The History of Cancer

70–80 million years ago Evidence of cancer cells in dinosaur fossils, found in 2003.

4.2–3.9 million years ago The oldest known hominid malignant tumor was found in Homo erectus or Australopithecus by Louis Leakey in 1932.

3000 BCE Egypt: Evidence of cancerous cells in mummies.

1900–1600 BCE Cancer found in remains of Bronze Age human female skull.

1750 BCE Babylonian code of Hammurabi set standard fee for surgical removal of tumors (ten shekels) and penalties for failure.

1600 BCE Egypt: The Egyptians blamed cancers on the Gods. Ancient Egyptian scrolls describe eight cases of breast tumors treated by cauterization. Stomach cancer treated with boiled barley mixed with dates; cancer of the uterus by a concoction of fresh dates mixed with pig’s brain introduced into vagina.

1100–400 BCE China: Physicians specializing in treating swellings and ulcerations are referred to in The Rites of the Zhou Dynasty.

1100–400 BCE China: Physicians specializing in treating swellings and ulcerations are referred to in The Rites of the Zhou Dynasty.

500 BCE India: Indian epic tale, the Ramayana, describes treatment with arsenic paste to thwart tumor growth.

400 BCE Peru: Pre-Columbian Inca mummies contain lesions suggestive of malignant melanoma.

400 BCE Greece: Greek physician Hippocrates (460–370 BCE), the “Father of Medicine”, believed illness was caused by imbalance of four bodily humors: yellow bile, black bile, blood, and phlegm. He was the first to recognize differences between benign and malignant tumors.

circa 250 BCE China: The first clinical picture of breast cancer, including progression, metastasis and death, and prognosis approximately ten years after diagnosis, was described in The Nei Ching, or The Yellow Emperor’s Classic of Internal Medicine. It gave the first description of tumors and five forms of therapy: spiritual, pharmacological, diet, acupuncture, and treatment of respiratory diseases.

50 AD Italy: The Romans found some tumors could be removed by surgery and cauterized, but thought medicine did not work. They noted some tumors grew again.

100 AD Italy: Greek doctor Claudius Galen (129–216 AD) removed some tumors surgically, but he generally believed that cancer was best left untreated. Galen believed melancholia the chief factor in causing breast cancer, and recommended special diets, exorcism and topical applications.

500–1500 Europe: Surgery and cautery were used on smaller tumors. Caustic pastes, usually containing arsenic, were used on more extensive cancers, as well as phlebotomy (blood-letting), diet, herbal medicines, powder of crab and symbolic charms.

1400–1500s Italy: Leonardo da Vinci (1452–1519) dissected cadavers for artistic and scientific purposes, adding to the knowledge of the human body.

1492 Christopher Columbus returned to Europe from the Americas with the first tobacco leaves and seeds ever seen on the continent. A crew member, Rodrigo de Jerez, was seen smoking and imprisoned by the Inquisition, which believed he was possessed by the devil.

1500 Europe: Autopsies were conducted more often and understanding of internal cancers grew.

1595 Netherlands: Zacharias Janssen invented the first compound microscope.

17th century Netherlands: Dutch surgeon Adrian Helvetius performed both lumpectomy and mastectomy, claiming this cured breast cancer.

17th century Germany: Cancer surgery techniques improved, but lack of anesthesia and antiseptic conditions made surgery a risky choice. German surgeon Wilhelm Fabricius Hildanus (1560–1634), removed enlarged lymph nodes in breast cancer operations, while Johann Scultetus (1595–1645) performed total mastectomies.

17th century France: Physician Claude Gendron (1663–1750) concluded that cancer arises locally as a hard, growing mass, untreatable with drugs, and that it must be removed with all its “filaments”.

17th century Netherlands: Professor Hermann Boerhaave (1668–1738) believed inflammation could result in cancer.

17th–18th centuries Netherlands: Antony van Leeuwenhoek (1632–1723) refined the single lens microscope and was the first to see blood cells and bacteria, aiding the better understanding of cells, blood and lymphatic system – major steps in improving the understanding of cancer.

