Today, carcinoma is the medical term for a malignant tumor derived from epithelial cells. It is Celsus who translated carcinos into the Latin cancer, also meaning crab. Galen used “oncos” to describe all tumours, the root for the modern word oncology.
Hippocrates described several kinds of cancers. He called benign tumours oncos, Greek for swelling, and malignant tumours carcinos, Greek for crab or crayfish. This strange choice of name probably comes from the appearance of the cut surface of a solid malignant tumour, with a roundish hard center surrounded by pointy projections, vaguely resembling the silhouette of a crab. He later added the suffix -oma, Greek for swelling, giving the name carcinoma. Since it was against Greek tradition to open the body, Hippocrates only described and made drawings of outwardly visible tumors on the skin, nose, and breasts. Treatment was based on the humor theory of four bodily fluids (black and yellow bile, blood, and phlegm). According to the patient’s humor, treatment consisted of diet, blood-letting, and/or laxatives. Through the centuries it was discovered that cancer could occur anywhere in the body, but humor-theory based treatment remained popular until the 19th century with the discovery of cells.
Though treatment remained the same, in the 16th and 17th centuries it became more acceptable for doctors to dissect bodies to discover the cause of death. The German professor Wilhelm Fabry believed that breast cancer was caused by a milk clot in a mammary duct. The Dutch professor Francois de la Boe Sylvius, a follower of Descartes, believed that all disease was the outcome of chemical processes, and that acidic lymph fluid was the cause of cancer. His contemporary Nicolaes Tulp believed that cancer was a poison that slowly spreads, and concluded that it was contagious.
With the widespread use of the microscope in the 18th century, it was discovered that the ‘cancer poison’ spread from the primary tumor through the lymph nodes to other sites (”metastasis”). The use of surgery to treat cancer had poor results due to problems with hygiene. The renowned Scottish surgeon Alexander Monro (1697-1767) saw only 2 breast tumor patients out of 60 surviving surgery for two years. In the 19th century, asepsis improved surgical hygiene and the survival statistics went up.
The idea that the body was made up of various tissues, that in turn were made up of millions of cells, laid rest the humor-theories about chemical imbalances in the body. The age of cellular pathology was born. The first cause of cancer was identified through the work of British surgeon Percivall Pott, who discovered in 1775 that cancer of the scrotum was a common disease among chimney sweeps. In the late 1800’s, William Coley discovered that the rate of cure after surgery had been higher in the 18th century than in his day, when antiseptics were used to prevent infection. This prompted him to develop a treatment based on injecting bacteria directly into a tumor. This elicited tumour shrinkage in some cases, probably by stimulating a non-specific immune reaction. Whilst Coley’s Toxins fell out of use, there is currently interest in utilisation of non-specific immunity in the treatment of some cancers.
When Marie Curie and Pierre Curie discovered radiation, the first effective non-surgical cancer treatment became popular. In the first half of the 20th century, studies led to the introduction of chemotherapy.
