How was cancer treated in ancient times?

How did the ancients treat cancer, which is extremely complicated even for today's medicine? In recent years, more and more scholars have studied the ancient ways of diagnosing and treating cancer.

The first foundation from Hippocrates

Medicine first mentioned cancer around 1600 BC. At that time, the term karkinoma was used to describe the incurable tumors, which arose in some patients. Hippocrates, the Greek physician known as the father of medicine (460 - 370 BC), was the first to observe and record these tumors and give them names.

Other doctors of the time believed in Hippocrates' humoral theory, which held that various diseases were caused by an excess of different amounts of bile. For Hippocrates and the doctors at the time, the cancer was caused by the patient's 'excessive amount of black bile'. Common treatments include blood transfusions, laxatives, or dietary changes. There is no evidence of any surgical technique to remove the tumor at this point in history.

From the theory of four types of bile in the body, ancient doctors believed that excess bile was the cause of cancer.

Going after Hippocrates, between 25 BC and 50 AD, Aulus Cornelius Celsus, a Roman physician and encyclopedist, appeared to have taken Hippocrates' term for this medical condition,' carcinoma' and translates into Latin as 'crab'. The name 'crab' remains today, and translates to 'cancer' in modern languages. Aulus Cornelius Celsus was the first to document the spread of cancer, even documenting how breast cancer could spread from the breast down to the armpit in some patients. He also classifies cancers differently based on their severity and physical characteristics. He describes finding cancers on all parts of the body, including the face, mouth, throat, breast, liver, colon, etc.

But it wasn't until a few decades after both Hippocrates and Celsus that advances in cancer treatment began to emerge. Archigenes, a Greco-Syrian physician in the 1st and 2nd centuries AD, was the first physician to attempt to surgically remove cancer on his patients. Oribasius, another doctor who described the surgery, stressed that an early diagnosis is essential and any nerves surrounding the tumor must be avoided. He also describes methods of burning the tumor to prevent recurrence, as well as post-operative treatment to prevent infection including the use of poultices, salt, leeks, and other astringents.

Treatment techniques

Claudius Galen, a Greek physician in the 2nd century AD, continued to develop the theories and treatments of Hippocrates and Archigenes. Based on Hippocrates' humoral theory, he also suggested that cancer is caused by an excess of black bile. Specifically, Galen believes that black bile is produced by the liver and accumulates over time as it is not processed by the spleen. Galen also suggested that black bile leads to incurable cancer while yellow bile leads to curable cancer. This may be the first time an ancient physician has identified the difference between malignant and benign tumors.

Galen claims to have observed numerous cases of cancerous 'excess black bile' in the breast tissues of postmenopausal women. He detailed the process of removing these tumors, saying that he would remove the tumor and a bit of the surrounding area, and then burn the base of the tumor to prevent it from growing back. He also notes the importance of early treatment with bleach to try to get rid of the black bile. Only when no other treatment options are available, surgical excision is used as a last resort.

Leonides, a Greek physician who lived in the same century as Galen, frequently consulted Galen's writings to apply in the analysis and treatment of various breast cancer cases. But Leonides says surgery should be done early rather than as a last resort. His profile describes several cases of mastectomy as early as possible to treat breast cancer in women.

In addition, Leonides also described some rarer cases of male breast cancer, as well as the different ways that breast cancer can manifest in different patients. He was the first to identify inverted nipples as a sign of breast cancer. Burning during Leonides' surgeries was mainly to prevent bleeding, but also to remove the last traces of cancer from the body after a mastectomy. Leonides believed that burning the entire mastectomy area and the tumor would keep the disease from coming back.

Finally, Paulus Aegineta, a 7th century AD physician and encyclopedist, further described the findings concerning cancer treatment. Aegineta mainly believed in Galen's theories, except that he suggested that burning the entire surgical area should not be done because it would cause more harm to the patient in the long run by delaying wound healing and increasing the risk of infection. . Aegineta believes that burning should only be used to slightly destroy the root of the tumor. Even with bleeding, Aegineta very limited use of cauterization in surgeries.

For Aegineta, non-ulcerative tumors (under the skin, or thought to be inside an organ such as the uterus) were too dangerous and potentially too fatal to perform surgery. Thus, like Hippocrates and Galen, he turned to treatments focused on the expulsion of 'black bile' to treat these patients.

Later, the physicians who followed Hippocrates, Archigenes of Apamea and Galen continued to treat them based on the methods of their predecessors. They continued to believe that black bile was the cause of cancers (sometimes they used foul-smelling secretions from tumors to support this hypothesis), and sought different ways to improve this. advances in surgical techniques to remove tumors from different parts of the body.

But in general, most ancient surgeries only dealt with tumors that were visible to the naked eye. With the medical level at that time, surgery deeper than this was too dangerous and had a high mortality rate. It was not until the last few centuries that more advanced cancer treatments appeared.

Fortunately, thanks to scanning equipment and sampling techniques, modern medicine is capable of accurately diagnosing tumors in all parts of the body, and in most cases can give intervention measures.