France: Physician Le Dran (1685–1770) first recognized that breast cancer could spread to the regional auxiliary lymph nodes, carrying a poorer prognosis.

1700 Italy: Dr Bernardino Ramazzini (1633–1714), a founder of occupational/ industrial medicine, reported the virtual absence of cervical cancer and relatively high incidence of breast cancer in nuns. This observation was an important step toward identifying hormonal factors such as pregnancy and infections related to sexual contact in cancer risk, and was the first indication that lifestyle might affect the development of cancer.

1733–88 France: Physicians and scientists performed systematic experiments on cancer, leading to oncology as a medical specialty. Two French scientists – physician Jean Astruc and chemist Bernard Peyrilhe – were key to these new investigations.

1761 Padua, Italy: Giovanni Morgagni performed the first autopsies to relate the patient’s illness to the science of disease, laying the foundation for modern pathology.

1761 UK: Dr John Hill published “Cautions Against the Immoderate Use of Snuff ”, the first report linking tobacco and cancer.

1775 UK: Dr Percival Pott of Saint Bartholomew’s Hospital in London described cancer in chimney sweeps caused by soot collecting under their scrotum, the first indication that exposure to chemicals in the environment could cause cancer. This research led to many additional studies that identified other occupational carcinogens and thence to public health measures to reduce cancer risk.

1779 France: First cancer hospital founded in Reims. It was forced to move from the city because people believed cancer was contagious.

18th century Scotland: Scottish surgeon John Hunter (1728–93) stated that tumors originated in the lymph system and then seeded around the body. He suggested that some cancers might be cured by surgery, especially those that had not invaded nearby tissue.

19th century Scotland: In the early 1800s, Scottish physician John Waldrop proposed that “glioma of the retina”, which typically appeared within the eyes of new-borns and young children and was usually lethal, might be cured via early removal of affected organs.

19th century Scotland: In the early 1800s, Scottish physician John Waldrop proposed that “glioma of the retina”, which typically appeared within the eyes of new-borns and young children and was usually lethal, might be cured via early removal of affected organs.

1829 France: Gynacologist Joseph Recamier described the invasion of the bloodstream by cancer cells, coining the term metastasis, which came to mean the distant spread of cancer from its primary site to other places in the body.

1838 Germany: Pathologist Johannes Müller demonstrated that cancer is made up of cells and not lymph. His student, Rudolph Virchow (1821–1902), later proposed that chronic inflammation – the site of a wound that never heals – was the cause of cancer.

1842 Italy: Domenico Antonio Rigoni-Stern undertook first major statistical analysis of cancer incidence and mortality using 1760–1839 data from Verona. This showed that more women than men died from tumors, and that the commonest female cancers were breast and uterine (each accounting for a third of total deaths). He found cancer death rates for both sexes were rising and concluded that incidence of cancer increases with age, that cancer is found less in the country than in the city, and that unmarried people are more likely to contract the disease.

1845 Scotland: John Hughes Bennett, the Edinburgh physician, was the first to describe leukemia as an excessive proliferation of blood cells.

1851–1971 UK: Decennial reports linked cancer death to occupation and social class.

1880 UK: Earlier invention of general anesthesia (chloroform, ether, nitrous oxide) became more widespread, making cancer surgery more acceptable.

1881 USA: First practical cigarette-making machine patented by James Bonsack. It could produce 120,000 cigarettes a day, each machine doing the work of 48 people. Production costs plummeted, and – with the invention of the safety match a few decades later – cigarette-smoking began its explosive growth.

1886 Brazil: Hereditary basis for cancer first suggested after Professor Hilario de Gouvea of the Medical School in Rio de Janeiro reported a family with increased susceptibility to retinoblastoma.

1890s USA: Professor William Stewart Halsted at Johns Hopkins University developed the radical mastectomy for breast cancer, removing breast, underlying muscles and lymph nodes under the arm.

