Cancer is a leading cause of death in the world today, however it is something that archaeologists rarely identify in human remains from the past. The hypothesis behind this is that cancer is primarily caused by modern living conditions and increased longevity in humans. It is medically known as malignant neoplasia, and covers a broad range of diseases that involve the unregulated growth of cells. This growth causes tumors to form, and they can either be malignant, invading other body parts and causing damage, or benign, not technically harmful despite the growth and not invading other body parts. There are over 200 different known cancers that can have an effect on humans, and the causes of these are diverse, complex and only partially understood- it can be genetic, acquired through lifestyle, or seemingly random.
Very little is known about the history of cancer, however there is textual evidence from Ancient Egypt and Rome that the disease dates into antiquity. Only about 200 human remains from history have evidence of cancer related lesions, and the majority of these date to the last 500 years. The oldest accepted example of a malignant neoplasm was found in a 6,000 year old skeleton from Austria. Ancient Egypt in particular has old cases of cancer. The earliest from this region is an Old Kingdom skull found in Giza that is around 5,000 years old and has lytic lesions consistent with metastatic carcinoma. Between 2,300 BCE and 300 CE there are four more examples from this area, and the most commonly reported type is nasopharyngeal carcinoma. However, these early examples are often incomplete due to a lack of complete skeleton, poor preservation, or potential differential diagnosis.
A new study from Durham University’s Binder et al. (2014) has found what may be evidence for the oldest clear-cut case of cancer in a human. The remains are from the archaeological site of Amara West in modern Sudan, currently being excavated by the British Museum in an ongoing project (they have a rather nice blog as well). The settlement was founded in 1300 BCE as an administrative capital of Kush, Upper Nubia, and the region was part of the pharaonic Egyptian state in this period. The local cemetery was used from 1300 to 800 BCE, determined by 14C dating of human remains and dating the ceramic assemblages found within the graves. Evidence from the local domestic site indicate that it was an agricultural community subsisting off grain cultivation and livestock, though it likely also had trading networks with Egypt as well. Epigraphy reveals there were a number of higher ranking officials at the site.
The individual under investigation here was recovered in 2013 from the north-eastern cemetery of the Amara West site. This area was determined to be used for the sub-elite of the town based on architecture and funerary ritual artifacts- while the tomb is a tumulus with separate burial chambers, it isn’t as grand as the pyramid structures found to the northwest for the elite, nor is it just a simple grave. The tomb of the sub-elites is a good blend of both Nubian and Egyptian funerary elements, suggesting blending between the cultures. The individual under investigation was found with eight others, laid out as an extended burial within a painted wooden coffin. The layout of bones suggests the bodies were tightly wrapped in cloth before being placed in the coffins. Graves goods found within the tombs support the hypothesis that these were wealthier individuals, and allow the tomb to be dated to the 20th Dynasty (1187-1064 BCE). Based on the human remains, our individual under investigation is a male, aged 25 to 35 years old. Numerous small oval to round-shaped lesions ranging in size from 30 to 3 mm were recorded by Binder et al. (2014) on the scapulae, clavicles, sternum, vertebrae and pelvis. Careful examination was done to note differences between lytic lesions that indicate cancer like bone destruction and natural post-depositional degradation.
Binder et al. (2014) argue there are multiple explanations for the high number of lesions. 1) Metastatic carcinoma: large numbers of tumors form throughout the body based on blood and nerve lines, and while tumors are in the soft tissue, they can cause bone loss or growth in neighboring bony elements. 2) Multiple myeloma: neoplastic condition within the bone marrow that creates lesions throughout the body. 3) Fungal infection causing lesions that mimic cancerous ones. 4) Taphonomic destruction: bones over time degrade due to environmental conditions, such as roots damaging bone, water causing bone erosion, or small mammals chewing on the bones. They argue it is most likely metastatic carcinoma based on the locations of the lesions and their shape. They conclude “This 25–35 year old man from Amara West, buried around 1200 BC, further evidence, provides another piece of evidence that cancer is in fact not a modern phenomenon” (Binder et al. 2014).
They end the article with a brief discussion of the broader context of change that the individual was living in and how the changes in environment and diet may have led to the cancer forming. “The potential exists, therefore, to explore possible underlying causes of cancer in an ancient population, before the onset of modernity. As such it could provide important new insights into cancer aetiology and epidemiology in the past” (Binder et al. 2014). Personally, I think this is where the juicy information is- this is where I want the article to continue, but sadly it does not. I want to know more about this man, about what he was buried with, about the neighboring settlement, about the broader political and social landscape, about potential pollutants, about his diet, about everything that may have led to cancer! Sigh… maybe the next article…
Binder, M., Roberts, C., Spencer, N., Antoine, D., & Cartwright, C. (2014). On the Antiquity of Cancer: Evidence for Metastatic Carcinoma in a Young Man from Ancient Nubia (c. 1200BC) PLoS ONE, 9 (3) DOI: 10.1371/journal.pone.0090924
Also see this article from The Journal for different summary of the paper: http://www.thejournal.co.uk/news/north-east-news/archaeologists-durham-university-discover-earliest-6842412