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Authors: George Johnson
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like other Greek writers, uses the word
therioma,
“wild beast,” to mean malignant. “The early cancer we have cured, but the one that rose to considerable size, without surgery, nobody has cured.”
The medieval surgeon Abu al-Qasim al-Zahrawi was no luckier: “When a cancer has lasted long and is large, you should not come near it. I have never been able to save any case of this kind, nor have I seen anyone else who has been successful.”
It is not so different now.
There is something comforting about knowing that cancer has always been with us, that it is not all our fault, that you can take every precaution and still something in the genetic coils can become unsprung. Usually it takes decades for the micro damage to accumulate—77 percent of cancer isdiagnosed in people fifty-five or older. With life spans in past centurieshovering around thirty or forty years, finding cancer in the fossil record is like sighting a rare bird. People would have died first of something else. Yet in spite of the odds, cases continue to be discovered, some documented so vividly that you can almost imagine the ruined lives.
After my visit to London I received from theNatural History Museum photographs oftheSaxon skeleton whose tumorous femur I had hoped to examine. I had read that the growth was large—10 inches vertically by 11 inches horizontally—but I was astonished to see what looked like a basketball grafted onto the young man’s leg. The tumor shows a sunburst pattern that pathologists recognize asa sign ofosteosarcoma. They see it most often inadolescents whose limbs are undergoing hormone-induced spurts of growth—more evidence for one ofcancer’s few established rules: The more frequently cells are dividing, the more likelymutations will occur. The right combination willlead to a malignancy. Osteosarcoma is so rare that one would have tocomb through the bones of tens of thousands of people to find a single example. Yet ancient cases continue to turn up.
There were signs of thecancer in anIron Age man in Switzerland and a fifth-century Visigoth from Spain. An osteosarcoma froma medieval cemetery in the Black Forest Mountains of southernGermany destroyed the top of a young child’s leg and ate into the hip joint. Bony growths inside the roof of the eye sockets indicatedanemia, which may have been an effect of the cancer. The authors of the report speculated on the cause: contamination from a nearby lead and silver mine. Cancer is especially hard to acceptin children, even in one from nine centuries ago, and the paper ended with a poignant note: “The tumour would certainly lead the childto die a painful death.” Though child mortality was very high in those days, the authors noted, children who made it past the first few years might live into their forties. But not this time. “The flame of life in the affected child was extinguished just when the child had survived the first years of infant excess mortality.”
Maybe it helped to believe there was a reason—metallic poisoning from a mine. But no one knows what causes osteosarcoma. Then, as now, a few cases probably were hereditary, traced to chromosomal abnormalities. In modern times speculation turned for a while tofluoride-treated water and, more plausibly,radiation—therapeutic treatments for other disease or exposure to radioactive isotopes likestrontium-90, which is spread bynuclear fallout. Strontium sits just below calcium in the periodic table of elements and imitates its behavior, incorporating itself tightly into bone. But most often osteosarcoma strikes for no apparent reason, leaving parents grasping to understand what remains as inexplicable as a meteor strike.
Another malignancy,nasopharyngeal carcinoma, which affects the mucous membrane in the nose, can scar adjacent bone, and signs of it have been found in skeletons fromancient Egypt. One woman’s face had been all but obliterated, and I tried to imagine her stumbling through life. “The large
therioma,
“wild beast,” to mean malignant. “The early cancer we have cured, but the one that rose to considerable size, without surgery, nobody has cured.”
The medieval surgeon Abu al-Qasim al-Zahrawi was no luckier: “When a cancer has lasted long and is large, you should not come near it. I have never been able to save any case of this kind, nor have I seen anyone else who has been successful.”
It is not so different now.
There is something comforting about knowing that cancer has always been with us, that it is not all our fault, that you can take every precaution and still something in the genetic coils can become unsprung. Usually it takes decades for the micro damage to accumulate—77 percent of cancer isdiagnosed in people fifty-five or older. With life spans in past centurieshovering around thirty or forty years, finding cancer in the fossil record is like sighting a rare bird. People would have died first of something else. Yet in spite of the odds, cases continue to be discovered, some documented so vividly that you can almost imagine the ruined lives.
After my visit to London I received from theNatural History Museum photographs oftheSaxon skeleton whose tumorous femur I had hoped to examine. I had read that the growth was large—10 inches vertically by 11 inches horizontally—but I was astonished to see what looked like a basketball grafted onto the young man’s leg. The tumor shows a sunburst pattern that pathologists recognize asa sign ofosteosarcoma. They see it most often inadolescents whose limbs are undergoing hormone-induced spurts of growth—more evidence for one ofcancer’s few established rules: The more frequently cells are dividing, the more likelymutations will occur. The right combination willlead to a malignancy. Osteosarcoma is so rare that one would have tocomb through the bones of tens of thousands of people to find a single example. Yet ancient cases continue to turn up.
There were signs of thecancer in anIron Age man in Switzerland and a fifth-century Visigoth from Spain. An osteosarcoma froma medieval cemetery in the Black Forest Mountains of southernGermany destroyed the top of a young child’s leg and ate into the hip joint. Bony growths inside the roof of the eye sockets indicatedanemia, which may have been an effect of the cancer. The authors of the report speculated on the cause: contamination from a nearby lead and silver mine. Cancer is especially hard to acceptin children, even in one from nine centuries ago, and the paper ended with a poignant note: “The tumour would certainly lead the childto die a painful death.” Though child mortality was very high in those days, the authors noted, children who made it past the first few years might live into their forties. But not this time. “The flame of life in the affected child was extinguished just when the child had survived the first years of infant excess mortality.”
Maybe it helped to believe there was a reason—metallic poisoning from a mine. But no one knows what causes osteosarcoma. Then, as now, a few cases probably were hereditary, traced to chromosomal abnormalities. In modern times speculation turned for a while tofluoride-treated water and, more plausibly,radiation—therapeutic treatments for other disease or exposure to radioactive isotopes likestrontium-90, which is spread bynuclear fallout. Strontium sits just below calcium in the periodic table of elements and imitates its behavior, incorporating itself tightly into bone. But most often osteosarcoma strikes for no apparent reason, leaving parents grasping to understand what remains as inexplicable as a meteor strike.
Another malignancy,nasopharyngeal carcinoma, which affects the mucous membrane in the nose, can scar adjacent bone, and signs of it have been found in skeletons fromancient Egypt. One woman’s face had been all but obliterated, and I tried to imagine her stumbling through life. “The large
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