The Paleopathology of Cancer: Past, Present and Future (original) (raw)

2018, The Antiquity of Cancer – A colloquium hosted by the European Society for the History of Oncology

Most scientific knowledge of cancer is based upon very recent evidence, with most information coming from studies over the last 200 years. With increased understanding of the manifestation and presentation of cancers throughout thousands, if not millions, of years, researchers can work together to answer the complex questions surrounding cancers today and tomorrow. The rapidly expanding field of palaeo-oncology, the study of the global history of cancers and other neoplastic diseases, contributes to this expansion of data and our collective understanding of neoplastic diseases and their evolution. This paper delves into the development of techniques, technologies and theoretical models used in the detection and interpretation of palaeo-oncological evidence in skeletonized and mummified remains. When palaeopathology was first introduced as a scientific endeavour, visual analysis of the bodily remains was the only available method and studies required the unwrapping and defleshing of mummified remains. These early methods were terribly destructive, and many soft tissue and bone pathologies were overlooked. Thankfully, the fields of palaeopathology and palaeo-oncology have a history of quickly adapting to incorporate state-of-the-art diagnostic tools and methods, resulting in a drastic reduction of destructive studies. For example, the first palaeo-radiological image of an ancient neoplasm was taken only two years after the discovery of x-rays, and one year after the first x-ray of bone cancer. Palaeo-oncological research has similarly incorporated more complex medical imaging techniques and histological analysis following their introduction to the world. Most recently, biomolecular methods of analysis, such as aDNA and proteomic analyses, have begun to make an impact on palaeo-oncological research with promising results. This paper begins with a historical review of the development of the palaeo-oncological toolbox enabling the minimally invasive analysis of physical remains and the limitations of these methods. Following this history of palaeo-oncological methodology, attention is turned to the quantification of the use of these methods in palaeo-oncological studies to date. This information is gleaned from the CRAB (Cancer Research in Ancient Bodies) Database (http://www.cancerantiquity.org/crabdatabase); a global summary of the published evidence of ancient cancer in humans and early hominins as well as the methods used in these studies. This database was created by Kathryn Hunt for her Masters degree at Durham University, then verified, further refined and published online with the assistance of the Palaeo-oncology Research Organization’s executive team, including the current speaker. Results of an associated article (Hunt et al., 2018), co-authored by the current speaker, are also briefly discussed with regard to the state of the art of palaeo-oncology to date, its limitations, and the need for more multidisciplinary collaboration. In addition to methodological progress, the role of recent theoretical breakthroughs in the advancement of palaeo-oncology are also discussed in relation to the potential for further discovery in this field. Looking to the future, the unfulfilled potential of palaeo-oncological research is noted, along with its ability to contribute to our collective scholarly understanding of cancer and neoplastic disease in manners not possible through clinical studies.