The Evolution of Surgical Treatment for Cancer

By: Sona Rao

Cancer has always been a disease of mystery.

It is the subject of countless movies and songs and has demanded increasing amounts of attention through time. Thousands of years ago, when great medical experts like Galen and Hippocrates revolutionized science, cancer was deemed incurable. Today, a handful of treatments help eliminate cancer sites, like chemotherapy, radiation, immunotherapy and hormone therapy. Perhaps the oldest and most improved type of treatment is surgery.

Photo credit: UCDMedicine / Foter / CC BY-NC-ND

Photo credit: UCDMedicine / Foter / CC BY-NC-ND

In Galen’s time, around the 2nd century BCE, surgery was complicated, painful, and life-threatening. Surgeons weren’t exactly equipped with sterilized scalpels and stainless steel forceps. Scholars and experts recorded accounts of medical procedures and trends in pedagogic documents. One of these landmark documents was the Florentine Codex, a 16th century text written by a Franciscan friar named Bernardino de Sahagún. Bernadino’s intentions were to proselytize the Aztecs, so he attempted to understand their culture by recording the entire spectrum of Aztec beliefs and customs, including medicine. He encountered medical practices that were bizarre treatments for various ailments and diseases, like bathing in urine and consuming fried chameleons; however, surgery was rarely an option. The operations they did perform were done without the use of anesthesia, so patients underwent excruciating episodes of pain during the process.

When it came to treating cancer, surgery was a more popular option, though it was still rare. Many times, surgery was required because physicians needed to identify a tumor within a patient’s body. For certain cases like breast cancer, patients underwent procedures similar to modern techniques, in which tumors are removed entirely before they develop. The practice of surgery on cancer did not extend beyond this.

It wasn’t until 1846 when physicians administered anesthetics that surgery became more prevalent. One of the pioneers of this breakthrough was Crawford W. Long, a former University of Georgia student, who utilized diethyl ether to facilitate a surgical removal of a cancerous tumor from a patient’s neck. This was when physicians proceeded to eliminate tumors more frequently, since patients would no longer feel pain during the operation.

Today, cameras are used to identify tumors and cancer sites and operations occur on a daily basis. Of course, this trend could be attributed to the nearly exponential increase in cancer diagnoses since antiquity as well as the steady increase of cases within the last 40 years alone. According to the SEER Cancer Statistics Review, overall cancer diagnoses per year have increased from 400,000 cases in 1975 to nearly 500,000 in 2010. Of these cases, surgery was the most common treatment for early stage cancer, particularly rectal and colon cancer, for which 94% and 74% of patients underwent surgery respectively. Surgery definitely has a presence in modern cancer treatment despite its ancient roots. The practice of surgery has experienced a major transformation through the history of cancer, and it continues to delay, if not cure cancer’s mysterious effects.