to make a mistake,” he says.