1895 Germany: Physicist Wilhelm Konrad Roentgen (1845–1923) discovered X-rays, used in the diagnosis of cancer. Within a few years this led to the use of radiation for cancer treatment.

1897 USA: Walter B Cannon (1871–1945) was still a college student when he fed bismuth and barium mixtures to geese, outlining their gullets on an X-ray plate (the fore-runner of the Barium meal examination).

19th century Invention and use of the modern microscope, which later helped identify cancer cells.

19th century Germany: Johannes Müller’s student Rudolph Virchow (1821–1902), “the founder of cellular pathology”, determined that all cells, including cancer cells, are derived from other cells. He was the first to coin the term “leukemia” and believed chronic inflammation was the cause of cancer.

19th century Germany: Surgeon Karl Thiersch showed cancers metastasize through the spread of malignant cells.

1800s UK: Surgeon Stephen Paget (1855–1926) first deduced that cancer cells spread to all organs of the body by the bloodstream, but only grow in the organ (“soil”) they find compatible. This laid the groundwork for the true understanding of metastasis.

1895 Scotland: Dr Thomas Beatson discovered that the breasts of rabbits stopped producing milk after he removed the ovaries. This control of one organ over another led Beatson to test what would happen if the ovaries were removed in patients suffering from advanced breast cancer, and he found that oophorectomy often resulted in improvement. He thus discovered the stimulating effect of estrogen on breast tumors long before the hormone was discovered. This work provided a foundation for the modern use of hormones and analogs (eg tamoxifen, taxol) for treatment and prevention of breast cancer.

before 1900 Lung cancer was extremely rare; now it is one of the commonest cancers.

by 1900 Hundreds of materials, both man-made and natural, were recognized as causes of cancer (carcinogens).

1902 X-ray exposure led to skin cancer on the hand of a lab technician. Within a decade, many more physicians and scientists, unaware of the dangers of radiation, developed a variety of cancers.

1905 UK: Physicians at the Royal Ophthalmology Hospital reported the first case of “hereditary” retinal glioma, which presented in the child of a parent cured of the disease.

1907 USA: Epidemiological study found that meat-eating Germans, Irish, and Scandinavians living in Chicago had higher rates of cancer than did Italians and Chinese, who ate considerably less meat.

1910 Austria: First national cancer society founded: Austrian Cancer Society.

1911 France: Marie Curie was awarded a second Nobel Prize, this time in Chemistry, in recognition of her work in radioactivity.

1900–1950 Radiotherapy – the use of radiation to kill cancer cells or stop them dividing – was developed as a treatment.

1911 USA: Peyton Rous (1879–1970) proved that viruses caused cancer in chickens, for which he was eventually awarded the Nobel Prize in 1966.

1913 USA: The American Cancer Society was founded as the American Society for the Control of Cancer (ASCC) by 15 physicians and business leaders in New York City. In 1945 the ASCC was renamed the American Cancer Society. It remains the world’s largest voluntary organization.

1915 Japan: Cancer was induced in laboratory animals for the first time by a chemical, coal tar, applied to rabbits’ skin at Tokyo University. Soon many other substances were observed to be carcinogens, including benzene, hydrocarbons, aniline, asbestos and tobacco.

1928 Greece, USA: George Papanicolaou (1883–1962) identified malignant cells among the normal cast off vaginal cells of women with cancer of the cervix, which led to the Pap smear test.

1930 Germany: Researchers in Cologne drew the first statistical connection between smoking and cancer.

1930s Puerto Rico: Dr Cornelius Rhoads, a pathologist, allegedly injected his Puerto Rican subjects with cancer cells – 13 people died.

1933 International Union Against Cancer (UICC) founded.

1933 Spain: First World Cancer Congress held in Madrid.

1930s–1950s Classification of breast cancer introduced, enabling the planning of more rational treatment tailored to the individual.

