Abstract
Cancer, one of the world’s leading causes of death today, remains almost absent relative to other pathological conditions, in the archaeological record, giving rise to the conclusion that the disease is mainly a product of modern living and increased longevity. This paper presents a male, young-adult individual from the archaeological site of Amara West in northern Sudan (c. 1200BC) displaying multiple, mainly osteolytic, lesions on the vertebrae, ribs, sternum, clavicles, scapulae, pelvis, and humeral and femoral heads. Following radiographic, microscopic and scanning electron microscopic (SEM) imaging of the lesions, and a consideration of differential diagnoses, a diagnosis of metastatic carcinoma secondary to an unknown soft tissue cancer is suggested. This represents the earliest complete example in the world of a human who suffered metastatic cancer to date. The study further draws its strength from modern analytical techniques applied to differential diagnoses and the fact that it is firmly rooted within a well-documented archaeological and historical context, thus providing new insights into the history and antiquity of the disease as well as its underlying causes and progression.
Highlights
Today, cancer represents one of the leading causes of death worldwide [1], with numbers more than doubling over the past thirty years
Cancer represents one of the leading causes of death worldwide [1], with numbers more than doubling over the past thirty years. It is a particular feature of the 2nd epidemiological transition where industrialisation developed, living conditions improved, there was a decline in mortality from infectious diseases, and a corresponding rise in chronic non-infectious diseases such as cancer
While the world finds itself in the 3rd epidemiological transition, our human population has experienced a transition to agriculturally based societies from hunting and gathering (1st transition)
Summary
Cancer represents one of the leading causes of death worldwide [1], with numbers more than doubling over the past thirty years. It is a particular feature of the 2nd epidemiological transition where industrialisation developed, living conditions improved, there was a decline in mortality from infectious diseases, and a corresponding rise in chronic non-infectious diseases such as cancer. Very little is known about the antiquity, epidemiology and evolution of cancer in past human populations. Ancient medical documents indicate pathological conditions, tentatively identified as cancer, were known both to the Ancient Egyptians and Greeks [5,6]. The Edwin Smith Papyrus (c. 1600BC but assumed to be a copy of a document dating to c. 3000BC) provides the earliest known reference to a tumor-like swelling of the breast [7,8] and is generally believed to be the earliest known description of cancer per se [9]
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