Did early civilizations, such as the Aztecs lets say, suffer from the same kinds of cancers and as much of it as we see today? I realize that some types, such as prostate cancer, are more comon now due to our increased life expectancy, but some cancers, such as leukemia, occur in children.
Three example questions:
Lung cancer is common now, but smoking tabacco wasn’t popular until about 250 years ago. Did any early civilizations that didn’t smoke tobacco suffer from lung cancer at all?
Is there any evidence that the rate of cancer in Egyptian times was anywhere near what it is today… taking life expectancy into account?
Since some cancers are thought to be caused by environmental factors is the overall cancer rate for aboriginal peoples around today, who presumably haven’t been exposed to the same environmental factors as the rest of us have, been any where near that of industrialized peoples?
My sense is that, for whatever reason, the cancer rate has risen dramatically in the past 100 years or so. Perhaps that’s because we have better ways of knowing what caused someone to die, but certainly that can’t account for all of it.
I’m not a doctor, medical historian, or even much of a bright guy, but I’d imagine that the incidence of cancer is higher at least partly because it’s one of the things for which we haven’t yet got an effective, cheap, widely available prevention/cure. Keep preventing or curing all the other diseases people get, and sooner or later they’ll get something that stumps you.
I’m sure there are other factors, of course; do enough reading and it becomes apparent that nothing in the real world is traceable to one single cause.
My sense is that people are living a hell of a lot longer than they ever did before. Many more people are dying of cancer simply because they’re not dying of anything else first. The “real” rate doesn’t have to have gone up at all.
Plus, our diagnostic technique is many orders of magnitude better than it ever was historically. People no longer die of ‘augue’ or ‘excess bile’ or vague symptomatic diagnoses like that, they die of specific, known disorders that can be tallied up in annual morbidity and mortality reports.
It certainly accounts for a lot of it. Quite simply most people who died of cancer 200 years ago never knew what killed them. Trying to differentiate between lung cancer and a lung infection, leukaemia and ‘wasting’ and a brain tunour and ‘insanity’ was simply impossible aside from possibly via autopsy, and very fewbodies were autopsied. Many cancers simply weren’t known 100 years ago, so of course such diseases have seen an infinte rate of increase as diganosis has improved.
When you add in the effect of aging and eliminating other fatal diseases that would kill people wekaned by cancer before it could possibly be diagnosed it’s hard to see any evidence that most cancer rates have increased. You are correct that lung cancer rates have increased, as a result of smoking naturally.
Okay. Fair enough, but when they x-ray a mummy do they ever see tumors much like we would see today? I would like to believe that Egyptians didn’t suffer nearly as much from cancer as we do… but I really have no idea.
I agree that most would have died from common diseases we have almost eliminated by middle age. But if they would have lived long enough would they have seen the same rate of prostate cancer and we see?
[nitpick] Not all lung cancer is caused by smoking; my grandfather died at 49 from lung cancer, never having smoked a day in his life. Presumably societies without smoking would have much lower rates of lung cancer, but not nil. [/nitpick]
I’d imagine so. Lung cancer is caused by smoking only about 80-90% of the time. That means about 20 to 40,000 people a year get lung cancer in the U.S. each year without having smoked.
Which means even if nobody smoked, lung cancer would still be one of the leading causes of cancer - and certainly cancer death.
As for what your sense tells you about the cancer rate rising - I wouldn’t rely on it. 100 years ago people simply didn’t talk about cancer. It was considered a shameful illness, was not discussed at all or was referred to in euphemisms. So if you don’t read about cancer in older literature, that doesn’t mean there wasn’t a lot of it around. When I was young I had a very old teacher who grew up in the early part of the century, and I remember him telling me that when he was young you simply never heard the term cancer, and if ever did come up it was whispered as if you were discussing something scandalous.
Amy Dudley, wife of one of Elizabeth I’s favorite courtiers was well-known to suffer from “a malady in her breast.” I have also seen examples of other people who had tumors.
