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Cancer

Prior to the 19th century, cancer had been treatable only by surgical removal or cauterization of the tumor, and even that was seldom possible when a tumor was deep inside the body.1 From about the 1820s to 1900, three developments set the stage for an oncological revolution: cell theory helped doctors understand cancer better; germ theory made surgical tumor removal eminently more survivable; and the invention of radiotherapy opened up highly effective non-surgical treatment options.

After the Industrial Revolution, microscopes accurate enough to see cells and bacteria became more widely available than ever before.2 Working closely with Matthias Schleiden and Theodor Schwann (who are credited with first articulating cell theory, the idea that all living things are composed of autonomous cells), Johannes Muller showed in 1832 that cancerous tumors are also composed of cells; others quickly realized those cells were abnormal.3 This remains the basic foundation of our understanding of cancer as uncontrolled cell division.4 Surgical tumor ablation grew increasingly safer as antiseptic practices became more widely accepted in the later 19th century. Doctors at the time favored radical operations to remove as much cancerous tissue as possible; William Stewart Halsted's radical mastectomy (removal of the entire breast, some chest muscles, and lymph nodes) was the de rigeur treatment for breast cancer from the 1880's til it fell out of favor in the 1970s.5 Many such radical surgeries, like the total hysterectomy, continued to carry high mortality rates well into the early 20th century.6 Around that time, oncological radiotherapy started to be regarded as a safer alternative to surgery.7 Within a year of the 1896 discovery of naturally-occurring radiation by Henri Becquerel and Marie & Pierre Curie, doctors were using targeted applications of radium to successfully shrink cancerous tumors.8 However, the full dangers of exposing healthy tissue to radiation were not yet well understood. In 1910, Paris student Jean Clunet proved in his thesis that overexposure to x-rays can cause cancer.9

Notes

  1. Ekmektzoglou, Xanthos, German, and Zografos, "Breast Cancer," 3-5; Rather, Genesis, 8.
  2. Microorganisms and cell structures were first observed through microscopes in the 1670's, but the technology stagnated from roughly the end of the 17th century until the beginning of the 19th. See Hajdu, "First Use of the Microscope in Medicine," 309-310 and Rather, Genesis, 82-3.
  3. Lowy, A Woman's Disease, 30; Rather, Genesis, 83-89, 95. For a detailed account of how microscopy influenced the development of oncology as a clinical discipline, see La Berge, "Dichotomy or Integration?", especially pp. 297-302. 
  4. See, for example, the National Cancer Institute (NIH), "What is Cancer?"
  5. Lowy, Woman's Disease, 29; Olson, Bathsheba's Breast, 61-74; Lerner, The Breast Cancer Wars, 32-40, 129ff.
  6. Lowy, Woman's Disease, 27-34.
  7. Lowy, Woman's Disease, 36; Lerner, Breast Cancer Wars, 34.
  8. Ekmektzoglou et al, "Breast Cancer," 6; Badash, "Discovery of Radioactivity," 26.
  9. Mustacci and Shimkin, "Radiation cancer and Jean Clunet," 1073.

Bibliography & Further Reading

    • Badash, Lawrence. "The Discovery of Radioactivity." Physics Today 49.2 (1996): 21-26.
    • Ekmektzoglou, Konstantinos A., Theodoros Xanthos, Vasilios German, and Georgios C. Zografos. “Breast Cancer: From the earliest times through to the end of the 20th century.” European Journal of Obstetrics & Gynecology and Reproductive Biology 145.1 (2009): 3-8. DOI:10.1016/j.ejogrb.2009.03.017.
    • Hajdu, Steven I. "The First Use of the Microscope in Medicine." Annals of Clinical & Laboratory Science 32.3 (2002): 309-310.
    • Holsti, Lars R. "Development of Clinical Radiotherapy Since 1896." Acta Oncologica 34.8 (1995): 995-1003. DOI: 10.3109/02841869509127225.
    • La Berge, Ann. "Dichotomy or Integration? Medical Microscopy and the Paris Clinical Tradition" in Constructing Paris Medicine, edited by Caroline Hannaway and Ann La Berge. Rodopi, 1998: 275-312.
    • Lerner, Barron H. The Breast Cancer Wars: Hope, Fear, and the Pursuit of a Cure in Twentieth-Century America. Oxford University Press, 2001.
    • Lowy, Ilana. A Woman's Disease: The history of cervical cancer. Oxford University Press, 2011.
    • Mustacchi, Piero and Michael B. Shimkin. "Radiation cancer and Jean Clunet." Cancer 9.6 (1956): 1073-1074. DOI:3.0.CO;2-9>10.1002/1097-0142(195611/12)9:6<1073::aid-cncr2820090602>3.0.CO;2-9.
    • National Cancer Institute (NCI). "What is Cancer?" Last updated 9 February, 2015. Accessed 4 May 2018. https://www.cancer.gov/about-cancer/understanding/what-is-cancer.
    • Olson, James S. Bathsheba's Breast: Women, Cancer, and History. Johns Hopkins University Press, 2002.
    • Rather, L.J. The Genesis of Cancer: A Study in the History of Ideas. The Johns Hopkins University Press, 1978.