1934 UK: Wood and Gloyne reported first two cases of lung cancer linked to asbestos.

1937 USA: National Cancer Institute inaugurated

1939 USA: Drs Alton Ochsner and Michael DeBakey first reported the association of smoking and lung cancer.

1939–45 During the Second World War US Army discovered that nitrogen mustard was effective in treating cancer of the lymph nodes (lymphoma). This was the birth of chemotherapy – the use of drugs to treat cancer.

1943–45 Denmark, UK: First national cancer registries established.

1940s–1950s USA: Dr Charles B Huggins’ (1901–97) research on prostate cancer changed the way scientists regarded the behavior of all cancer cells, and for the first time brought hope to the prospect of treating advanced cancers. He showed that cancer cells were not autonomous and self-perpetuating but were dependent on chemical signals such as hormones to grow and survive, and that depriving cancer cells of these signals could restore the health of patients with widespread metastases. He was awarded the Nobel Prize in 1966 (shared with Peyton Rous).

1950 USA: Gertrude Elion (1918–99) created a purine chemical, which she developed into 6-mercaptopurine, or 6-MP. It was rapidly approved for use in childhood leukemia. She received the Nobel Prize in 1988.

1950 USA: The link between smoking and lung cancer was confirmed. A landmark article from The Journal of the American Medical Association appeared on May 27, 1950: “Tobacco smoking as a possible etiologic factor in bronchogenic carcinoma” by E L Wynder and Evarts Graham. The same issue featured a full-page ad for Chesterfields with the actress Gene Tierney and golfer Ben Hogan; the journal accepted tobacco ads until 1953.

1951 UK: Dr Richard Doll and Prof Austin Bradford Hill conducted first large-scale study of link between smoking and lung cancer.

1953 UK: James Watson and Francis Crick described the double helical structure of DNA, marking the beginning of the modern era of genetics.

1954 USA: First tobacco litigation against the cigarette companies, brought by a widow on behalf of her smoker husband, who died from cancer. The cigarette companies won.

1956 USA: Dr Min Chiu Li ( –1980) first demonstrated clinically that chemotherapy could result in the cure of a widely metastatic malignant disease.

1960 Japan: Group cancer screening for stomach cancer began with a mobile clinic in Tohoku region.

1960 USA: Dr Min Chiu Li published another important and original finding: the use of multiple-agent combination chemotherapy for the treatment of metastatic cancers of the testis. Twenty years later, it was demonstrated that combination chemotherapy, combined with techniques for local control, had virtually eliminated deaths from testicular malignancy.

1963 Japan: Cancer research programs were established by the Ministry of Health and Welfare and the Ministry of Education, Science and Culture.

1964 USA: First US Surgeon General’s report on smoking and health.

1965 WHO established International Agency for Research on Cancer (IARC) based in Lyons, France.

1966 International Association of Cancer Registries (IACR) founded.

1960s–1970s Trials in several countries demonstrated the effectiveness of mammography screening for breast cancer.

1970s USA, Italy: Bernard Fisher in the USA and Umberto Veronesi in Italy both launched long-term studies as to whether lumpectomy followed by radiation therapy was an option to radical mastectomy in early breast cancer. These studies concluded that total mastectomy offered no advantage over either lumpectomy or lumpectomy plus radiation therapy.

1971 USA: The National Cancer Act in President Nixon’s “War on Cancer” mandated financial support for cancer research, established a network of population-based cancer registries, outlined intervention strategies and, in 1973 established the SEER (Surveillance, Epidemiology and End Results).

1973 USA: Bone marrow transplantation first performed successfully on a dog in Seattle by Dr E Donnall Thomas (1920–). This led to human bone marrow transplantation, resulting in cures for leukemias and lymphomas. In 1990 Dr Thomas won a Nobel Prize for his work.

1970s Childhood leukemia became one of the first cancers that could be cured by a combination of drugs.

1970s USA: Discovery of the first cancer gene (the oncogene, which in certain circumstances can transform a cell into a tumor cell).

1970s onwards WHO, UICC and others promoted national cancer planning for nations to prioritize and focus their cancer activities.

