The Antiquity of Cancer

Historic Tumor Drawing, before and after, via Wikimedia Commons

Historic Tumor Drawing, before and after, via Wikimedia Commons

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.

Photo via Binder et al. 2014 "Skeleton Sk244-8 in its original burial position in the western chamber of G244. The insert shows faience amulet F9273 found associated with the individual from both sides. The Egyptian god Bes (right side) is depicted on the reverse side."  doi:10.1371/journal.pone.0090924.g002

Photo via Binder et al. 2014
“Skeleton Sk244-8 in its original burial position in the western chamber of G244. The insert shows faience amulet F9273 found associated with the individual from both sides. The Egyptian god Bes (right side) is depicted on the reverse side.” doi:10.1371/journal.pone.0090924.g002

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…

Works Cited

ResearchBlogging.orgBinder, 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:

12 responses to “The Antiquity of Cancer

  1. I was thinking aloud about this a couple of days ago myself…about the history of cancer and whether it is malaise of our times…of course unlike you my questions were not a result of my academic interests (though I do have an interest in certain other areas of medical anthropology) but a consequence of spending an entire evening watching House (the TV series). And now I see your post. Thanks for writing this. Reminds me to google scholar this. Would you know of any other book other than Binder’s for a prelim reading?

      • Just did that. I think I will start with Zimmerman (2010). They have also referred to Mukherjee’s The Emperor of Maladies. This was a best seller in India (where I live), but I had completely forgotten about it. Thanks again Katy., And good luck with your work.

  2. May I share this on my blog? I have a bachelor’s degree in anthropology from Illinois State University and my interest was mortuary archaeology. I was recently diagnosed with endometrial cancer.

    • You are more than welcome to reblog this work as it is shared under Creative Commons license, the only requirement is that it is attributed to me (Katy Meyers, Bones Don’t Lie)!

  3. It is my personal belief that while cancer may be somewhat more prevalent in society today, it was also a significant factor in the past.

    Today, while true we we ingest a considerable amount of man-made chemicals, there are other factors which perhaps are being ignored. In the past a heat deal of food was preserved using smoking, which introduces carcinogens to the diet. Furthermore, all cooking, lighting and heating was done using fire, introducing particulate matter into the environment. If the environment were quite closed with less ventilation, such as for heating, the amount of particulate matter breathed would be quite high. It is a proven fact that a higher concentration of particulates breathed in increases the incidence of cancer in the lungs and esophagus.

    It is a pity that soft tissues do not survive. If they did, I firmly believe that the incidence of cancer in the lungs and digestive tract would be (nearly) as high as the present day.

  4. Hi Katy. Thanks for featuring our article on your blog! I’m a regular reader of BDL and always enjoy your posts. As for your comment about not enough contextual information, I totally agree but going more into detail was a bit beyond the scope of the paper. The Amara West research project is ongoing and there are several publications (and my PhD for that matter) about the cemeteries, human remains, settlement and landscape in the making. In the meantime I can refer you to our website and blog The settlement team is still out in Sudan at the moment and there are regular updates about their exciting finding. Best, Michaela

    • Thank you for sharing the information! I figured the contextual data was out there and being discussed, and totally understand that not everything can be included. I’ve been following the project quite a bit, fascinating stuff going on there. Is there going to be a more contextualized discussion of the overall site? I would love to write some more follow-up posts on this!

  5. Katy, my interest in cancer in antiquity has been ignited now that I am going through chemotherapy for colon cancer stage 3. I’ve read many research articles and it would be interesting to note how to differentiate primary from secondary origin cancer growth in bone. Breast and lung cancers were also prevalent in the industrial age, that in itself is worth the study. Thanks for the great article!!!

      • Definitely. I’m interested in learning how past therapies were used, i.e., arsenic. Arsenic was the chemotherapy back then, among others. Pretty heavy duty considering that today’s chemo drugs are no slouch.
        They are very toxic to the liver, bone, and renal system. I’ll still pass on the arsenic considering the benefits of today’s drugs. Cancer is definitely a subject I would like to pursue in my graduate studies and beyond! Thanks Katy!

        “Cancer: an old disease, a new disease, or something in between.” A.Rosalie Daird and Michael Zimmerman. Perspectives October 2010 Vol. 10.

        “Antiquity of Cancer” Luigi L. Capasso. International Journal of Cancer Vol. 113, Issue 1, pp. 2-13, 1 January 2005.
        “A disease without history? Evidence for the antiquity of head and neck cancers.” William J. Pestle and Michael Colvard. Current Perspectives 2013, pp. 5-36.

        “Antiquity of Breast Cancer” Joseph H. Farrow, MD, FACS. Cancer Vol. 28, Issue 6, December 1971 pp. 1369-1371.

        “Skeletal Metastatic Carcinoma. A Case from 15th – 20th Century Coimbra, Portugal.” International Journal of Osteoarchaeology, Vol. 21 Issue 3 May/June 2011 pp. 336-346

        These 2 articles I had to buy from Karger and Ingentaconnect publishers: (But they are great).
        “Skeletal Metastatic Carcinomas from the Roman Period (1st to 5th Century AD) in Hungary”
        Merczi M.a · Marcsik A.b · Bernert Z.c · Józsa L.e · Buczkó K.d · Lassányi G.f · Kelemen M.H.a · Zádori P.h · Vandulek C.h · Biró G.h · Hajdu T.g · Molnár E.b

        “Tumors in the 18th and 19th centuries at Brno, Czech Republic”
        Authors: Vargová, Lenka; Horáčková, Ladislava; Němečková, Alena; Krupa, Petr; Menšíková, Miroslava
        Source: Anthropologischer Anzeiger, Volume 70, Number 4, December 2013 , pp. 385-405(21)

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