Cancer

The term cancer derives from the Latin cancer, which in turn derives from the Greek καεκιυoω both originally meaning a crab. Other medical terms used in classical antiquity derive from the same root.

As a medical term, καεκιυoω first appears in Hippocrates but in contexts that only suggest what is meant today by cancer. Later uses of the term by Galen and his followers were similar to the medical and clinical uses that prevailed up to the time of Rudolph Virchow. In the same way, the more re­stricted term carcinoma might have denoted a malig­nant condition, especially when the condition termi­nated fatally as, for example, in Hippocrates, Caelius Aurelianus, and Cassius Felix. The most extended account of cancer, next to Galen’s, was that of Celsus, who attempted to distinguish a variety of swellings (tumors). He gave special names (e.g., atheroma, steatoma, and therioma) to some of these - probably not the malignant ones. However, he also described certain, more serious conditions, perhaps complications of erysipelas and gangrene, and these he likened to cancer. He reserved the term carci­noma or carcinode for other tumors that, when they did not appear to have been the result of another, antecedent disease, may have been malignant.

The terms just noted and other Greco-Roman cog­nates such as cancroma are not as common in the medical literature as one might expect and are even rarer in the nonmedical literature. Instead, there developed an elaborate taxonomy, with correspond­ing names, for a wide range of conditions that are reproduced in English by the nonspecific, generic term swellings. Celsus’s distinctions were carried further by Galen, who distinguished among a wide range of diseases, localized morbid conditions, and various dermatological complaints.

The large amount of space devoted to recipes and other therapeutic forms for “swellings” and abscesses (e.g., by Cato, Paul of Aegina, Pliny, and Hippocrates) strongly suggests that malignant, often fatal, condi­tions were not uncommon, despite the lack of con­sensus on signs and symptoms and the equally obvi­ous lack of a standardized nomenclature. Slightly more certain to have involved cancer is a series of in­operable, incurable, or fatal conditions of specific organs or bodily parts that were, more or less, amena­ble to examination, such as the breast, testicles, nose, and throat. It is even more problematic that neoplastic growths of internal organs were recog­nized, but perhaps it was to these that Hippocrates was referring by the phrase κευπτoι καεχιωoι (hidden cancers).

Reflecting the uncertainties in the diagnosis and therapy of what Galen called “swellings contrary to nature,” their etiology was equally uncertain. Galen, however, twice explicitly stated that black bile was the cause of cancers. A hint of another, not necessarily incompatible etiology is contained in Celsus’s statement that, whereas some ulcers arise from an external cause, carcinomata and the like “arise from within, from some part of the body which has been corrupted.”