November 22, 2024

4,000-year-old Egyptian skulls reveal earliest attempt to surgically treat cancer

Skull and mandible 236, dating from between 2687 and 2345 BCE, belonged to a male individual aged 30 to 35.
Skull and mandible 236, dating between 2687 and 2345 BCE, belonged to a male individual aged 30 to 35. Image: Tondini, Isidro, Camarós, 2024.

The ancient Egyptians are known for their advances in medicine, serving as a precursor to science-based medicine. They used splints and poultices to treat broken bones and injuries. Papyrus scrolls detail their use of natural remedies like honey, onions, and willow bark for a range of ailments including infections, pain, and digestive issues.

However, treating cancer was beyond their capabilities. But that doesn’t mean they didn’t try.

Researchers have found cutmarks on two 4,000-year-old Egyptian skulls with evidence of tumors that suggest ancient Egyptians might have tried to treat cancer or investigate it posthumously.

“It means that more than 4,000 years ago ancient Egyptians were interested in understanding what we nowadays call cancer. It’s the origin of surgical oncology. This is the first step of a very complex history of medicine in relation to the treatment of neoplastic conditions. We tend to perceive cancer as a modern disease, but for thousands of years we suffered from cancer. We know that, but now we know that we have been trying to understand it from a medical perspective since antiquity,” the study’s lead author, Professor Edgard Camarós, a paleopathologist at the University of Santiago de Compostela, told ZME Science.

Cutting Away Cancer

The researchers examined two skulls from the University of Cambridge’s Duckworth Collection. Skull 236, from a male aged 30 to 35, and Skull E270, from a female over 50, both showed signs of severe lesions. Skull 236 exhibited extensive tissue destruction, known as neoplasm, and dozens of smaller metastasized lesions scattered across the skull.

Several of the metastatic lesions on Skull 236 display cutmarks.
Several of the metastatic lesions on Skull 236 display cutmarks. Credit:: Tondini, Isidro, Camarós, 2024.

Tumors can directly invade and break down bone, or their growth can put pressure on the skull or brain leading to cell death. In the worst cases, some cancers spread to the bone or brain as new tumors, forming their own destructive lesions. Still, the most interesting observation was the presence of cutmarks around these lesions, which suggests some form of surgical intervention.

“This is the earliest known (for the moment!) surgical procedure related to a cancerous tumor,” Camarós said.

Cutmarks found on skull 236, probably made with a sharp object.
Cutmarks found on skull 236, probably made with a sharp object. Image: Tondini, Isidro, Camarós, 2024.

“When we first observed the cutmarks under the microscope, we could not believe what was in front of us,” said Tatiana Tondini, a researcher at the University of Tübingen and first author of the study.

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“It seems ancient Egyptians performed some kind of surgical intervention related to the presence of cancerous cells, proving that ancient Egyptian medicine was also conducting experimental treatments or medical explorations in relation to cancer,” explained co-author Prof Albert Isidro, a surgical oncologist at the University Hospital Sagrat Cor, who specializes in Egyptology.

Examining the Limits of Ancient Medicine

Skull E270, belonging to an older female, also displayed a large lesion from a cancerous tumor. It’s a dreadful reminder that cancer was just as prevalent in ancient times as today. Interestingly, this skull also showed two healed traumatic injuries, hinting that the individual might have received treatment and survived these injuries.

The alternative is that this woman was involved in violent conflicts. Still, most ancient violence-related injuries were among men. So, it seems plausible that the marks on her skull are due to a surgical intervention. If that’s the case, that’s all the more remarkable because the lesions are healed — meaning she survived.

Nevertheless, the researchers advise caution. Studying skeletal remains is fraught with difficulties due to their incomplete nature and lack of clinical history.

“In archaeology, we work with a fragmented portion of the past, complicating an accurate approach,” Isidro noted. Despite these challenges, the study sets a foundation for future research in paleo-oncology, aiming to unravel how ancient societies dealt with cancer.

While the recent discovery suggests the Egyptians might have attempted surgery, there’s evidence of various approaches to cancer throughout history across different cultures. For instance, there are accounts from ancient Greece around 400 BC where physicians like Hippocrates used caustic substances or burning to try and eliminate tumors. Similarly, historical texts from China describe attempts to remove tumors via surgery as early as 2,000 years ago.

It’s important to note that these treatments were likely not very effective. Still, they do highlight a common thread across human history – the fight against cancer and the search for ways to treat it, even with limited medical knowledge.

“It’s exciting thinking that we have discovered the first steps in our understanding and exploration of what we nowadays call cancer. Successful modern medicine treating cancer had a beginning, and that surgical intervention is the origin of that history,” Camarós said.

The findings appeared in the journal Frontiers in Medicine.

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