On the other hand, people today don’t typically rely on open wood or coal fires for indoor heating and cooking. I imagine people of a bygone age had significant exposure to carcinogenic smoke. I can’t quantify it, of course, but I have to wonder.
The Empress of Germany (Vicky, Queen Victoria’s oldest daughter and Wilhelm’s mother) died of breast cancer. It was an agonizing, horrific way to die, but certainly not unknown.
There’s a story I’ve read in many places (which doesn’t prove that it’s true) about a doctor who was in training about a hundred years ago. His professor called him and his fellow students in to see an autopsy on a man who’d died of lung cancer. The reason he called them in was that, he said, lung cancer was a rare disease, and this was one of the few opportunities thety might have to see a case of it.
I have no idea if it’s true or not – frequency of citing is no guarantee, and I’ve never even seen the original reference. It’s certainly possible, though – gicarettes are a really efficient mechanism for getting cigarette smoke into the lungs. The famous cases of cigar, pipe smokers, and tobacco chewers seem to be oral cancers (Freud, Grant).
It’s tough to tell if cancer rates are increasing or not. Certainly we have a greater variety and number of carcinogens being liberated, but we’re also more careful than our ancestors, using protective gear and limiting exposures. And our ability to detect cancers, both pre- and post-mortem have increased, too. I haven’t seen any figures to say anythingh one way otr the other, but I wouldn’t run across them in the normal course of things, and I haven’t looked.
In 1895, Aldred Scott Warthin, MD, PhD,initiated one of the most thoroughly documented and longest cancer family histories ever recorded. The unusually high incidence and segregation of cancers of the colon, rectum, stomach, and endometrium in Dr Warthin’s family G was later followed up by his colleagues, most recently by Henry Lynch, MD. Described today as a Lynch syndrome family, family G was last documented in 1971, prior to the modern era of molecular diagnostics.
Contrary to front-page newspaper headlines, incidence rates for childhood leukemia are not rising. Preserving specimens for future studies has been valuable: blood from people who were exposed to dioxin in Seveso, Italy; mummified umbilical cords containing methyl mercury at Minamata Bay, Japan; and Guthrie dried blood spots to screen retrospectively for 43 genetic disorders and a specific prenatal cytogenetic abnormality in some children with 1 form of leukemia.
(only tangentially related) Scientific knowledge of the harmful effects of active tobacco smoking has accumulated during the past 60 years since early descriptions of the increasing prevalence of lung cancer. The first epidemiological studies showing an association between smoking and lung cancer were published in 1950. In 1990 the US Surgeon General concluded that smoking was the most extensively documented cause of disease ever investigated but governments worldwide have been ambivalent and slow in taking action to reduce smoking.
Courtesy of Pubmed. Some of those are free, others not, but the abstracts give you an idea.
If it’s any help, Robert Proctor’s history Cancer Wars (Basic, 1995, p275, n14) dates the story to Charing Cross Hospital in London in 1869, but his reference is a 1979 secondary work and so one’s still in the position of an original report being elusive.
As a somewhat more definite cite that makes much the same point, for The Nazi War on Cancer (Princeton, 1999, p180) he unearthed an 1898 German medical dissertation that claimed that the total number of lung cancer cases that had ever been recorded was just 140. He also points to a couple of other statements from the same period that confirm that doctors of the time did regard this particular cancer as extremely rare.
Right. If you die at age 35 from the Plague, you won’t have a chance to die from cancer. We are living longer, thus we have more chances to die from cancer, heart disease, etc.
There were many common lung diseases before cigarette smoking (TB for example). My WAG is that many dudes who died from lung problems were assumed to die from one of them instead of from a cancer. (Autopsies were also less common) But certainly the rise of cigarette smoking has greatly increased the lung cancer rate. Tobacco use was mainly chew, cigars and pipes for hundreds of years. While these are certainly not safe, the risk of lung cancer is very low. Lung cancer from smoking also mostly requires you live long enough to smoke enough to cause the lung cancer. If we only lived to 40, I wouldn’t be super concerned with lung cancer risk.