1981 Japan: Professor Takeshi Hirayama (1923–95) published the first report linking passive smoking and lung cancer in the non-smoking wives of men who smoked.

1981 Italy: Dr G Bonnadona in Milan performed first study of adjuvant chemotherapy for breast cancer using cyclophosphamide, methotrexate and 5-fluorouracil, resulting in reduction of cancer relapse. Adjuvant chemotherapy is now standard treatment for lung, breast, colon, stomach and ovary cancers.

1980s USA: Kaposi’s sarcoma and T-cell lymphoma linked to AIDS.

1982 USA: Nobel Laureate Baruch S Blumberg was instrumental in developing a reliable and safe vaccine against hepatitis B (which causes primary liver cancer).

1980s Australia: Barry Marshall and J Robin Warren identified bacterium h pylori, noting it caused duodenal and gastric ulcers and increased the risks of gastric cancer. H pylori infection can be eradicated with antibiotics. They received the 2005 Nobel Prize for Medicine.

1980s USA: Vincent DeVita developed a four-drug combination to raise the cure rate of Hodgkin’s disease from nearly hopeless to 80%.

mid-1980s Human Genome Project was initiated to pinpoint location and function of estimated 50,000– 100,000 genes that make up the inherited set of “instructions” for functions and behavior of human beings.

1980s WHO Program on Cancer Control established.

1988 Global First WHO World No Tobacco Day, subsequently an annual event.

1989 European Network of Cancer Registries (ENCR) established.

1989 USA: National Institutes of Health researchers performed the first approved gene therapy, inserting foreign genes to track tumor-killing cells in cancer patients. This project proved the safety of gene therapy.

1990 USA: The Breast and Cervical Cancer Mortality Prevention Act signed into US law. Established the only nationwide organized cancer screening program in the US, the National Breast and Cervical Cancer Early Detection Program.

1991 Evidence linking specific environmental carcinogens to telltale DNA damage emerged, eg sun radiation was found to produce change in tumor suppressor genes in skin cells, aflatoxin (a fungus poison) or hepatitis B virus to cause a mutation in the liver, and chemicals in cigarette smoke to switch on a gene that makes lung cells vulnerable to the chemicals' cancer-causing properties.

1994 USA, Canada, UK, France, Japan: Scientists collaborated and discovered BRCA1, the first breast and ovarian cancer predisposing gene.

1994 USA: National Program of Cancer Registries (NPCR) established.

1995 Gene therapy, immune system modulation and genetically engineered antibodies used to treat cancer.

1999 Netherlands, USA:Jan Walboomers of the Free University of Amsterdam and Michele Manos of Johns Hopkins provided evidence that the human papilloma virus is present in 99.7% of all cases of cervical cancer.

1999 The Bill & Melinda Gates Foundation awarded a five-year, $50 million grant to the Alliance for Cervical Cancer Prevention (ACCP), a group of five international organizations with a shared goal of working to prevent cervical cancer in developing countries.

1999 France: American Lance Armstrong became an inspiration to cancer survivors around the world when he overcame testicular cancer and won his first of a record seven Tour de France cycling victories.

2000 53rd World Health Assembly presided over by Dr Libertina Amathila (Namibia) endorsed “Global strategy for non-communicable disease (NCD) prevention and control”, which outlined major objectives for monitoring, preventing and managing NCDs, with special emphasis on major NCDs with common risk factors and determinants – cardiovascular disease, cancer, diabetes and chronic respiratory disease.

2000 The entire human genome is mapped.

2000 Charter of Paris against Cancer signed.

2000 Luxembourg: International Childhood Cancer Day was launched, its aim to raise awareness of the 250,000 children worldwide who get cancer every year. Some 80% of these children have little or no access to treatment. The first annual event in 2002 was supported in 30 countries around the world and raised over US$100,000 for parent organizations to help children in their own countries.

2002 US Cancer Statistics first published. Provided cancer incidence data covering 78% of US population.

2004 Geneva,Switzerland: WHO cancer prevention and control resolution approved by World Health Assembly.